{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T07:59:04Z","timestamp":1791273544659,"version":"4.1.0"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2016,11,11]],"date-time":"2016-11-11T00:00:00Z","timestamp":1478822400000},"content-version":"vor","delay-in-days":680,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Background. \u2003Echinocandins are first-line treatment for Candida glabrata candidemia. Echinocandin resistance is concerning due to limited remaining treatment options. We used data from a multisite, population-based surveillance program to describe the epidemiology and risk factors for echinocandin nonsusceptible (NS) C glabrata candidemia.<\/jats:p>\n               <jats:p>Methods. \u2003The Centers for Disease Control and Prevention's Emerging Infections Program conducts population-based laboratory surveillance for candidemia in 4 metropolitan areas (7.9 million persons; 80 hospitals). We identified C glabrata cases occurring during 2008\u20132014; medical records of cases were reviewed, and C glabrata isolates underwent broth microdilution antifungal susceptibility testing. We defined echinocandin-NS C glabrata (intermediate or resistant) based on 2012 Clinical and Laboratory Standards Institute minimum inhibitory concentration breakpoints. Independent risk factors for NS C glabrata were determined by stepwise logistic regression.<\/jats:p>\n               <jats:p>Results. \u2003Of 1385 C glabrata cases, 83 (6.0%) had NS isolates (19 intermediate and 64 resistant); the proportion of NS isolates rose from 4.2% in 2008 to 7.8% in 2014 (P &amp;lt; .001). The proportion of NS isolates at each hospital ranged from 0% to 25.8%; 3 large, academic hospitals accounted for almost half of all NS isolates. In multivariate analysis, prior echinocandin exposure (adjusted odds ratio [aOR], 5.3; 95% CI, 2.6\u20131.2), previous candidemia episode (aOR, 2.5; 95% CI, 1.2\u20135.1), hospitalization in the last 90 days (aOR, 1.9; 95% CI, 1.0\u20133.5, and fluconazole resistance [aOR, 3.6; 95% CI, 2.0\u20136.4]) were significantly associated with NS C glabrata. Fifty-nine percent of NS C glabrata cases had no known prior echinocandin exposure.<\/jats:p>\n               <jats:p>Conclusion. \u2003The proportion of NS C glabrata isolates rose significantly during 2008\u20132014, and NS C glabrata frequency differed across hospitals. In addition to acquired resistance resulting from prior drug exposure, occurrence of NS C glabrata without prior echinocandin exposure suggests possible transmission of resistant organisms.<\/jats:p>","DOI":"10.1093\/ofid\/ofv163","type":"journal-article","created":{"date-parts":[[2015,12,15]],"date-time":"2015-12-15T02:04:10Z","timestamp":1450145050000},"source":"Crossref","is-referenced-by-count":168,"title":["Epidemiology and Risk Factors for Echinocandin Nonsusceptible Candida glabrata Bloodstream Infections: Data From a Large Multisite Population-Based Candidemia Surveillance Program, 2008\u20132014"],"prefix":"10.1093","volume":"2","author":[{"given":"Snigdha","family":"Vallabhaneni","sequence":"first","affiliation":[{"name":"Epidemic Intelligence Service, Centers for Disease Control and Prevention"},{"name":"Mycotic Diseases Branch, Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela A.","family":"Cleveland","sequence":"additional","affiliation":[{"name":"Mycotic Diseases Branch, Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica M.","family":"Farley","sequence":"additional","affiliation":[{"name":"Department of Medicine, Emory University School of Medicine, Atlanta, Georgia"},{"name":"Atlanta Veterans Affairs Medical Center, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee H.","family":"Harrison","sequence":"additional","affiliation":[{"name":"Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Schaffner","sequence":"additional","affiliation":[{"name":"Vanderbilt University School of Medicine, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zintar G.","family":"Beldavs","sequence":"additional","affiliation":[{"name":"Acute and Communicable Disease Prevention, Oregon Health Authority, Portland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gordana","family":"Derado","sequence":"additional","affiliation":[{"name":"Biostatistics and Information Management Office, Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cau D.","family":"Pham","sequence":"additional","affiliation":[{"name":"Mycotic Diseases Branch, Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shawn R.","family":"Lockhart","sequence":"additional","affiliation":[{"name":"Mycotic Diseases Branch, Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel M.","family":"Smith","sequence":"additional","affiliation":[{"name":"Mycotic Diseases Branch, Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2015,12,14]]},"reference":[{"key":"2020081009464309900_OFV163C1","doi-asserted-by":"crossref","first-page":"1198","DOI":"10.1056\/NEJMoa1306801","article-title":"Multistate point-prevalence survey of health care-associated infections","volume":"370","author":"Magill","year":"2014","journal-title":"N Engl J 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