Which statement is most accurate about non-albicans Candida species?

• A. They are always susceptible to fluconazole
• B. They do not cause mucosal infections
• C. They are rarely encountered in clinical practice
• D. They are more likely to be resistant to fluconazole

Answer: (D)

Non-albicans Candida species are more likely to have reduced susceptibility or resistance to fluconazole than Candida albicans, which is the key idea. Fluconazole works well against many C. albicans infections, but several non-albicans species common in clinical practice—most notably Candida glabrata—often show higher minimum inhibitory concentrations and may be resistant, especially in invasive infections. One species, Candida krusei, is intrinsically resistant to fluconazole, underscoring that resistance patterns vary by species and are not uniform across all Candida.

This is why the statement that non-albicans are more likely to be resistant to fluconazole is the best choice. It reflects the practical impact: when you’re dealing with a Candida infection that might be non-albicans, susceptibility testing or choosing an agent with broader activity (like an echinocandin) becomes important, particularly for serious infections or in patients with prior azole exposure.

The other options are inconsistent with real-world patterns: non-albicans can cause mucosal infections; they are not rare in practice; and they are not always susceptible to fluconazole.