Antifungal Resistance Among Candida Species: Diagnostic and Clinical Challenges in Specialized Cancer Care Hospital of Lahore

Background: The increased consumption of antifungal agents increases the emergence of resistant fungal strains among immunocompromised patients. The present study aims to determine the antifungal consumption and resistance pattern among adult and pediatric cancer patients with systemic Candida infections.

Method: A descriptive, retrospective study was conducted by reviewing admitted patients' electronic medical records from 2019 to 2023. Consumption was estimated using Days of Therapy (DOT) metrics. Culture reports of Candida-positive isolates were collected from the hospital microbiology laboratory to determine the resistance pattern of Candida species.

Results: Consumption of antifungals showed a declining trend, with highest consumption of oral voriconazole (mean DOT/1000 pt. days 18653.49) and oral fluconazole (mean DOT/1000 pt. days 15258.14). Candida albicans was the most isolated pathogen 768 (53.60%) and among all Candida species, major resistance was found in C. tropicalis 58 (4.05%). All Candida species except C. parapsilosis and C. guilliermondii exhibited more resistance to fluconazole.

Conclusion: The findings indicated that the number of resistant isolates is clinically important 133 (9.2%) in the immunocompromised population, which underscores the necessity of conducting culture sensitivity analyses of antifungals. This approach is crucial for early detection and mitigation of antifungal resistance and optimizing therapy.