{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T19:35:46Z","timestamp":1789414546881,"version":"build-2803163510"},"reference-count":49,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2023,8,25]],"date-time":"2023-08-25T00:00:00Z","timestamp":1692921600000},"content-version":"unspecified","delay-in-days":236,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004508","name":"Prince of Songkla University","doi-asserted-by":"publisher","award":["MET590671S"],"award-info":[{"award-number":["MET590671S"]}],"id":[{"id":"10.13039\/501100004508","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004508","name":"Prince of Songkla University","doi-asserted-by":"publisher","award":["MET6601053S"],"award-info":[{"award-number":["MET6601053S"]}],"id":[{"id":"10.13039\/501100004508","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2023]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:p>Antifungal susceptibility of <jats:italic>Candida<\/jats:italic> species is decreasing. Successful treatment for antifungal-resistant candida infection is challenging and associated with significant mortality. We performed a prospective observational study to identify the species and antifungal susceptibilities of invasive isolates of <jats:italic>Candida<\/jats:italic> species over a 5-year period at a university hospital in southern Thailand. Between 2017 and 2021, the species distribution was 39.1% <jats:italic>Candida tropicalis<\/jats:italic>, 24.8% <jats:italic>Candida albicans<\/jats:italic>, 20.3% <jats:italic>Candida parapsilosis<\/jats:italic> complex, 10.5% <jats:italic>Candida glabrata<\/jats:italic>, and 5.2% miscellaneous <jats:italic>Candida<\/jats:italic> spp. Notable observations include elevated minimal inhibitory concentration (MIC) and decrease susceptibility of <jats:italic>C. tropicalis<\/jats:italic> and <jats:italic>C. glabrata<\/jats:italic> to echinocandin and all tested triazoles. A shift of MIC<jats:sub>90<\/jats:sub> value in the COVID-19 era was seen in <jats:italic>C. albicans<\/jats:italic> and <jats:italic>C. tropicalis<\/jats:italic> with azoles and echinocandins. Azole resistance increased among <jats:italic>C. tropicalis<\/jats:italic> isolates, and echinocandin resistance also increased among <jats:italic>C. parapsilosis<\/jats:italic> and <jats:italic>C. glabrata<\/jats:italic> isolates. Novel alterations in <jats:italic>FKS<\/jats:italic>1 HS1 and HS2 were detected in both isolates of anidulafungin-resistant <jats:italic>C. parapsilosis.<\/jats:italic> As <jats:italic>Candida<\/jats:italic> species have become more resistant to azoles and less susceptible to echinocandin development, the need arose to observe the emergence of resistance to both antifungal classes in candida clinical isolates, for a more effective infection control in the hospital.<\/jats:p>","DOI":"10.1017\/s0950268823001346","type":"journal-article","created":{"date-parts":[[2023,8,25]],"date-time":"2023-08-25T09:13:09Z","timestamp":1692954789000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":22,"title":["Fluconazole and echinocandin resistance of <i>Candida<\/i> species in invasive candidiasis at a university hospital during pre-COVID-19 and the COVID-19 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