Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

Candida infections are one of the most important nosocomial infections that have increased by 3.5 to 14 folds over the past decades. Although the sources of infection are human normal flora, hospital environments have an undeniable role. The increased use of antifungals, prolonged prophylaxis, and some organism-associated genetic factors have led to antifungal resistance. The aim of the present prospective study was to identify Candida species from clinical specimens, normal flora, and hospital environments. Furthermore, the susceptibility profile of strains to several antifungals was also evaluated. Two hundred and twenty-one samples (clinical specimens, hospital environments, and personal normal flora) were collected. Samples were inoculated on CHROMagar Candida, incubated at 35°C, and were identified using classical and molecular techniques. Consequently, all recovered isolates were tested against six antifungal drugs, using the microdilution method. Ninety-two Candida strains, belonging to 10 different yeast species, were detected with the most common isolate, Candida albicans (46.74%). Candida albicans made up the majority of species that were obtained from oral samples and non-albicans species with uncommon frequency were obtained from hospital environment samples. Miconazole was a unique antifungal, towards which all strains were sensitive. However, most of the isolates were also sensitive to fluconazole. Although resistance to amphotericin B, terbinafine, fluconazole, caspofungin, and itraconazole was found among C. albicans and non-albicans species, however, miconazole is the most effective antifungals against all strains.