Abstract
BACKGROUND AND PURPOSE: Fungal infections are prevalent in tropical countries, and their etiology depends on various factors, including the underlying cause and accompanying risk factors. Accurate diagnosis through culture and identification is crucial to determine the causative agent, followed by antifungal susceptibility testing to guide appropriate management. Candida species are the most commonly found causative agents in fungal infection cases. Given the diverse range of Candida causing infections, antifungal treatments vary accordingly. This study aimed to investigate Candida species profiles and evaluate their susceptibility to various antifungal agents, providing valuable insights for effective treatment strategies. MATERIALS AND METHODS: This study was conducted during 2020-2024, consisting of 2,470 samples of various specimens. Samples were inoculated onto Sabouraud Dextrose Agar for fungal culture, and isolates were subsequently identified and subjected to antifungal susceptibility testing using the Vitek 2 compact automated system. RESULTS: A total of 799 Candida isolates (32.34%) were identified, comprising 21 species. The most prevalent species were Candida albicans (44.68%, 357/799), Candida glabrata (17.02%, 136/799), and Candida tropicalis (16.15%, 129/799). Susceptibility testing of predominant Candida species revealed susceptibility rates of 96.06% to fluconazole, 93.51% to voriconazole, 69.84% to caspofungin, 95.64% to micafungin, 95.07% to amphotericin B, and 97.40% to flucytosine. Several uncommon Candida species were successfully identified, including Candida lusitaniae, Candida pelliculosa, Candida rugosa, Candida intermedia, Candida kefyr, Candida lipolytica, and Candida utilis. These species demonstrated susceptibility to voriconazole, amphotericin B, and flucytosine. However, antifungal susceptibility data were not available for other uncommon species, such as Candida laurentii, Candida famata, Candida colliculosa, Candida magnoliae, Candida sphaerica, and Candida haemulonii. CONCLUSION: The trends in Candida species profiles and their susceptibility to various antifungal agents over consecutive years revealed variability in both species distribution and susceptibility rates. Understanding the profile and susceptibility of Candida species is essential for developing effective treatment strategies.