{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T18:47:24Z","timestamp":1791226044809,"version":"4.1.0"},"reference-count":40,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2012,4,3]],"date-time":"2012-04-03T00:00:00Z","timestamp":1333411200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Kaohsiung J of Med Scie"],"published-print":{"date-parts":[[2012,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:label\/><jats:p>The emergence of antifungal resistance in <jats:italic>Candida<\/jats:italic> species has raised concern in recent years, especially resistance toward triazole. Several newer triazole antifungal agents have been introduced which have a broader spectrum for fungal infections, such as voriconazole. However, cross\u2010resistance among triazoles is a major concern with regard to their clinical application. Antifungal susceptibility was performed using E\u2010test for 166 clinical isolates (29 blood and 137 nonblood isolates) in 2003 and 2004. We applied pulsed\u2010field gel electrophoresis for genotyping. Ninety isolates of <jats:italic>C. albicans<\/jats:italic>, 47 isolates of <jats:italic>C. tropicalis<\/jats:italic>, 27 isolates of <jats:italic>C. glabrata<\/jats:italic>, and two isolates of <jats:italic>C. krusei<\/jats:italic> were included. All isolates were susceptible to amphotericin B. Eleven (40.7%) of the 27 <jats:italic>C. glabrata<\/jats:italic> had intermediate resistance to caspofungin. Forty\u2010seven (28.3%) of the 166 isolates were not susceptible to fluconazole, including two <jats:italic>C. albicans<\/jats:italic>, 16 <jats:italic>C. tropicalis<\/jats:italic>, 27 <jats:italic>C. glabrata<\/jats:italic>, and two <jats:italic>C. krusei<\/jats:italic> isolates. All except seven of the <jats:italic>C.\u2009glabrata<\/jats:italic> isolates were susceptible to voriconazole. All the triazole drugs had a positive correlation among their minimum inhibitory concentrations (MICs). Fluconazole MIC was a good predictor for susceptibility to voriconazole, as determined using a receiver operating characteristic curve. Furthermore, a high diversity of pulsotypes for the 27 clinical isolates of <jats:italic>C. glabrata<\/jats:italic> was observed. Previous fluconazole exposure within 3 months was associated with reduced triazole susceptibility for <jats:italic>C. glabrata<\/jats:italic>. We demonstrated a significant positive correlation of MIC values among the four tested triazole drugs. No amphotericin B and caspofungin resistant isolates were found in this study. The cross\u2010resistance to triazole among <jats:italic>C. glabrata<\/jats:italic> isolates was associated with previous fluconazole exposure as opposed to clonal spreading. Selection pressure due to fluconazole use may play a major role in triazole cross\u2010resistance.<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.kjms.2011.11.011","type":"journal-article","created":{"date-parts":[[2012,4,4]],"date-time":"2012-04-04T05:34:11Z","timestamp":1333517651000},"page":"306-315","source":"Crossref","is-referenced-by-count":25,"title":["Fluconazole exposure rather than clonal spreading is correlated with the emergence of <i>Candida glabrata<\/i> with cross\u2010resistance to triazole antifungal agents"],"prefix":"10.1002","volume":"28","author":[{"given":"Tun\u2010Chieh","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yen\u2010Hsu","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yee\u2010Chun","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Po\u2010Liang","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,4,3]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"crossref","first-page":"369","DOI":"10.2307\/30141234","article-title":"Secular trends in the epidemiology of noscomial fungal infections at a teaching hospital in Taiwan, 1981 to 1993","volume":"18","author":"Chen Y.C.","year":"1997","journal-title":"Infect Control Hosp Epidemiol"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0929-6646(09)60091-7"},{"key":"e_1_2_6_4_2","volume-title":"Statistics of Communicable Diseases and Surveillance Report","author":"Centers for Disease Control, R.O.C. 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