Antifungal resistance and phenotypic variability in pulmonary mycoses in critically ill patients with COVID-19: Resistencia antifúngica y variabilidad fenotípica en micosis pulmonares en pacientes críticos con COVID-19

• Autores: Paredes-Gago, Rolando, Valencia-Vásquez, Pedro Gustavo, Úrcia-Ausejo, Flor Cecilia, Escalante-Maldonado, Oscar Roberto, Ayala-Mendívil, Ronald Espíritu
• Formato: artículo
• Fecha de Publicación: 2025
• Institución: Universidad de Ciencias y Humanidades
• Repositorio: Health care & global health
• Lenguaje: español
• OAI Identifier: oai:ojs.openhgh.org:article/305
• Enlace del recurso: http://revista.uch.edu.pe/index.php/hgh/article/view/305
• Nivel de acceso: acceso abierto

Objective: This study analyzed the phenotypic and antifungal resistance profile of fungi isolated from pulmonary infections in critically patients with COVID-19. Materials and methods: Information was obtained on fungal strains isolated at the National Reference Laboratory of Mycology (LRNM) from hospitalized patients with COVID-19. The Fungi were identified by mass spectrometry (MALDI-TOF) and molecular techniques, classifying phenotypes and evaluating antifungal sensitivity according to the Clinical & Laboratory Standards Institute (CLSI). Antifungals such as anidulafungin, micafungin, caspofungin, voriconazole, fluconazole, itraconazole and amphotericin B were tested. Results: In yeasts, Candida albicans was the predominant species (73,5%), followed by Candida tropicalis (19,3%). In filamentous fungi, Aspergillus fumigatus was the most frequent (78,3%), followed by Aspergillus terreus (17,4%). Most strains of Candida albicans were sensitive to antifungals, with a small percentage resistant to fluconazole. In Aspergillus fumigatus, voriconazole was effective in 77.8% of cases, with some strains categorized as intermediate or resistant. In general, Candida and Aspergillus strains showed sensitivity to echinocandins and azoles, with minimal resistance. The variability in the minimum inhibitory concentrations of the different species was reflected in the data obtained. Conclusions: Candida albicans and Aspergillus fumigatus were the predominant fungi, with general sensitivity to echinocandins and azoles, although some resistant strains were observed, especially to fluconazole and voriconazole. These findings highlight the importance of accurate diagnosis and appropriate therapeutic management in fungal infections, underlining the need to customize treatments according to the species and its sensitivity profile. Keywords: COVID-19; Lung Diseases, Fungal; Drug Resistance, Fungal; Aspergillus (Source: MeSH, NLM).