Susceptibility patterns of species collected from intensive care units in Portugal: a prospective study in 2020-2022.

BACKGROUND

For infections antifungal therapy is often empirical and mainly depends on locally antifungal surveillance data, which differs between geographic regions.

AIMS

To monitor the epidemiology and antifungal susceptibility of spp. from combined axillar-groin samples in intensive care unit (ICU) patients on admission (day1, D1), day 5 (D5) and day 8 (D8).

METHODS

From 2020 to 2022, 675 patients from three ICUs were enrolled. isolates were identified by MALDI-TOF MS and PCR. antifungals susceptibility tests (AFST) were performed for fluconazole, voriconazole, amphotericin B and anidulafungin, by concentration gradient Etest® strip technique.

RESULTS

Out of 988 swabs, 355 isolates were identified as species from 232 patients, being 89 isolates retrieved from patients that remained colonised at D5 and D8. AFST was conducted for all isolates. The overall rate of resistance to fluconazole was 2.7%, with 3 out of 133 , 2 out of 89 and 2 out of 24 isolates identified as resistant. Voriconazole susceptibility was observed in 99.2% of the isolates, with only one isolate identified as resistant to this triazole. All isolates were susceptible to amphotericin B and 98.5% to anidulafungin. Three spp. exhibited resistance to anidulafungin, , , and .

CONCLUSIONS

This study highlights the importance of as a frequent coloniser and showed that antifungal resistance remains uncommon among isolates from ICUs in Portugal. The results may contribute to better management within institutions to guide therapeutic decision making.