# Candida Susceptibility to Antifungals in Amniotic Fluid: A Preliminary Study

## TL;DR

This study examines antifungal resistance in Candida species found in amniotic fluid, highlighting the need for species-specific susceptibility testing to improve treatment outcomes.

## Contribution

The study provides preliminary antifungal susceptibility data for Candida species isolated from amniotic fluid, emphasizing the importance of species-level testing.

## Key findings

- C. albicans was the most common species isolated from amniotic fluid samples.
- Fluconazole resistance was observed in two C. albicans isolates, and all C. albicans isolates were resistant to micafungin.
- Amphotericin B remained effective against all tested isolates.

## Abstract

(1) Background: Fungal infections of amniotic fluid, especially those caused by Candida spp., are rare but clinically important, as they can be correlated with preterm birth and poor neonatal outcomes. The aim of this study was to assess the antifungal susceptibility of Candida spp. isolated from amniotic fluid using an MIC (minimum inhibitory concentration)-based assay. (2) Methods: Forty consecutive, exploratory Candida isolates were identified from amniotic fluid samples at the “Cuza Vodă” Clinical Hospital of Obstetrics and Gynecology, Iași, and were analyzed successively using Sabouraud agar, the VITEK® 2 Compact system, and real-time PCR (RT-PCR). (3) Results: C. albicans was the most abundant species (67.5%), followed by Pichia kudriavzevii, Nakaseomyces glabratus, C. parapsilosis, and C. dubliniensis. Fluconazole resistance was observed in two C. albicans isolates, emphasizing the clinical importance of routine antifungal susceptibility testing, and all C. albicans isolates were resistant to micafungin, while amphotericin B remained effective against all isolates. RT-PCR confirmed the presence of C. albicans DNA. (4) Conclusions: The detection of resistant Candida strains highlights the importance of conducting assessments at the species level, which could help clinicians to ensure better antifungal stewardship.