{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T23:52:04Z","timestamp":1793404324214,"version":"4.5.0"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T00:00:00Z","timestamp":1736899200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>This study assesses the impact of fluconazole resistance on 30-day all-cause mortality and 1-year recurrence in patients with Candida parapsilosis bloodstream infections (BSI).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A multicenter retrospective study was performed at 3 hospitals in Italy and Spain between 2018 and 2022. Adult patients with positive blood cultures for C. parapsilosis who received appropriate targeted therapy with either echinocandins or fluconazole were included.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 457 patients, 196 (42.9%) had fluconazole-resistant C. parapsilosis (FLZR-CP) BSI and 261 (57.1%) had fluconazole-susceptible C. parapsilosis (FLZS-CP) BSI. All FLZR-CP patients received targeted echinocandins, while FLZS-CP patients received either echinocandins (60.5%) or fluconazole (39.5%). Unadjusted 30-day all-cause mortality rates were 28.6% for FLZR-CP and 28.4% for FLZS-CP (log-rank test, P = .998). In multivariable analysis, increased mortality was associated with age (adjusted hazard ratio [aHR] 1.03 per year; 95% confidence interval [CI], 1.01\u20131.05; P = .0005), solid tumor (aHR 1.91; 95% CI, 1.06\u20133.46; P = .0302), previous antifungal treatment (aHR 1.84; 95% CI, 1.12\u20133.10; P = .0192), and septic shock (aHR 2.39; 95% CI, 1.42\u20134.06; P = .0010), but not fluconazole resistance (aHR 1.00; 95% CI, .62\u20131.63; P = .9864) nor the type of initial antifungal therapy (aHR 1.46; 95% CI, .69\u20133.06; P = .3202). Propensity score-matched analysis showed no 30-day all-cause mortality difference between echinocandin-treated FLZR-CP and fluconazole-treated FLZS-CP patients (HR 0.81; 95% CI, .37\u20131.75; P = .5915). However, a higher 1-year recurrence risk was observed in FLZR-CP patients (odds ratio, 7.37; 95% CI, 2.11\u201325.80; P = .0018).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Our results suggest that fluconazole resistance is not associated with a higher mortality risk in patients with C. parapsilosis BSI, though 1-year recurrence rates were higher in the FLZR-CP group.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciae603","type":"journal-article","created":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T08:15:18Z","timestamp":1736928918000},"page":"540-550","source":"Crossref","is-referenced-by-count":27,"title":["Impact of Fluconazole Resistance on the Outcomes of Patients With <i>Candida parapsilosis<\/i> Bloodstream Infections: A Retrospective Multicenter Study"],"prefix":"10.1093","volume":"80","author":[{"given":"Antonio","family":"Vena","sequence":"first","affiliation":[{"name":"Infectious Diseases Unit, Policlinico San Martino Hospital\u2014IRCCS , Genoa ,","place":["Italy"]},{"name":"Department of Health Sciences (DISSAL), University of Genoa , Genoa ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3884-4933","authenticated-orcid":false,"given":"Giusy","family":"Tiseo","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliera Universitaria Pisana , Pisa ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3813-8796","authenticated-orcid":false,"given":"Marco","family":"Falcone","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliera Universitaria Pisana , Pisa ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Bartalucci","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Policlinico San Martino Hospital\u2014IRCCS , Genoa ,","place":["Italy"]},{"name":"Department of Health Sciences (DISSAL), University of Genoa , Genoa ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1510-1819","authenticated-orcid":false,"given":"Cristina","family":"Marelli","sequence":"additional","affiliation":[{"name":"Department of Health Sciences (DISSAL), University of Genoa , Genoa ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Cesaretti","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliera Universitaria Pisana , Pisa 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Madrid ,","place":["Spain"]},{"name":"Faculty of Health Sciences - HM Hospitals, Universidad Camilo Jos\u00e9 Cela , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arianna","family":"Forniti","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliera Universitaria Pisana , Pisa ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2385-1759","authenticated-orcid":false,"given":"Daniele Roberto","family":"Giacobbe","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Policlinico San Martino Hospital\u2014IRCCS , Genoa ,","place":["Italy"]},{"name":"Department of Health Sciences (DISSAL), University of Genoa , Genoa 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University of Genoa , Genoa ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"Lupetti","sequence":"additional","affiliation":[{"name":"Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa , Pisa ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8370-2248","authenticated-orcid":false,"given":"Marina","family":"Machado","sequence":"additional","affiliation":[{"name":"Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Mara\u00f1\u00f3n , Madrid ,","place":["Spain"]},{"name":"Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n (IiSGM) , Madrid ,","place":["Spain"]},{"name":"CIBER Enfermedades Respiratorias-CIBERES (CB06\/06\/0058) , Madrid 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Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, University Hospital Cologne, Institute of Translational Research , Cologne ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Soriano-Martin","sequence":"additional","affiliation":[{"name":"Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Mara\u00f1\u00f3n , Madrid ,","place":["Spain"]},{"name":"Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n (IiSGM) , Madrid ,","place":["Spain"]},{"name":"CIBER Enfermedades Respiratorias-CIBERES (CB06\/06\/0058) , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6622-6358","authenticated-orcid":false,"given":"Lucia","family":"Taramasso","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Policlinico San Martino Hospital\u2014IRCCS , Genoa 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