Changes in the etiology of candidiasis: analysis of the detection frequency of Candida spp. among patients with inflammatory respiratory diseases in the Kharkiv region, Ukraine (2019–2021)

In clinical practice, invasive mycoses are becoming increasingly important due to the increase in morbidity in the world, the rapid spread of resistant strains, and a critical shortage of new antifungal drugs. The leading etiological role in the development of mycotic infections belongs to fungi of the genus Candida, among which the species Candida albicans remains traditionally dominant; however, the epidemiological picture of candidiasis is gradually changing due to the increase in the proportion of the Candida non-albicans group in mycotic pathology. The aim of this study was to assess the prevalence and species distribution of clinically significant Candida spp. isolates. circulating among patients with inflammatory respiratory tract diseases in the city of Kharkiv and the Kharkiv community (Ukraine). Materials and methods. Over a three-year observation period (from 2019 to 2021), the authors conducted a microbiological study of clinical material (oropharyngeal mucosa samples) from 1,150 people with inflammatory respiratory tract diseases. Laboratory diagnostics included a standard set of mycological methods, and final identification and antifungal susceptibility testing were performed using the automated Vitek2 Compact system. Results and discussion. The results indicate an increasing persistence of Candida spp. across the observation groups, from 3.7% in 2019 to 4% in 2020 and 5.7% in 2021. In the non-albicans group, the species Candida krusei dominated – 6.9%, other Candida species were isolated significantly less frequently: C. glabrata, C. tropicalis, C. kefyr – 4.3%, 3.4%, 2.6%, respectively. The susceptibility profile of the recovered isolates to itraconazole, fluconazole, and voriconazole was studied: Candida non-albicans strains demonstrated increased resistance to itraconazole (42.8%) and voriconazole (57.2%), while C. albicans isolates were characterized by higher levels of fluconazole resistance (31.6%). Analysis of the obtained results allows predicting a further increase in infectious complications caused by Candida among patients with inflammatory processes of the respiratory tract, which may require mandatory laboratory monitoring and therapeutic adjustments to prevent the occurrence of invasive candidiasis.