{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T21:19:07Z","timestamp":1780348747183,"version":"3.54.1"},"reference-count":66,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T00:00:00Z","timestamp":1763942400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100001411","name":"Indian Council of Medical Research","doi-asserted-by":"publisher","award":["AMR\/160\/2018-ECD-II"],"award-info":[{"award-number":["AMR\/160\/2018-ECD-II"]}],"id":[{"id":"10.13039\/501100001411","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Wickerhamomyces anomalus is an emerging pathogen in Indian hospitals, with limited data on antifungal resistance and its clinical impact. We aimed to explore its antifungal susceptibility, clinical outcomes, resistance mechanisms and molecular epidemiology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>Seventy clinical isolates of W. anomalus (2016\u201324) were collected from PGIMER, Chandigarh (n\u200a=\u200a29), BHU, Varanasi (n\u200a=\u200a33), and AIIMS, New Delhi (n\u200a=\u200a8). Antifungal susceptibility testing (AFST) was done for amphotericin B, fluconazole, voriconazole, itraconazole, posaconazole, caspofungin, anidulafungin and micafungin. ERG11 sequencing, ERG11, MDR1 and CDR1 expression analysis (RT-qPCR), biofilm formation, ergosterol content and genetic relatedness [short tandem repeat (STR) typing] were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The AFST (n\u200a=\u200a70) showed that 72% isolates were non-wild-type (NWT) for fluconazole, 17% cross-resistance with voriconazole, and 1.4% with micafungin. Among fungemia cases, 53.2% occurred in neonates. Respiratory distress syndrome was the most common associated comorbidity, 26\/62 (41.9%), with mortality in 31\/62 (50%). ERG11 sequencing revealed four non-synonymous mutations, N41K, R420K, P485L, and T486K(novel), in 28 (55%) NWT isolates. Gene expression analysis revealed upregulation of ERG11 (12.72-fold) and CDR1 (3.08-fold) in NWT isolates without ERG11 mutations. Biofilm formation was higher in NWT versus wild-type. STR genotyping revealed 22 genotypes and 5 clusters (\u22653 isolates), suggesting clonal transmission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This multicentre study demonstrates the emergence of fluconazole-NWT W. anomalus in Indian hospitals, predominantly affecting neonates, with a high mortality. Resistance was associated with ERG11 mutations, efflux pump overexpression and biofilm formation. These findings highlight that the drug-resistant W. anomalus fungemia is an emerging concern.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jac\/dkaf420","type":"journal-article","created":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T13:02:08Z","timestamp":1762434128000},"source":"Crossref","is-referenced-by-count":3,"title":["Multicentre investigation of\n                    <i>Wickerhamomyces anomalus<\/i>\n                    fungemia in India: emerging resistance and mechanistic insights"],"prefix":"10.1093","volume":"81","author":[{"given":"Shristi","family":"Verma","sequence":"first","affiliation":[{"name":"Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research , Chandigarh ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ragini","family":"Tilak","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University , Varanasi 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Expertise for Mycology , Nijmegen ,","place":["The Netherlands"]},{"name":"Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseased (CECAD) and Excellence Center for Medical Mycology, University of Cologne , Cologne ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theun","family":"de Groot","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Radboudumc-CWZ Center of Expertise for Mycology , Nijmegen ,","place":["The Netherlands"]},{"name":"Department of Medical Microbiology and Immunology, Canisius-Wilhelmina Hospital (CWZ)\/Dicoon , Nijmegen ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eelco F J","family":"Meijer","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Radboudumc-CWZ Center of Expertise for Mycology , Nijmegen ,","place":["The 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