Candida Isolation During COVID-19: Microbiological Findings of a Prospective Study in a Regional Hospital

Background

Prolonged hospitalization due to the COVID-19 pandemic gathered risk factors for developing invasive candidiasis.

Aim

To describe Candida spp. isolated from patients with clinical suspicion of COVID treated in a public hospital specialized in COVID-19 during the pandemic, considering the susceptibility profiles and the risk factors related to the species detected in a positive yeast culture.

Methods

From different samples of 33 patients with comorbidities, 42 clinical isolates were identified by VITEK^Ⓡ MS Plus. Antifungal susceptibility testing was performed using VITEK^Ⓡ 2 Compact with the AST-YS08 card.

Results

The most frequently identified species were C. albicans and C. glabrata, which were also the most common co-infections, Saprochaete capitata, an uncommon yeast was isolated in one patient. 85% of the co-infections were COVID positive and 100% of patients with a co-infection required mechanical ventilation (MV) which has been described as one of the major predisposing factors to candidiasis. Candida species vary in their response to treatment. In this study, 44% of isolates identified as C. glabrata were fluconazole-resistant, which were also immediately susceptible to caspofungin; this profile limits therapeutic options and emphasizes the importance of evaluating the susceptibility profile.

Conclusions

This work highlights the increase in isolation of different Candida species during COVID-19 and the importance of establishing criteria to declare Candida colonization or infection and the correct etiological identification to establish an agent-based antifungal treatment, to reduce the spreading risk of Candida spp. in the hospital environment, mortality, time, and cost of hospitalization.