{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T09:56:11Z","timestamp":1753869371657,"version":"3.41.2"},"reference-count":39,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,3,29]],"date-time":"2025-03-29T00:00:00Z","timestamp":1743206400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Laboratory Analysis"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The increased consumption of antifungal agents increases the emergence of resistant fungal strains among immunocompromised patients. The present study aims to determine the antifungal consumption and resistance pattern among adult and pediatric cancer patients with systemic <jats:italic>Candida<\/jats:italic> infections.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A descriptive, retrospective study was conducted by reviewing admitted patients' electronic medical records from 2019 to 2023. Consumption was estimated using Days of Therapy (DOT) metrics. Culture reports of <jats:italic>Candida\u2010positive<\/jats:italic> isolates were collected from the hospital microbiology laboratory to determine the resistance pattern of <jats:italic>Candida<\/jats:italic> species.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Consumption of antifungals showed a declining trend, with highest consumption of oral voriconazole (mean DOT\/1000\u2009pt. days 18653.49) and oral fluconazole (mean DOT\/1000\u2009pt. days 15258.14). <jats:styled-content style=\"fixed-case\"><jats:italic>Candida albicans<\/jats:italic><\/jats:styled-content> was the most isolated pathogen 768 (53.60%) and among all <jats:italic>Candida<\/jats:italic> species, major resistance was found in <jats:styled-content style=\"fixed-case\"><jats:italic>C. tropicalis<\/jats:italic><\/jats:styled-content> 58 (4.05%). All <jats:italic>Candida<\/jats:italic> species except <jats:italic><jats:styled-content style=\"fixed-case\">C. parapsilosis<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">C. guilliermondii<\/jats:styled-content><\/jats:italic> exhibited more resistance to fluconazole.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The findings indicated that the number of resistant isolates is clinically important 133 (9.2%) in the immunocompromised population, which underscores the necessity of conducting culture sensitivity analyses of antifungals. This approach is crucial for early detection and mitigation of antifungal resistance and optimizing therapy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcla.70022","type":"journal-article","created":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T08:11:31Z","timestamp":1743408691000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Antifungal Resistance Among <scp><i>Candida<\/i><\/scp> Species: Diagnostic and Clinical Challenges in Specialized Cancer Care Hospital of Lahore"],"prefix":"10.1002","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7592-8677","authenticated-orcid":false,"given":"Zunaira","family":"Akbar","sequence":"first","affiliation":[{"name":"Department of Pharmacy The University of Lahore  Lahore Pakistan"},{"name":"Riphah Institute of Pharmaceutical Sciences Riphah International University  Lahore Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad","family":"Aamir","sequence":"additional","affiliation":[{"name":"Department of Pharmacy The University of Lahore  Lahore Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zikria","family":"Saleem","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, Faculty of Pharmacy Bahauddin Zakariya University  Multan Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad Rehan Khan","family":"Niazi","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Shaukat Khanum Memorial Cancer Hospital and Research Centre  Lahore Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6185-2042","authenticated-orcid":false,"given":"Hasan","family":"Ejaz","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Sciences College of Applied Medical Sciences, Jouf University  Sakaka Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muharib","family":"Alruwaili","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Sciences College of Applied Medical Sciences, Jouf University  Sakaka Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khalid","family":"Abosalif","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Sciences College of Applied Medical Sciences, Jouf University  Sakaka Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,3,29]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/pathogens5010006"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.13082"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s15010-015-0742-5"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/jof5030067"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.3004404"},{"issue":"30","key":"e_1_2_12_7_1","first-page":"30300","article-title":"Emerging Aspergillosis by Azole\u2010Resistant Aspergillus fumigatus at an Intensive Care Unit in The Netherlands, 2010 to 2013","volume":"21","author":"Paassen J.","year":"2016","journal-title":"Eurosurveillance"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-019-3999-y"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/mmy\/myz112"},{"issue":"12","key":"e_1_2_12_10_1","doi-asserted-by":"crossref","DOI":"10.1099\/jmm.0.001459","article-title":"Antifungal Susceptibility Profile of Invasive Candida Glabrata Isolates (2009\u20132020) From a Tertiary Care Hospital Laboratory in Pakistan","volume":"70","author":"Memon S.","year":"2021","journal-title":"Journal of Medical Microbiology"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/jof8111146"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.12912"},{"key":"e_1_2_12_13_1","doi-asserted-by":"crossref","first-page":"S97","DOI":"10.1093\/cid\/ciu542","article-title":"Core Elements of Hospital Antibiotic Stewardship Programs From the Centers for Disease Control and Prevention","volume":"59","author":"Pollack L. 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