Molecular-Based Identification and Antifungal Resistance Patterns of Candida Species Isolated from Burn Wound Infections in Duhok, Iraq

Objective: Burn injuries are a significant global health concern that are frequently intensified by infections. Fungal infections, especially those produced by Candida species, are a leading cause of morbidity and mortality in burn patients. This study investigated the prevalence, species distribution, and antifungal susceptibility of fungal pathogens in burn wound infections in Duhok, Iraq.Materials and Methods: From September 2024 to March 2025, 156 burn wound swabs were obtained from patients attending burn units in Duhok. Samples were cultured on Sabouraud dextrose agar and blood agar. Fungal isolates were identified using conventional methods and validated by PCR amplification and ITS region sequencing. Antifungal susceptibility testing was performed for fungal isolates.Results: Fungal infections were observed in 25.6% of cases (40/156), with Candida spp. accounting for 52.5% (21/40) of isolates. The predominant species was Candida albicans (71.4%, 15/21), followed by Candida parapsilosis (23.8%, 5/21) and Candida tropicalis (4.7%, 1/21). The most common isolates were found in the leg (42.8%) and hand (28.5%), primarily caused by second-degree burns (61.9%) and hot fluid (42.8%). Mortality among infected patients was 19.0%. Most Candida isolates were nystatin-resistant, with variable sensitivity to other antifungalsConclusion: Candida species, specifically Candida albicans, are the most prevalent pathogens in burn wound infections in Duhok. The early and accurate identification of fungal species, coupled with antifungal susceptibility profiling, is the key to optimising therapeutic strategies and improving patient outcomes.