{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T17:22:05Z","timestamp":1788283325003,"version":"build-2803163510"},"reference-count":36,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2024,5,16]],"date-time":"2024-05-16T00:00:00Z","timestamp":1715817600000},"content-version":"unspecified","delay-in-days":136,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ASHE"],"published-print":{"date-parts":[[2024]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:sec id=\"S2732494X24000779_as1\">\n\t    <jats:title>Objective:<\/jats:title>\n\t    <jats:p>This study aimed to investigate and contain a cluster of invasive candidiasis cases caused by fluconazole-resistant <jats:italic>Candida parapsilosis<\/jats:italic> (FRC) in a neonatal intensive care unit.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X24000779_as2\">\n\t    <jats:title>Methods:<\/jats:title>\n\t    <jats:p>Active surveillance was initiated. Direct observations of hand-hygiene compliance (HHC) among staff were conducted before and after the implementation of hand-hygiene (HH) education. Thirty-five environmental cultures were obtained. Phylogenetic analysis of FRC was performed using Fourier-transform infrared spectroscopy and microsatellite genotyping.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X24000779_as3\">\n\t    <jats:title>Results:<\/jats:title>\n\t    <jats:p>A total of 14 patients (mean birth weight = 860 g, gestational age = 25 weeks) infected with FRC were identified using the fully automated analyzer, including 5 with clinical infection (three with catheter-related bloodstream infection, one with cutaneous infection, and one with fatal peritonitis) and 9 with colonization. The HHC rate in nurses before performing a sterile or aseptic procedure significantly improved after the HH education (<jats:italic>P<\/jats:italic> &lt; .05). Sinks near the patients were contaminated with FRC. All FRC strains were confirmed to be susceptible to fluconazole using the CLSI method, and the microdilution procedure indicated a trailing effect. Phylogenetic analysis showed that all the fluconazole-trailing isolates from patients were clustered together and had the same genotype. Sinks were successfully decontaminated using accelerated hydrogen peroxide and drainage pipes were replaced. Ultraviolet-C decontamination was applied in the milk preparation room. No new cases were detected after the education and disinfection interventions.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X24000779_as4\">\n\t    <jats:title>Conclusions:<\/jats:title>\n\t    <jats:p>Sinks are an important reservoir of <jats:italic>C. parapsilosis<\/jats:italic>. Active surveillance, environmental hygiene, and constant staff education on maintaining a high level of HHC are necessary to limit the spread of <jats:italic>C. parapsilosis<\/jats:italic>.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1017\/ash.2024.77","type":"journal-article","created":{"date-parts":[[2024,5,16]],"date-time":"2024-05-16T01:31:25Z","timestamp":1715823085000},"source":"Crossref","is-referenced-by-count":3,"title":["A cluster of <i>Candida parapsilosis<\/i> displaying fluconazole-trailing in a neonatal intensive care unit successfully contained by multiple infection-control interventions"],"prefix":"10.1017","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5487-6698","authenticated-orcid":false,"given":"Hiroaki","family":"Baba","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hajime","family":"Kanamori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asami","family":"Nakayama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takami","family":"Sato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Katsumi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takae","family":"Chida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinobu","family":"Ikeda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rio","family":"Seki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teppei","family":"Arai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsuhiko","family":"Kamei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichi","family":"Tokuda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2024,5,16]]},"reference":[{"key":"S2732494X24000779_ref10","unstructured":"10. 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