Abstract: Background: Candida infections are a major global public health challenge due to their high rates of illness and death. Species of Candida rank among the most prevalent fungal pathogens globally, causing a wide spectrum of clinical manifestations in both immunocompetent and immunocompromised individuals. Although Candida species commonly exist as commensal organisms in healthy individuals, the global emergence of fluconazole-resistant strains has become a significant concern.

Material and Methods: This prospective cross-sectional study was carried out in the Mycology Laboratory, Department of Microbiology at a tertiary care hospital. Sabouraud’s dextrose agar was utilized for the isolation of Candida spp. and further confirmed by Gram staining and germ tube test. Speciation was done following conventional and CHROMagar differential media. Antifungal susceptibility testing was performed using the disk diffusion method in accordance with the guidelines of the Clinical and Laboratory Standards Institute (CLSI).

Results: A total of 250 Candida species isolates were identified, of which 71.20% were obtained from IPD patients and 28.80% from OPD patients. Most of the isolates were recovered from female patients (52.4%), whereas 47.6% were obtained from male patients. Among all the Antifungal agents tested, the highest sensitivity was observed to Caspofungin (80.40%) and Micafungin (80.40%) followed by Amphotericin B (78.80%). In contrast, Candida spp showed high resistance to Fluconazole (53.60%) followed by Voriconazole (43.60%) and Itraconazole (37.60%). Fluconazole resistance was observed in 53.6% of isolates. Candida albicans exhibited the highest resistance to fluconazole, followed by non-albicans Candida species.

Conclusion: Candida species are opportunistic pathogenic organisms. The prevalence of fluconazole resistance among Candida isolates is steadily rising. The inappropriate and over-the-counter use of antifungal agents has contributed to this issue. The rise of fluconazole-resistant Candida albicans and non-albicans Candida species highlights the importance of species identification and antifungal susceptibility testing in the diagnosis and management of Candida infections.