Fluconazole and echinocandin resistance of species in invasive candidiasis at a university hospital during pre-COVID-19 and the COVID-19 outbreak.

Antifungal susceptibility of species is decreasing. Successful treatment for antifungal-resistant candida infection is challenging and associated with significant mortality. We performed a prospective observational study to identify the species and antifungal susceptibilities of invasive isolates of species over a 5-year period at a university hospital in southern Thailand. Between 2017 and 2021, the species distribution was 39.1% , 24.8% , 20.3% complex, 10.5% , and 5.2% miscellaneous spp. Notable observations include elevated minimal inhibitory concentration (MIC) and decrease susceptibility of and to echinocandin and all tested triazoles. A shift of MIC value in the COVID-19 era was seen in and with azoles and echinocandins. Azole resistance increased among isolates, and echinocandin resistance also increased among and isolates. Novel alterations in 1 HS1 and HS2 were detected in both isolates of anidulafungin-resistant As species have become more resistant to azoles and less susceptible to echinocandin development, the need arose to observe the emergence of resistance to both antifungal classes in candida clinical isolates, for a more effective infection control in the hospital.