Antifungalgram: A unique tool to track fungal resistance

The prevalence of Candida infections increases each year in the US. The most common Candida species are Candida albicans, Candida glabrata, Candida parapsilosis, Candida tropicalis, and Candida krusei. Because of concerns about emerging resistance and impact on clinical outcomes, selection of appropriate empiric antifungal therapy is crucial. At our institution, an antifungalgram was created to help monitor antifungal susceptibility patterns.

A retrospective chart review was conducted at UnityPoint Health-Des Moines for the time period from January 2013 to July 2023. Patients were included if they had a sterile site culture positive for C. albicans, C. glabrata, C. parapsilosis, C. krusei, or C. tropicalis. Species were excluded if the sample size was fewer than 10 isolates or if susceptibility data were not available. The objective of this study was to evaluate the quantity and type of sterile site Candida species isolates and antifungal susceptibility to create an antifungalgram.

This study reviewed 251 sterile site Candida isolates, of which 242 were included. Of the 242 sterile site isolates, 218 (90.1%) were from adult patients and 24 (9.9%) were from neonatal/pediatric patients. C. albicans was the most common organism with 132 (54.5%) isolates, followed by C. glabrata (74 isolates, 30.6%), C. parapsilosis (25 isolates, 10.3%), and C. tropicalis (11 isolates, 4.5%). The susceptibility rates for each Candida species were summarized.

The creation of a local antifungalgram helps to detect resistance patterns within healthcare systems and may guide empiric antifungal therapy selection.