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Species Identification, Virulence Factors, and Antifungal Resistance in Clinical Candida Isolates from ICU Patients

Paola Aparecida Alves Ferreira1, Lucas Daniel Cibolli Roso1, Daniel Almeida Freitas1

  • 1Department of Basic Sciences, Federal University of Vale of Jequitinhonha and Mucuri (UFVJM), Street MGT 367-Km 583, no 5000, Alto da Jacuba, Diamantina 39100-000, MG, Brazil.

Microorganisms
|January 28, 2026
PubMed

Insights

This study identified Candida species in Intensive Care Unit patients, finding high rates of antifungal resistance and virulence factors, particularly in oral isolates. Characterizing these yeasts is crucial for effective clinical management.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Clinical Microbiology

Background:

  • Candida species are significant opportunistic fungal pathogens in healthcare settings.
  • Intensive Care Unit (ICU) patients are particularly vulnerable to invasive Candida infections.
  • Understanding the characteristics of Candida isolates in ICUs is vital for patient care.

Purpose of the Study:

  • To identify and characterize Candida species from ICU patients.
  • To assess the virulence attributes of these isolates.
  • To determine their susceptibility to key antifungal agents.

Main Methods:

  • Isolates were obtained from oral and tracheobronchial secretions of adult ICU patients.
  • Phenotypic identification was confirmed by MALDI-TOF mass spectrometry and ITS sequencing.
  • Antifungal susceptibility testing (disk diffusion) and virulence assays (esterase, DNase, protease, hemolysis) were performed.

Main Results:

  • Candida albicans was the most prevalent species, followed by C. tropicalis and C. krusei.
  • High antifungal resistance rates were observed: 51.1% for fluconazole, 42.7% for ketoconazole, and 19.1% for amphotericin B.
  • Most isolates exhibited virulence factors, with oral isolates showing higher resistance and virulence.

Conclusions:

  • Candida species in ICUs possess significant antifungal resistance and virulence traits.
  • Oral Candida isolates present a greater challenge due to increased resistance and virulence.
  • Epidemiological characterization of Candida in hospitals is essential for guiding clinical and therapeutic strategies.
Keywords:
Candida albicansCandida non-albicansMALDI-TOFantifungal resistanceidentificationvirulence factors

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