Candida Isolation During COVID-19: Microbiological Findings of a Prospective Study in a Regional Hospital

Background. Prolonged hospitalization due to the COVID-19 pandemic gathered risk factors for developing invasive candidiasis. Aim. To describe Candida spp. isolated from patients with clinical suspicion of COVID treated in a public hospital specialized in COVID-19 during the pandemic, considering the susceptibility profiles and the risk factors related to the species detected in a positive yeast culture. Methods. From different samples of 33 patients with comorbidities, 42 clinical isolates were identified by VITEK R MS Plus. Antifungal susceptibility testing was performed using VITEK R 2 Compact with the AST-YS08 card. Results. The most frequently identified species were C. albicans and C. glabrata , which were also the most common co-infections, Saprochaete capitata , an uncommon yeast was isolated in one patient. 85% of the co-infections were COVID positive and 100% of patients with a co-infection required mechanical ventilation (MV) which has been described as one of the major predisposing factors to candidiasis. Candida species vary in their response to treatment. In this study, 44% of isolates identified as C. glabrata were fluconazole-resistant, which were also immediately susceptible to caspofungin; this profile limits therapeutic options and emphasizes the importance of evaluating the susceptibility profile. Conclusions. This work highlights the increase in isolation of different Candida species during COVID-19 and the importance of establishing criteria to declare Candida colonization or infection and the correct etiological identification to establish an agentbased antifungal treatment, to reduce the spreading risk of Candida spp. in the hospital environment, mortality, time, and cost of hospitalization. (c) 2024 The Authors. Published by Elsevier Inc. on behalf of Instituto Mexicano del Seguro Social (IMSS). This is an open access article under the CC BY-NC-ND license