Molecular Mechanism of Fluconazole Resistance among Clinical Isolates of Non albicans Candida Species in a Rural Tertiary Healthcare Centre of Central India: A Research Protocol

Introduction: The most common fungal infections are caused by Candida spp., and non albicans Candida (NAC) species are increasingly prevalent in India. This study protocol provides a concise summary of fluconazole resistance mechanisms in NAC species. Although fluconazole is fungistatic and resistance can be either intrinsic or acquired, it remains a mainstay of current treatment. Understanding species-specific molecular pathways is crucial because resistance mechanisms differ among species. Clarifying the mechanisms that drive fluconazole resistance is essential to preserve the effectiveness of this important antifungal agent. Need of the study: The results of this study may inform public health initiatives and help shape policies to curb the emergence and spread of antifungal resistance, emphasising the need for targeted interventions and sustained surveillance programs. Aim: To study the molecular mechanisms of fluconazole resistance among clinical isolates of NAC species. Materials and Methods: This will be a cross-sectional study. A total of 78 clinically relevant NAC isolates obtained from specimens received between February 2024 and August 2026 in the Department of Microbiology will be tested for fluconazole resistance using disk diffusion and microbroth dilution methods. Polymerase Chain Reaction (PCR) will be performed to investigate molecular mechanisms of fluconazole resistance by examining mutations in ERG11. Data will be analysed using Student’s t-test, Chi-square test and Fisher’s exact test as appropriate. R and IBM Statistical Package for the Social Sciences (SPSS) Statistics version 29.0 will be used for statistical analysis.