changing trends of candida species and antifungal susceptibilityprofile of candida bloodstream isolates: a 5-year retrospective survey

Background: candida species have emerged as one of the most common causes of bloodstream infections (bsis). there are limited data on the distribution of candida spp. and susceptibility by year.objectives: in this study, we analyzed changes in the distribution of candida spp. and their antifungal susceptibility profiles from blood cultures.methods: records from january 2016 to december 2020 were obtained from the microbiology laboratory in istanbul. antifungal susceptibility tests were performed using the vitek 2 compact system and evaluated according to eucast breakpoints. a total of241 unique candidemia episodes were included in this study.results: candida albicans was the predominant pathogen (n = 95, 39.42%), followed by c. parapsilosis (n = 82, 34.02%), c. glabrata (n = 18, 7.47%), c. tropicalis (n = 17, 7.05%), c. krusei (n = 15, 6.22%), and other candida spp. (n = 14, 5.79%). there was no statisticallysignificant difference in the percentage of episodes of candida spp. after data analysis, a tendency to shift from c. albicans to c. parapsilosis was observed in the period analyzed in this study. candida albicans was the most common species in intensive careunits (icus), hematology and hemopoietic stem cell transplantation units, and surgical clinics, with c. parapsilosis predominant inmedical clinics. in general, micafungin susceptibility was the highest, and fluconazole was the lowest. there was reduced sensitivityto fluconazole and voriconazole for c. albicans and c. parapsilosis over 5 years.conclusions: detecting changes in the distribution of candida spp. and antifungal susceptibility over time will lead to the selectionof appropriate empirical therapy and monitor phenomena of antifungal resistance. empirical treatment with antifungal agents isassociated with high costs, toxicities, and risk of antifungal resistance. therefore, it is mandatory to determine and monitor candidaspp. and antifungal susceptibility testing to select appropriate antifungal agents.