Species Distribution and Antifungal Susceptibility Profiles of Candidemia Isolates: A Three-Year Analysis from Southeastern Anatolia, Türkiye

Tuncay Topaç

Species Distribution and Antifungal Susceptibility Profiles of Candidemia Isolates: A Three-Year Analysis from Southeastern Anatolia, Türkiye

Abstract

Candidemia remains a significant cause of bloodstream infections, and knowledge of species distribution and antifungal susceptibility profiles is essential for appropriate empirical antifungal therapy. These epidemiological characteristics may vary across regions. This study aimed to evaluate the distribution of Candida species isolated from blood cultures and their antifungal susceptibility profiles over a three-year period in a training and research hospital. Candida isolates recovered from blood cultures between January 2019 and January 2022 were retrospectively analyzed. Species identification and antifungal susceptibility testing were performed using the VITEK 2 Compact system (bioMérieux, France), and the results were interpreted according to the Clinical and Laboratory Standards Institute (CLSI) M60 criteria. A total of 440 candidemia episodes from 361 patients were evaluated. Candida albicans and Candida parapsilosis were the most frequently isolated species, each accounting for 34.3% of all candidemia episodes. In pediatric patients, Candida parapsilosis was the predominant species (42.7%). Overall antifungal susceptibility was preserved among Candida albicans and Candida tropicalis isolates, and no echinocandin resistance was detected in Candida glabrata. In contrast, fluconazole resistance was observed in 23% of Candida parapsilosis isolates, representing a remarkably high rate. The majority of fluconazole-resistant isolates were recovered from pediatric patients. Our findings demonstrate that Candida parapsilosis was the predominant causative agent, particularly among pediatric patients, and exhibited a high rate of fluconazole resistance. These results highlight the importance of considering local epidemiological data when selecting empirical antifungal therapy. Resistance patterns clustered within specific patient populations should be further investigated through molecular studies to assess potential clonal transmission.

Keywords

Ethical Statement

The author declares that this study was conducted in accordance with ethical principles in scientific publishing.

Thanks

The author gratefully acknowledges the support of Dr. Mustafa Demirbilek and the laboratory staff of Şanlıurfa Training and Research Hospital during this study.

References

Cassagne, C., Normand, A.-C., Bonzon, L., L'Ollivier, C., Gautier, M., Jeddi, F., Ranque, S., & Piarroux, R. (2016). Routine identification and mixed species detection in 6,192 clinical yeast isolates. Medical Mycology, 54 (3), 256–265. https://doi.org/10.1093/mmy/myv095
Clinical and Laboratory Standards Institute. (2018). Epidemiological Cutoff Values for Antifungal Susceptibility Testing (2nd ed., CLSI supplement M59). Wayne, PA: Clinical and Laboratory Standards Institute.
Clinical and Laboratory Standards Institute. (2020). Performance Standards for Antifungal Susceptibility Testing of Yeasts (2nd ed., CLSI supplement M60). Wayne, PA: Clinical and Laboratory Standards Institute.
Cornely, O. A., Sprute, R., Bassetti, M., Chen, S. C.-A., Groll, A. H., Kurzai, O., Lass-Flörl, C., Ostrosky-Zeichner, L., Rautemaa-Richardson, R., Revathi, G., Santolaya, M. E., White, P. L., & et al. (2025). Global guideline for the diagnosis and management of candidiasis: An initiative of the ECMM in cooperation with ISHAM and ASM. The Lancet Infectious Diseases, 25 (5), e280–e293. https://doi.org/10.1016/S1473-3099(24)00749-7
Fekkar, A., Blaize, M., Cassaing, S., Sendid, B., Pasquier, G., Imbert, S., Hennequin, C., Botterel, F., Morio, F., Menotti, J., Le Gal, S., Bailly, E., Bougnoux, M. E., Huguenin, A., Bonnal, C., Sasso, M., Feuss, A., Jabet, A., Godmer, A., & et al. (2026). Incidence of azole resistance among clinical isolates of Candida parapsilosis: Results from the French nationwide multicenter prospective study "ReCap" 2022–2024. New Microbes and New Infections, 71, 101738. https://doi.org/10.1016/j.nmni.2026.101738
Kathuria, S., Singh, P. K., Sharma, C., Prakash, A., Masih, A., Kumar, A., Meis, J. F., & Chowdhary, A. (2015). Multidrug-resistant Candida auris misidentified as Candida haemulonii: Characterization by matrix-assisted laser desorption ionization–time of flight mass spectrometry and DNA sequencing and its antifungal susceptibility profile variability by Vitek 2, CLSI broth microdilution, and Etest method. Journal of Clinical Microbiology, 53 (6), 1823–1830. https://doi.org/10.1128/JCM.00367-15
Kazak, E., Akın, H., Ener, B., Sığırlı, D., Özkan, Ö., Gürcüoğlu, E., Yılmaz, E., Çelebi, S., Akçağlar, S., & Akalın, H. (2014). An investigation of Candida species isolated from blood cultures during 17 years in a university hospital. Mycoses, 57 (10), 623–629. https://doi.org/10.1111/myc.12209
Klotz, S. A., Chasin, B. S., Powell, B., Gaur, N. K., & Lipke, P. N. (2007). Polymicrobial bloodstream infections involving Candida species: Analysis of patients and review of the literature. Diagnostic Microbiology and Infectious Disease, 59 (4), 401–406. https://doi.org/10.1016/j.diagmicrobio.2007.07.001

