A multicentre, laboratory-based analysis was conducted on aggregated data from 23 hospitals across Colombia. Of 1761 fungal isolates identified, 1642 were yeasts and constitute the focus of this study. Isolates were identified using the VITEK^®2 system, with confirmatory identification by MALDI-TOF-MS for a subset. Antifungal susceptibility testing for fluconazole, voriconazole, amphotericin B, and the echinocandins was performed on Candida albicans, C. parapsilosis, and C. tropicalis. Data were stratified by clinical service: adult ICU, adult wards, paediatric ICU, neonatal ICU, and paediatric wards. Temporal trends were assessed using the Cochran–Armitage test. The most prevalent species were C. albicans (42%), C. parapsilosis (24%), C. tropicalis (11%), C. glabrata (7%), and C. auris (3%). C. albicans predominated in adult services, whereas C. parapsilosis was the leading pathogen across paediatric settings. Among species with validated breakpoints, the overall fluconazole resistance rate was 19%, driven primarily by C. parapsilosis (35%, exceeding 40% in some clinical services). Non-wild-type to voriconazole and amphotericin B was low (<5%), and echinocandin resistance was exceedingly rare. The substantial fluconazole resistance driven by C. parapsilosis, together with the emergence of C. auris, underscores the urgent need for sustained surveillance and species-directed antifungal stewardship programmes.

Background: Candida parapsilosis is an opportunistic yeast of increasing clinical importance, with fluconazole resistance rates rising globally and reaching concerning levels in clinical settings across several countries, including Colombia. However, the occurrence of antifungal-resistant Candida species in domestic water systems in the country remains largely unexplored. Methods: This cross-sectional study assessed the occurrence and antifungal susceptibility of Candida spp. in intradomiciliary water from 104 households in Villavicencio, Colombia, during two monitoring periods. Water samples were filtered, and yeast-like colonies were identified using MALDI-TOF mass spectrometry. Susceptibility to fluconazole, amphotericin B, and anidulafungin was determined using the CLSI broth microdilution method. The ERG11 gene was sequenced in the fluconazole-resistant isolate. Results: C. parapsilosis was recovered from 16 of 104 households (15.4%), yielding 22 isolates distributed across six communes. Most isolates (72.7%) were obtained from household water-storage tanks. One isolate was resistant to fluconazole (MIC = 8 µg/mL) and harbored a nonsynonymous R398I substitution in ERG11. Conclusions: To our knowledge, this is the first report of C. parapsilosis, including a fluconazole-resistant isolate carrying an ERG11 substitution, recovered from domestic water in Colombia. These findings suggest that household water-storage tanks may serve as environmental reservoirs for this opportunistic yeast. The implications for human exposure remain to be determined and highlight the need for integrated One Health surveillance.

Background: Candida parapsilosis is an opportunistic yeast of increasing clinical importance, with fluconazole resistance rates rising globally and reaching concerning levels in clinical settings across several countries, including Colombia. However, the occurrence of antifungal-resistant Candida species in domestic water systems in the country remains largely unexplored. Methods: This cross-sectional study assessed the occurrence and antifungal susceptibility of Candida spp. in intradomiciliary water from 104 households in Villavicencio, Colombia, during two monitoring periods. Water samples were filtered, and yeast-like colonies were identified using MALDI-TOF mass spectrometry. Susceptibility to fluconazole, amphotericin B, and anidulafungin was determined using the CLSI broth microdilution method. The ERG11 gene was sequenced in the fluconazole-resistant isolate. Results: C. parapsilosis was recovered from 16 of 104 households (15.4%), yielding 22 isolates distributed across six communes. Most isolates (72.7%) were obtained from household water storage tanks. One isolate was resistant to fluconazole (MIC = 8 µg/mL) and harbored a nonsynonymous R398I substitution in ERG11. Conclusions: To our knowledge, this is the first report of C. parapsilosis, including a fluconazole-resistant isolate carrying an ERG11 substitution, recovered from domestic water in Colombia. These findings suggest that household water storage tanks may serve as environmental reservoirs for this opportunistic yeast. The implications for human exposure remain to be determined and highlight the need for integrated One Health surveillance.