Investigating the Increasing Azole Resistance in Candida Infections Among Critically Ill Patients: Experience From a Tertiary-Level Setup in North India

Author: mycolabadmin
12/3/2025
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Summary

This study tracked the increase in drug-resistant yeast infections in hospitalized patients in India from 2023 to 2025. The researchers found that common antifungal medications like fluconazole are becoming less effective, with resistance rates nearly doubling over the study period. The good news is that newer antifungal drugs called echinocandins remained highly effective. The findings highlight the need for better infection control measures and more careful use of antifungal medications.

Background

Candida species are common fungal pathogens with increasing resistance to azole drugs, particularly in critically ill patients. There has been a documented shift from Candida albicans to treatment-resistant non-albicans Candida species globally and in India.

Objective

To identify the spectrum of Candida species causing clinical infections and to determine their sensitivity patterns to available antifungal agents in critically ill patients at a tertiary-level healthcare facility.

Results

Of 382 samples analyzed, 118 (31%) were culture-positive for yeast isolates. Overall fluconazole resistance was 21.4% and voriconazole resistance was 5.6% in blood isolates. Azole resistance increased significantly from 2023 to 2025 (fluconazole: 18.5% to 34.6%, voriconazole: 5.7% to 10.2%), while echinocandin resistance remained low (0.6% to 1.6%).

Conclusion

The study demonstrates alarming increases in azole resistance in Candida isolates with a shift toward non-albicans species. While echinocandins remain effective, the rising fluconazole resistance necessitates continued regional surveillance, antifungal stewardship programs, and development of novel antifungal agents to improve clinical outcomes.

Published in:Cureus,
Study Type:Retrospective Cross-Sectional Study,
Source: PMID: 41487737, DOI: 10.7759/cureus.98425