Kolak, Ç. Ç., Erman-Daloğlu, A., Özhak, B., Öğünç, D., & Günseren, F. (2019). Epidemiology of candidemia, antifungal susceptibilities of Candida species and their impact on mortality in adult patients admitted to Akdeniz University Hospital. Klimik Dergisi, 32 (3), 250–258. https://doi.org/10.5152/kd.2019.71
Özbay, B. O., Baştuğ, A., Aydos, Ö., Kemirtlek, N., Gökçınar, D., Dinç, B., & Bodur, H. (2024). Rare conditions of candidemia: Risk factors and outcomes for mixed candidemia and late recurrent candidemia. Mediterranean Journal of Infection, Microbes and Antimicrobials, 13, 24180.10. https://doi.org/10.4274/mjima.galenos.2024.24180.10
Pappas, P. G., Kauffman, C. A., Andes, D. R., Clancy, C. J., Marr, K. A., Ostrosky-Zeichner, L., Reboli, A. C., Schuster, M. G., Vazquez, J. A., Walsh, T. J., Zaoutis, T. E., & Sobel, J. D. (2016). Clinical practice guideline for the management of candidiasis: 2016 update by the Infectious Diseases Society of America. Clinical Infectious Diseases, 62 (4), e1–50. https://doi.org/10.1093/cid/civ933
Pfaller, M. A., & Diekema, D. J. (2007). Epidemiology of invasive candidiasis: A persistent public health problem. Clinical Microbiology Reviews, 20 (1), 133–163. https://doi.org/10.1128/CMR.00029-06
Reiss, E., Shadomy, H. J., & Lyon, G. M., (2011). Fundamental Medical Mycology. Wiley-Blackwell, p. 45.
Rhodes, J., & Fisher, M. C. (2019). Global epidemiology of emerging Candida auris. Current Opinion in Microbiology, 52, 84–89. https://doi.org/10.1016/j.mib.2019.05.008
Toda, M., Williams, S. R., Berkow, E. L., Farley, M. M., Harrison, L. H., Bonner, L., Marceaux, K. M., Hollick, R., Zhang, A. Y., Schaffner, W., Lockhart, S. R., Jackson, B. R., & Vallabhaneni, S. (2019). Population-based active surveillance for culture-confirmed candidemia—Four sites, United States, 2012–2016. Morbidity and Mortality Weekly Report: Surveillance Summaries, 68 (8), 1–15. https://doi.org/10.15585/mmwr.ss6808a1
Ünal, N., Spruijtenburg, B., Arastehfar, A., Gümral, R., de Groot, T., Meijer, E. F. J., Türk-Dağı, H., Birinci, A., Hilmioğlu-Polat, S., Meis, J. F., Lass-Flörl, C., & Ilkit, M. (2024). Multicentre study of Candida parapsilosis blood isolates in Türkiye highlights an increasing rate of fluconazole resistance and emergence of echinocandin and multidrug resistance. Mycoses, 67 (11), e70000. https://doi.org/10.1111/myc.70000
Wisplinghoff, H., Bischoff, T., Tallent, S. M., Seifert, H., Wenzel, R. P., & Edmond, M. B. (2004). Nosocomial bloodstream infections in US hospitals: Analysis of 24,179 cases from a prospective nationwide surveillance study. Clinical Infectious Diseases, 39 (3), 309–317. https://doi.org/10.1086/421946
Yamin, D. H., Husin, A., & Harun, A. (2021). Risk factors of Candida parapsilosis catheter-related bloodstream infection. Frontiers in Public Health, 9, 631865. https://doi.org/10.3389/fpubh.2021.631865

