Antifungal resistance patterns of Candida species isolated from a private laboratory in Zambia: implications for antifungal stewardship programs.

Abstract

Background: Fungal infections pose a significant but often underestimated public health threat. These infections range from superficial conditions, such as skin and nail infections, to invasive diseases like candidemia, which can be life-threatening. Candida species, in particular, have shown increasing resistance, contributing to higher morbidity and mortality among affected patients. This study investigated the resistance patterns of Candida species isolated from Mary Begg facilities.

Methods: This cross-sectional study utilized microbiology reports containing Candida species and the antifungal susceptibility results from October 2024 to October 2025.

Results: Of the 57 Candida species isolated between October 2024 and October 2025, the majority were Candida albicans (75.4%; 43/57) and were mainly from high vaginal swab samples (84.2%; 48/57). Among isolated C. albicans, resistance to fluconazole was 7.5% and to micafungin 7.1%. Candida krusei showed varied resistance to available drugs, with 25% of isolated species resistant to micafungin, caspofungin, and voriconazole.

Conclusion: Candida albicans remains most prevalent and largely susceptible to first-line agents; emerging non-albicans species present a severe therapeutic challenge. Therefore, the country needs to strengthen surveillance and diagnostic capacity to address the growing problem of fungal infections and antifungal resistance.