Epidemiology, risk factors, and antifungal susceptibility analysis of Candida tropicalis and non-C.tropicalis candidemia

In recent years, the incidence of Candida tropicalis bloodstream infections has been increasing annually, drawing increasing clinical attention. This study aimed to investigate the epidemiological characteristics, risk factors, and antifungal susceptibility patterns of C. tropicalis and non-C. tropicalis species among patients with candidemia at Nanjing Drum Tower Hospital from March 2020 to February 2024. A retrospective analysis was conducted on 209 patients, revealing that C. tropicalis accounted for 17.22% of cases, with a notable prevalence in medical departments, especially in hematology. Hematological diseases emerged as an independent risk factor for C. tropicalis candidemia. Antifungal susceptibility testing indicated higher resistance rates to azole drugs in C. tropicalis compared to non-C. tropicalis species, while susceptibility to echinocandin and amphotericin B was maintained. MALDI-TOF MS clustering analysis of 30 C. tropicalis isolates identified a specific subtype concentration of azole-resistant isolates, suggesting a genetic link to resistance. These findings underscore the growing significance of C. tropicalis in candidemia, highlighting the importance of understanding its clinical and resistance profiles to optimize antifungal therapy and enhance patient care.