ORIGINAL PAPER Invasive Fungal Infection in Romania: Changing Incidence and Epidemiology During Six Years of Surveillance in a Tertiary Hospital Floredana-Laura S ¸ ular . Edit Szekely . Violeta Corina Cristea . Minodora Dobreanu Received: 25 January 2018 / Accepted: 11 August 2018 Ó Springer Nature B.V. 2018 Abstract The present study aimed to evaluate the incidence of candidemia, the trend of species distri- bution and the antifungal susceptibility patterns of all invasive strains of Candida spp. isolated over a 6-year period in an Eastern European University hospital. A total number of 156 isolates were reidentified by MALDI-TOF and tested for susceptibility by Sensi- titre TM YeastOne TM . Isolates were assigned as non- susceptible or belonging to the wild type according to the new CLSI (2017, 2018) break points and epidemi- ological cut-off values. C. parapsilosis (37.82%) was the most frequently isolated yeast, followed by C. albicans (26.28%). The general tendency of the species distribution during the surveyed period shifted towards an increase in C. parapsilosis and C. lusita- niae isolates. Fluconazole resistance was present in 23.52% of C. glabrata, 5.08% of C. parapsilosis and in none of the C. albicans, C. tropicalis and C. lusitaniae isolates. Echinocandin resistance was pre- sent only in 1(5.88%) C. glabrata isolate. The study emphasises the importance of monitoring local epi- demiologic data and antifungal susceptibility trends due to the diversity of affected patient groups in our hospital. Keywords Candida spp. Á Invasive fungal infection Á Antifungal Á Resistance Á Susceptibility Handling editor: Stephane Ranque. F.-L. S ¸ ular (&) Á M. Dobreanu Department of Laboratory Medicine, University of Medicine and Pharmacy of Tı ˆrgu Mures ¸, Gheorghe Marinescu Street, No. 38, 540136 Tı ˆrgu Mures ¸, Romania e-mail: floredana.sular@gmail.com F.-L. S ¸ ular Á E. Szekely Á M. Dobreanu Central Laboratory, Emergency Clinical County Hospital Tı ˆrgu Mures ¸, Romania, Gheorghe Marinescu Street, No. 50, 540136 Tı ˆrgu Mures ¸, Romania E. Szekely Microbiology Department, University of Medicine and Pharmacy of Tı ˆrgu Mures ¸, Gheorghe Marinescu Street, No. 38, 540136 Tı ˆrgu Mures ¸, Romania V. C. Cristea Synevo Romania, Medicover Diagnostic Services, Industriilor Street, No. 25, Chiajna, Ilfov County, 007040 Bucharest, Romania V. C. Cristea ‘‘Carol Davila’’ University of Medicine and Pharmacy, Bucharest, Romania 123 Mycopathologia https://doi.org/10.1007/s11046-018-0293-2