Analyzing the Distribution and Antifungal Susceptibility Profile of Candida in Various Clinical Samples: A Retrospective Study From a Tertiary Care Hospital in North India

Introduction <i>Candida</i> is a leading cause of nosocomial infections due to its invasive nature and presence in prosthetic devices. <i>Candida albicans</i> is the most common <i>Candida</i> species, but prevalence varies by location. Globally, there has been a shift toward non-albicans <i>Candida</i> (NAC). The study aimed to determine the distribution of <i>Candida</i> species across various clinical samples. Materials and methods From January to December 2024, we conducted a retrospective observational study at Dr. Ram Manohar Lohia Institute of Medical Sciences (RMLIMS) Hospital in Lucknow. We reviewed antifungal resistance and patient medical information using the hospital information system. According to a database review, 1,641 <i>Candida</i> isolates were identified from a year's worth of clinical samples. For routine analysis, the clinical samples were processed following standard protocols. The Vitek 2 system (BioMérieux SA, Marcy-l'Étoile, France) was used to determine the antifungal susceptibility testing patterns of the isolates, while the matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry (MS) (BioMérieux SA, Marcy-l'Étoile, France) was employed for species-level identification. Results Urine made up 772 (47.1%) of all samples, followed by respiratory samples at 445 (27.1%) and blood at 387 (23.6%). Twelve distinct species of <i>Candida</i> were isolated. Compared to <i>Candida albicans</i> 450 (27.4%), NAC species accounted for 1191 (72.6%) of the total. <i>Candida tropicalis</i> was the most often isolated species of NAC. Among all <i>Candida </i>species, fluconazole was found to be the most resistant antifungal agent. Conclusion NAC species were responsible for a notable epidemiological shift in cases of candidiasis. Regularly identifying <i>Candida </i>isolates at the species level and, whenever possible, using antifungal susceptibility testing to identify emerging resistant strains is crucial for management.