{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T19:29:16Z","timestamp":1774380556808,"version":"3.50.1"},"reference-count":39,"publisher":"Microbiology Society","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,8,25]]},"abstract":"<jats:p>\n                  <jats:bold>Introduction.<\/jats:bold> Resistance rates to azoles and echinocandins of <jats:italic>Candida<\/jats:italic> spp. increased over the last decade.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Hypothesis\/Gap Statement.<\/jats:bold> Widespread use of antifungals could lead to development and dissemination of resistant <jats:italic>Candida<\/jats:italic> spp.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Aim.<\/jats:bold> To identify risk factors for isolation of <jats:italic>Candida<\/jats:italic> spp. non-susceptible to either fluconazole or echinocandins.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Methodology.<\/jats:bold> All patients hospitalized in the Intensive Care Unit (ICU) of the University General Hospital of Patras, Greece with <jats:italic>Candida<\/jats:italic> spp. isolated from clinical specimens during a ten-year period (2010\u201319) were included. <jats:italic>Candida<\/jats:italic> isolates were identified using Vitek-2 YST card. Consumption of antifungals was calculated.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Results.<\/jats:bold> During the study period, 253 isolates were included. <jats:italic>C<\/jats:italic>. non-<jats:italic>albicans<\/jats:italic> predominated (64.4\u200a%) with <jats:italic>C. parapsilosis<\/jats:italic> being the most commonly isolated (42.3\u200a%) followed by <jats:italic>C. glabrata<\/jats:italic> (nomenclatural change to <jats:italic>Nakaseomyces glabrataa<\/jats:italic>; 8.7\u200a%) and <jats:italic>C. tropicalis<\/jats:italic> (11.9\u200a%). Among all isolates, 45.8 and 28.5\u200a% were non-susceptible and resistant to fluconazole, respectively. Concerning echinocandins, 8.7\u200a% of isolates were non-susceptible to at least one echinocandin (anidulafungin or micafungin) and 3.1\u200a% resistant. Multivariate analysis revealed that hospitalization during 2015\u201319, as compared to 2010\u201314, isolate being non-<jats:italic>albicans<\/jats:italic> or non-susceptible to at least one echinocandin was associated with isolation of fluconazole non-susceptible isolate. Administration of echinocandin, isolate being <jats:italic>C. glabrata<\/jats:italic> or <jats:italic>C. tropicalis<\/jats:italic>, or <jats:italic>Candida<\/jats:italic> spp. non-susceptible to fluconazole were independently associated with isolation of <jats:italic>Candida<\/jats:italic> spp. non-susceptible to at least one echinocandin. Fluconazole\u2019s administration decreased during the study period, whereas liposomal-amphotericin B\u2019s and echinoncandins\u2019 administration remained stable.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Conclusion.<\/jats:bold> Fluconazole\u2019s non-susceptibility increased during the study period, despite the decrease of its administration. Although echinocandins\u2019 administration remained stable, non-susceptibility among <jats:italic>Candida<\/jats:italic> spp. increased.<\/jats:p>","DOI":"10.1099\/jmm.0.001401","type":"journal-article","created":{"date-parts":[[2021,8,25]],"date-time":"2021-08-25T14:17:27Z","timestamp":1629901047000},"source":"Crossref","is-referenced-by-count":2,"title":["Risk factors for isolation of fluconazole and echinocandin non-susceptible Candida species in critically ill patients"],"prefix":"10.1099","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0565-5105","authenticated-orcid":false,"given":"Matthaios","family":"Papadimitriou-Olivgeris","sequence":"first","affiliation":[{"name":"Present address: Infectious Diseases Service, Lausanne University Hospital, Lausanne, Switzerland"},{"name":"Division of Infectious Diseases, School of Medicine, University of Patras, Patras, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9125-8098","authenticated-orcid":false,"given":"Anastasia","family":"Spiliopoulou","sequence":"additional","affiliation":[{"name":"Department of Microbiology, School of Medicine, University of Patras, Patras, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fotini","family":"Fligou","sequence":"additional","affiliation":[{"name":"Division of Anaesthesiology and Intensive Care Medicine, School of Medicine, University of Patras, Patras, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ekaterini","family":"Tsiata","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, University General Hospital of Patras, Patras, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fevronia","family":"Kolonitsiou","sequence":"additional","affiliation":[{"name":"Department of Microbiology, School of Medicine, University of Patras, Patras, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra","family":"Nikolopoulou","sequence":"additional","affiliation":[{"name":"Division of Anaesthesiology and Intensive Care Medicine, School of Medicine, University of Patras, Patras, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chrysavgi","family":"Papamichail","sequence":"additional","affiliation":[{"name":"Division of Anaesthesiology and Intensive Care Medicine, School of Medicine, University of Patras, Patras, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8478-6378","authenticated-orcid":false,"given":"Iris","family":"Spiliopoulou","sequence":"additional","affiliation":[{"name":"Department of Microbiology, School of Medicine, University of Patras, Patras, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markos","family":"Marangos","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, School of Medicine, University of Patras, Patras, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Myrto","family":"Christofidou","sequence":"additional","affiliation":[{"name":"Department of Microbiology, School of Medicine, University of Patras, Patras, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"345","reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.1754"},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-019-2497-3"},{"key":"R3","doi-asserted-by":"publisher","DOI":"10.1007\/s15010-018-1217-2"},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ933"},{"key":"R5","doi-asserted-by":"publisher","DOI":"10.1111\/1469-0691.12037"},{"key":"R6","doi-asserted-by":"publisher","DOI":"10.1111\/myc.12206"},{"key":"R7","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkx444"},{"key":"R8","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofy358"},{"key":"R9","doi-asserted-by":"publisher","DOI":"10.1111\/j.1439-0507.2011.02069.x"},{"key":"R10","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofx253"},{"key":"R11","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01811-20"},{"key":"R12","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-019-03713-w"},{"key":"R13","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01516-19"},{"key":"R14","doi-asserted-by":"publisher","DOI":"10.1007\/s15010-017-1050-z"},{"key":"R15","volume-title":"Reference Method for Broth Dilution Antifungal Susceptibility Testing of Yeasts","year":"2012"},{"key":"R16","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02432-15"},{"key":"R17","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00512-17"},{"key":"R18","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.000383"},{"key":"R19","article-title":"Guidelines for ATC classification and DDD assignment. 2021. 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