Objective To investigate the epidemiological characteristics, resistance status and risk factors of Candida species isolated from five hospitals in Nanchong region from 2019 to 2023, providing a reference for the clinical diagnosis, treatment, and resistance prevention of invasive Candida infections. Methods A retrospective study was conducted, collecting data on 2,787 strains of clinically isolated Candida from five hospitals, including the Affiliated Hospital of North Sichuan Medical College and so on. Statistical analysis was performed using Whonet 5.6 and SPSS 27.0 software, including species distribution, patient age, gender, department, sample type, and antifungal drug resistance. Logistic regression was used to analyze risk factors for infection. Result During the study period, Candida albicans was the most prevalent species (38.46%). Elderly patients (≥60 years) had a significantly higher infection rate than younger groups (<60 years) (54.40% vs. 45.60%, χ2=21.54, P<0.05). But there was no significant difference in gender. Sterile-site specimens accounted for 10.44%, with blood, ascites, and pleural fluid being the most common, while non-sterile sites were primarily urine, pus, and urogenital swabs. The highest departmental distributions were in the Intensive Care Unit (13.21%), Urology Department (11.52%), and Plastic & Burn Surgery Department (11.05%). Multivariate analysis identified broad-spectrum antibiotic use (OR=9.70), invasive procedures (OR=68.53), catheterization (OR=13.67), and chemotherapy (OR=100.31) as independent risk factors for invasive infections (P<0.05). Antifungal susceptibility testing showed that Candida tropicalis exhibited higher resistance rates to voriconazole (21.71%), fluconazole (24.78%), amphotericin B (0.44%), and itraconazole (20.61%) compared to other Candida species. Conclusion There are obvious age, location, and departmental distribution characteristics of Candida infections in Nanchong. C. tropicalis showed a trend of multidrug resistance. Clinical monitoring of fungal resistance should be strengthened, and strategies for using antifungal drugs should be optimized. At the same time, targeted preventive measures should be taken for patients with risk factors