Species-specific antifungal resistance trends in yeast bloodstream isolates causing candidemia before, during, and after the COVID-19 pandemic: insights from the INVIFAR Mexican multicenter network

Yeast pathogens represent a major cause of bloodstream infections, with a rising prevalence of non-albicans Candida species displaying variable antifungal resistance patterns that complicate clinical management. This study evaluated antifungal susceptibility in 1,154 bloodstream yeast isolates collected from January 2019 to December 2024 through the INVIFAR (Investigación y Vigilancia de la Farmacorresistencia) multicentric network, encompassing hospital laboratories across diverse patient populations. Isolates were stratified into pre-pandemic, pandemic, and post-pandemic periods to assess temporal changes in resistance patterns. Identification and susceptibility testing were performed using automated systems and standardized CLSI methods. Longitudinal analysis of antifungal susceptibility in Candida albicans, Nakaseomyces glabratus, Candida parapsilosis, Candida tropicalis and Issatchenkia orientalis revealed predominantly stable profiles across pre-, during-, and post-pandemic periods. Statistically significant changes were observed in two instances: a post-pandemic decrease in caspofungin resistance for N. glabratus (adj. p = 0.0377) and a reduction in voriconazole resistance in C. parapsilosis (adj. p = 0.0015). Resistance velocity analysis highlighted a rapid increase in itraconazole resistance for C. parapsilosis, while C. albicans and I. orientalis remained susceptible. These results emphasize that selective pressure and clonal expansion can drive significant resistance shifts, underscoring the need for targeted surveillance and antifungal stewardship.

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Publication Details

Journal
European Journal of Clinical Microbiology & Infectious Diseases
Published
2026-03-04
DOI
https://doi.org/10.1007/s10096-026-05452-1
Primary Topic
Antifungal resistance and susceptibility
Type
article
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article

Species-specific antifungal resistance trends in yeast bloodstream isolates causing candidemia before, during, and after the COVID-19 pandemic: insights from the INVIFAR Mexican multicenter network

Daniel Aguilar-Zapata, José Manuel Feliciano-Guzmán, Enrique Bolado-Martínez, Joaquín Rincón-Zuno et al.
European Journal of Clinical Microbiology & Infectious Diseases
Antifungal resistance and susceptibility
article

Species-specific antifungal resistance trends in yeast bloodstream isolates causing candidemia before, during, and after the COVID-19 pandemic: insights from the INVIFAR Mexican multicenter network

Daniel Aguilar-Zapata, José Manuel Feliciano-Guzmán, Enrique Bolado-Martínez, Joaquín Rincón-Zuno, María Angelina Quevedo-Ramos, Cecilia Padilla-Ibarra, Aaron Molina-Jaimes, Elena Victoria Choy-Chang, Juan Luis Jaime-Sánchez, Reyna Edith Corte-Rojas, Mariana Gil-Veloz, Laura Karina Avilés-Benítez, Luis Esaú López-Jácome, Domingo Sánchez-Francia, María Fernanda González-Lara, Isabel Cristina Márquez-Avalos, Fabián Rojas-Larios, Hiram Villanueva-Lozano, Filiberto Alejandro Martínez-Lazo, Zaira Lucero Clemente-Callejas, Rogelio J. de Treviño-Rangel, Eduardo López-Gutiérrez, Christian D. Mireles-Dávalos, Cecilia T. Morales-de la Peña, Elvira Garza-González, Paula A. Castaño-Jimenez, Armando Mandujano-Ortíz, Laura I. López-Moreno, Martha Dorado-del Río, Iván R. Pérez-Méndez, Katia C. García-Estrada, Carlos A. Couoh May, Maribel López-García, Jesús E. Solís-Hernández
article en

Abstract

Yeast pathogens represent a major cause of bloodstream infections, with a rising prevalence of non-albicans Candida species displaying variable antifungal resistance patterns that complicate clinical management. This study evaluated antifungal susceptibility in 1,154 bloodstream yeast isolates collected from January 2019 to December 2024 through the INVIFAR (Investigación y Vigilancia de la Farmacorresistencia) multicentric network, encompassing hospital laboratories across diverse patient populations. Isolates were stratified into pre-pandemic, pandemic, and post-pandemic periods to assess temporal changes in resistance patterns. Identification and susceptibility testing were performed using automated systems and standardized CLSI methods. Longitudinal analysis of antifungal susceptibility in Candida albicans, Nakaseomyces glabratus, Candida parapsilosis, Candida tropicalis and Issatchenkia orientalis revealed predominantly stable profiles across pre-, during-, and post-pandemic periods. Statistically significant changes were observed in two instances: a post-pandemic decrease in caspofungin resistance for N. glabratus (adj. p = 0.0377) and a reduction in voriconazole resistance in C. parapsilosis (adj. p = 0.0015). Resistance velocity analysis highlighted a rapid increase in itraconazole resistance for C. parapsilosis, while C. albicans and I. orientalis remained susceptible. These results emphasize that selective pressure and clonal expansion can drive significant resistance shifts, underscoring the need for targeted surveillance and antifungal stewardship.

European Journal of Clinical Microbiology & Infectious Diseases
Universidad Politécnica de Baja California (MX), University of Quintana Roo (MX), Mexican Social Security Institute (MX), Universidad Autónoma de la Ciudad de México (MX), Universidad Autónoma de Nuevo León (MX), Instituto Tecnológico de Querétaro (MX), Universidad Autónoma de Guerrero (MX), Mexicali Institute of Technology (MX), Universidad de Sonora (MX), Universidad de Hermosillo (MX), Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (MX), Hospitales Regionales de Alta Especialidad (MX), Universidad de Morelia (MX), Instituto Nacional de Enfermedades Respiratorias (MX), Hospital Médica Sur (MX), Instituto Tecnológico de Apizaco (MX), Hospital Español (MX), Universidad del Valle de Toluca (MX), Benemerito Hospital General con Especialidades "Juan Maria de Salvatierra" (MX), Hospital Civil de Guadalajara (MX), Hospital General De Zona (MX), Instituto Nacional de Rehabilitación (MX), Centro Médico ABC (MX), Hospital de Especialidades (MX), Hospital Regional de Alta Especialidad del Bajío (MX), El Colegio de Sonora (MX), Hospital del Niño (PA), Siloam Eye Hospital (KR), Hospital Universitario de León (ES), Universidad Mesoamericana de San Agustín (MX), Instituto Tecnológico de Toluca (MX), Instituto Tecnológico de Morelia (MX), Universidad Nacional Autónoma de México (MX), Universidad de Colima (MX), Tecnológico de Monterrey (MX)
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Antifungal resistance and susceptibility
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