Prevalência, identificação e perfis de resistência de Candida spp. em Unidades de Terapia Intensiva de Manaus: Implicações para o Controle de Infecções Hospitalares

Abstract

The presence of yeasts of the genus Candida on surfaces in Intensive Care Units (ICUs) represents a potential risk for hospital infections, especially in regions with little data on environmental fungal contamination. This study aimed to quantify the fungal load, identify Candida species, evaluate susceptibility to fluconazole, and validate conventional identification with MALDI-TOF MS of isolates from inert surfaces in ICUs of three public hospitals in the city of Manaus, Brazil. Environmental samples were collected between November 2024 and January 2025, with isolation on Sabouraud agar, followed by morphological and biochemical identification, minimum inhibitory concentration (MIC) test for fluconazole, and confirmation by MALDI-TOF MS. Of the 117 samples, a total of 70 isolates with the highest fungal load were obtained in Hospital C (24 isolates), followed by hospitals A (23) and B (23). The most prevalent species were Candida parapsilosis and Candida glabrata, while Candida tropicalis had the highest mean MIC (8.00 µg/mL), suggesting greater resistance to fluconazole. There was 100% concordance between conventional identification and MALDI-TOF for the species C. krusei, C. tropicalis, and C. glabrata, while isolates previously classified as non-albicans were identified as C. parapsilosis by MALDI-TOF. These findings highlight the variability in fungal burden and species profile among hospitals, the importance of monitoring antifungal resistance, and the role of MALDI-TOF in the accurate identification of Candida in hospital settings in the Amazon region.