{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T21:00:25Z","timestamp":1790283625423,"version":"4.1.0"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2023,11,22]],"date-time":"2023-11-22T00:00:00Z","timestamp":1700611200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key R&D Program of China","doi-asserted-by":"publisher","award":["2022YFC2403300"],"award-info":[{"award-number":["2022YFC2403300"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005150","name":"Chinese Academy of Medical Sciences","doi-asserted-by":"publisher","award":["2021-I2M-1-044"],"award-info":[{"award-number":["2021-I2M-1-044"]}],"id":[{"id":"10.13039\/501100005150","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005150","name":"Chinese Academy of Medical Sciences","doi-asserted-by":"publisher","award":["2022-"],"award-info":[{"award-number":["2022-"]}],"id":[{"id":"10.13039\/501100005150","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005150","name":"Chinese Academy of Medical Sciences","doi-asserted-by":"publisher","award":["PUMCH-B-074"],"award-info":[{"award-number":["PUMCH-B-074"]}],"id":[{"id":"10.13039\/501100005150","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We explored the epidemiological and molecular characteristics of Candida parapsilosis sensu stricto isolates in China, and their mechanisms of azole resistance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Azole susceptibilities of 2318 non-duplicate isolates were determined using CLSI broth microdilution. Isolates were genotyped by a microsatellite typing method. Molecular resistance mechanisms were also studied and functionally validated by CRISPR\/Cas9-based genetic alterations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fluconazole resistance occurred in 2.4% (n = 56) of isolates, and these isolates showed a higher frequency of distribution in ICU inpatients compared with susceptible isolates (48.2%, n = 27\/56 versus 27.8%, 613\/2208; P = 0.019). Microsatellite-genotyping analysis yielded 29 genotypes among 56 fluconazole-resistant isolates, of which 10 genotypes, including 37 isolates, belonged to clusters, persisting and transmitting in Chinese hospitals for 1\u201329 months. Clusters harbouring Erg11Y132F (5\/10; 50%) were predominant in China. Among these, the second most dominant cluster MT07, including seven isolates, characteristically harbouring Erg11Y132F and Mrr1Q625K, lent its carriage to being one of the strongest associations with cross-resistance and high MICs of fluconazole (&amp;gt;256 mg\/L) and voriconazole (2\u20138 mg\/L), causing transmission across two hospitals. Among mutations tested, Mrr1Q625K led to the highest-level increase of fluconazole MIC (32-fold), while mutations located within or near the predicted transcription factor domain of Tac1 (D440Y, T492M and L518F) conferred cross-resistance to azoles.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study is the first Chinese report of persistence and transmissions of multiple fluconazole-resistant C. parapsilosis sensu stricto clones harbouring Erg11Y132F, and the first demonstration of the mutations Erg11G307A, Mrr1Q625K, Tac1L263S, Tac1D440Y and Tac1T492M as conferring resistance to azoles.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jac\/dkad356","type":"journal-article","created":{"date-parts":[[2023,11,6]],"date-time":"2023-11-06T09:40:27Z","timestamp":1699263627000},"page":"128-133","source":"Crossref","is-referenced-by-count":17,"title":["Emergence of multiple fluconazole-resistant\n                    <i>Candida parapsilosis sensu stricto<\/i>\n                    clones with persistence and transmission in China"],"prefix":"10.1093","volume":"79","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9418-3634","authenticated-orcid":false,"given":"Ya-Ting","family":"Ning","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences , Beijing , China"},{"name":"Graduate School, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China"},{"name":"Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases , Beijing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tian-Shu","family":"Sun","sequence":"additional","affiliation":[{"name":"Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases , Beijing , China"},{"name":"Clinical Biobank, Medical Research Centre, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science , Beijing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rong-Chen","family":"Dai","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences , Beijing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zheng-Yu","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences , Beijing , China"},{"name":"Graduate School, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China"},{"name":"Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases , Beijing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu-Ying","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences , Beijing , China"},{"name":"Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases , Beijing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ge","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences , Beijing , China"},{"name":"Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases , Beijing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ya-Ning","family":"Mei","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital , Nanjing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Lan","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Fujian Key Laboratory of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University , Fujian , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao-Lu","family":"Hasi","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, The First Hospital of Shanxi Medical University , Shanxi , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon C A","family":"Chen","sequence":"additional","affiliation":[{"name":"Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital, University of Sydney , Sydney , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fan-Rong","family":"Kong","sequence":"additional","affiliation":[{"name":"Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital, University of Sydney , Sydney , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences , Beijing , China"},{"name":"Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases , Beijing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying-Chun","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences , Beijing , China"},{"name":"Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases , Beijing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences , Beijing , China"},{"name":"Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases , Beijing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,11,22]]},"reference":[{"key":"2024010416403056800_dkad356-B1","doi-asserted-by":"crossref","first-page":"e470","DOI":"10.1016\/S2666-5247(23)00067-8","article-title":"Worldwide emergence of fluconazole-resistant Candida parapsilosis: current framework and future research roadmap","volume":"4","author":"Daneshnia","year":"2023","journal-title":"Lancet Microbe"},{"key":"2024010416403056800_dkad356-B2","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1093\/mmy\/myaa098","article-title":"General hospital outbreak of invasive candidiasis due to azole-resistant Candida parapsilosis associated with an Erg11 Y132F mutation","volume":"59","author":"Corzo-Leon","year":"2021","journal-title":"Med Mycol"},{"key":"2024010416403056800_dkad356-B3","doi-asserted-by":"crossref","first-page":"1768","DOI":"10.3201\/eid2409.180625","article-title":"Fluconazole-resistant Candida 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