Unveiling antifungal resistance and biocide tolerance in clinical isolates of spp.

AIMS

Candidiasis, caused by spp. is an opportunistic infection with significant healthcare risks, worsened by trends in antifungal resistance. This study aimed to evaluate the antifungal susceptibility profile, investigate resistance mechanisms, assess efflux pump activity, and examine biocide tolerance in clinical isolates.

METHODS

A total of 100 isolates from hospitalized and outpatient individuals were analyzed for their antifungal susceptibility profile, molecular resistance mechanisms through PCR, efflux pump activity with the Cartwheel method, and biocide tolerance (sodium hypochlorite, hydrogen peroxide, and benzalkonium chloride), which was assessed by disk diffusion.

RESULTS

A high prevalence of resistance (87%) to at least one antifungal was observed, with 47.12% of isolates showing simultaneous multiple resistance to three azole derivatives. The highest antifungal agent resistance was observed for fluconazole ( = 70) and the highest susceptibility for amphotericin B ( = 1). The most common mutation was in the gene ( = 38/43.7%). Efflux pump activity was detected in both and species. Biocide testing revealed a higher tolerance for sodium hypochlorite, with an inhibition zone ranging from 18.25 (4.40) to 34.0 (4.00).

CONCLUSIONS

This study highlights significant antifungal resistance in spp. particularly to azoles, stressing the need for improved infection control and novel therapeutic strategies.