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May 4, 2026Antibiotics2 citationsOpen Access

Shifting Epidemiology and Antifungal Susceptibility Patterns of Clinical Fungal Isolates in an Intensive Care Unit (ICU) from Bucharest, Romania: A Retrospective Observational Study

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MSMadalina (Preda) SolomonBMBeatrice MahlerOPOana Popescu

Key Points

  • This research aims to evaluate the antifungal susceptibility patterns and species distribution of clinical fungal isolates in an ICU setting.
  • Retrospective analysis of 747 fungal isolates from 2021-2026
  • Evaluation of species distribution and antifungal susceptibility profiles
  • Analysis of minimum inhibitory concentration (MIC) patterns and temporal resistance trends.
  • 67.5% of isolates were non-albicans Candida species, surpassing Candida albicans
  • Fluconazole and flucytosine had resistance rates of 16.1% and 17.4% respectively
  • Amphotericin B showed an 82.1% susceptibility rate, while MIC analysis indicated elevated values for azoles.

Abstract

Background: Antifungal resistance among Candida species represents a growing clinical challenge, particularly in the context of increasing prevalence of non-albicans species. Methods: We conducted a retrospective analysis of 747 fungal isolates collected between 2021 and 2026, evaluating species distribution, antifungal susceptibility profiles, minimum inhibitory concentration (MIC) patterns, and temporal trends in resistance. Results: Non-albicans Candida species accounted for 67.5% of isolates, exceeding the proportion of Candida albicans. Fluconazole and flucytosine exhibited the highest resistance rates (16.1% and 17.4%, respectively), while amphotericin B showed the highest susceptibility rate (82.1%). MIC analysis revealed elevated MIC90 values for azoles in Candida glabrata and Candida krusei, consistent with reduced susceptibility. A significant association between antifungal agent and susceptibility profile was observed (χ2 = 33.81, p < 0.001; Cramér’s V = 0.205). Temporal analysis demonstrated fluctuating resistance patterns rather than a consistent increase over time. Multidrug resistance was uncommon (2.5%), although non-susceptibility to multiple agents was more frequent (20.3%). Conclusions: The study highlights substantial variability in antifungal susceptibility across Candida species and antifungal agents, emphasizing the importance of continuous surveillance and species-specific treatment strategies.

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Cite This Study

Solomon et al. (2026) studied this question.

synapsesocial.com/papers/69f837ab3ed186a739981e3ehttps://doi.org/10.3390/antibiotics15050440
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