Details

Primary Language

English

Subjects

Microbiology (Other)

Journal Section

Research Article

Authors

Tuncay Topaç ^*
0000-0002-0032-4780
Türkiye

Early Pub Date

July 10, 2026

Publication Date

-

Submission Date

June 29, 2026

Acceptance Date

July 8, 2026

Published in Issue

Year 2026 Number: Advanced Online Publication

IZ

https://izlik.org/JA43GP62LX

Cite

RIS / Bibtex

APA

Topaç, T. (2026). Species Distribution and Antifungal Susceptibility Profiles of Candidemia Isolates: A Three-Year Analysis from Southeastern Anatolia, Türkiye. International Journal of Nature and Life Sciences, Advanced Online Publication, 72-79. https://izlik.org/JA43GP62LX

AMA

1.Topaç T. Species Distribution and Antifungal Susceptibility Profiles of Candidemia Isolates: A Three-Year Analysis from Southeastern Anatolia, Türkiye. Int J Nature Life Sci. 2026;(Advanced Online Publication):72-79. https://izlik.org/JA43GP62LX

Chicago

Topaç, Tuncay. 2026. “Species Distribution and Antifungal Susceptibility Profiles of Candidemia Isolates: A Three-Year Analysis from Southeastern Anatolia, Türkiye”. International Journal of Nature and Life Sciences, no. Advanced Online Publication: 72-79. https://izlik.org/JA43GP62LX.

EndNote

Topaç T (July 1, 2026) Species Distribution and Antifungal Susceptibility Profiles of Candidemia Isolates: A Three-Year Analysis from Southeastern Anatolia, Türkiye. International Journal of Nature and Life Sciences Advanced Online Publication 72–79.

IEEE

[1]T. Topaç, “Species Distribution and Antifungal Susceptibility Profiles of Candidemia Isolates: A Three-Year Analysis from Southeastern Anatolia, Türkiye”, Int J Nature Life Sci, no. Advanced Online Publication, pp. 72–79, July 2026, [Online]. Available: https://izlik.org/JA43GP62LX

ISNAD

Topaç, Tuncay. “Species Distribution and Antifungal Susceptibility Profiles of Candidemia Isolates: A Three-Year Analysis from Southeastern Anatolia, Türkiye”. International Journal of Nature and Life Sciences. Advanced Online Publication (July 1, 2026): 72-79. https://izlik.org/JA43GP62LX.

JAMA

1.Topaç T. Species Distribution and Antifungal Susceptibility Profiles of Candidemia Isolates: A Three-Year Analysis from Southeastern Anatolia, Türkiye. Int J Nature Life Sci. 2026;:72–79.

MLA

Topaç, Tuncay. “Species Distribution and Antifungal Susceptibility Profiles of Candidemia Isolates: A Three-Year Analysis from Southeastern Anatolia, Türkiye”. International Journal of Nature and Life Sciences, no. Advanced Online Publication, July 2026, pp. 72-79, https://izlik.org/JA43GP62LX.

Vancouver

1.Tuncay Topaç. Species Distribution and Antifungal Susceptibility Profiles of Candidemia Isolates: A Three-Year Analysis from Southeastern Anatolia, Türkiye. Int J Nature Life Sci [Internet]. 2026 Jul. 1;(Advanced Online Publication):72-9. Available from: https://izlik.org/JA43GP62LX