{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T05:51:39Z","timestamp":1788328299298,"version":"build-2803163510"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2024,5,6]],"date-time":"2024-05-06T00:00:00Z","timestamp":1714953600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"US CDC"},{"DOI":"10.13039\/100006229","name":"Oak Ridge Institute for Science and Education","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006229","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,6,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Reports of fluconazole-resistant Candida parapsilosis bloodstream infections are increasing. We describe a cluster of fluconazole-resistant C parapsilosis bloodstream infections identified in 2021 on routine surveillance by the Georgia Emerging Infections Program in conjunction with the Centers for Disease Control and Prevention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Whole-genome sequencing was used to analyze C parapsilosis bloodstream infections isolates. Epidemiological data were obtained from medical records. A social network analysis was conducted using Georgia Hospital Discharge Data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty fluconazole-resistant isolates were identified in 2021, representing the largest proportion (34%) of fluconazole-resistant C parapsilosis bloodstream infections identified in Georgia since surveillance began in 2008. All resistant isolates were closely genetically related and contained the Y132F mutation in the ERG11 gene. Patients with fluconazole-resistant isolates were more likely to have resided at long-term acute care hospitals compared with patients with susceptible isolates (P = .01). There was a trend toward increased mechanical ventilation and prior azole use in patients with fluconazole-resistant isolates. Social network analysis revealed that patients with fluconazole-resistant isolates interfaced with a distinct set of healthcare facilities centered around 2 long-term acute care hospitals compared with patients with susceptible isolates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Whole-genome sequencing results showing that fluconazole-resistant C parapsilosis isolates from Georgia surveillance demonstrated low genetic diversity compared with susceptible isolates and their association with a facility network centered around 2 long-term acute care hospitals suggests clonal spread of fluconazole-resistant C parapsilosis. Further studies are needed to better understand the sudden emergence and transmission of fluconazole-resistant C parapsilosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ofid\/ofae264","type":"journal-article","created":{"date-parts":[[2024,5,6]],"date-time":"2024-05-06T04:46:45Z","timestamp":1714970805000},"source":"Crossref","is-referenced-by-count":23,"title":["Molecular and Epidemiological Investigation of Fluconazole-resistant\n                    <i>Candida parapsilosis<\/i>\n                    \u2014Georgia, United States, 2021"],"prefix":"10.1093","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6243-7716","authenticated-orcid":false,"given":"Elizabeth","family":"Misas","sequence":"first","affiliation":[{"name":"Mycotic Diseases Branch, Centers for Disease Control and Prevention , Atlanta, Georgia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucy S","family":"Witt","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Emory University School of Medicine , Atlanta, Georgia , USA"},{"name":"Georgia Emerging Infections Program , Atlanta, Georgia , USA"},{"name":"Atlanta Veterans Affairs Medical Center , Atlanta, Georgia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica M","family":"Farley","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Emory University School of Medicine , Atlanta, Georgia , USA"},{"name":"Georgia Emerging Infections Program , Atlanta, Georgia , USA"},{"name":"Atlanta Veterans Affairs Medical Center , Atlanta, Georgia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stepy","family":"Thomas","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Emory University School of Medicine , Atlanta, Georgia , USA"},{"name":"Georgia Emerging Infections Program , Atlanta, Georgia , 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