Species Diversity And Resistance Markers of Candida Yeasts In COVID Positive and COVID Negative Patients With Community-Acquired Pneumonia

Abstract

Background. At the height of the novel coronavirus infection, the risk of fungal coinfection increases due to a decrease in the immune status of patients and massive antibacterial therapy, which leads to a complication in the course of the underlying disease and increases the risk of an unfavorable outcome. Therefore, it is necessary not only to identify all associates that cause the infectious process, but also to determine their sensitivity to antibacterial and antifungal drugs in order to select an adequate treatment regimen for a patient.The aim of the study was to investigate the species composition of fungal associates in corona positive and corona negative patients with community-acquired pneumonia (CAP), as well as to determine the spectrum of sensitivity/resistance of yeasts and yeast-like fungi to antimycotic drugs.Material and methods. The species composition of the fungal microflora in sputum samples from 723 patients with CAP, sent from a health care facility in Rostov-on-Don, was investigated. The isolated cultures were identified using bacteriological and mass spectrometric methods. The sensitivity of yeasts to antimycotic drugs was determined by disk-diffusion method.Results. It has been established that yeast and yeast-like fungi were present in sputum samples in 31–32% of patients with CAP in etiologically significant quantities. 10 different types of yeast and yeast-like fungi were identified. Candida albicans was the predominant species in terms of the number of isolated cultures (83%). A re-examination of corona positive patients after their hospital stay revealed a tendency towards an increase in the number and intensity of manifestation of candidal lesions. Moreover, a change in Candida species has been registered, which entails a change in their sensitivity to antifungal drugs. A high percentage of strains resistant to fluconazole was identified after determining the sensitivity of fungi to antimycotics.Conclusion. The data obtained demonstrate that yeast and yeast-like fungi are the dominant associates in complicated forms of CAP. In this regard, it seems appropriate to provide individual microbiological support to patients during their treatment with the identification of all pathogens.