Prevalence and Species Distribution of Clinical Isolates in a Tertiary Care Hospital in Ecuador Tested from January 2019 to February 2020.

The incidence of candidemia in healthcare centers is associated with high morbidity and mortality. Frequency varies significantly among regions, with some species being more prevalent than others in Latin America. In this study, 191 clinical isolates were collected from a major hospital in Ecuador from January 2019 to February 2020 aiming to assess their prevalence and distribution. After data processing, 168 isolates characterized by the VITEK 2 system were subsequently identified by ITS sequencing. Results showed diverse species distributions, with and being the most prevalent across different clinical sources. In hospitalized individuals, (38%) and (37%) were the most prevalent, followed by, (16%), (5%), and other non- (NCA) species (6%). Conversely, (48%), (20%), and (14%), associated with candidemia, were the most common in blood and CSF. Additionally, uncommon NCA species such as , , and were identified in Ecuador for the first time. Discrepancies in species identification were observed between the VITEK 2 system and ITS sequencing, coinciding at 85%. This highlights the need for ongoing surveillance and identification efforts in Ecuador's clinical and epidemiological settings.