{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T04:05:55Z","timestamp":1779681955495,"version":"3.53.1"},"reference-count":57,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,4,26]],"date-time":"2026-04-26T00:00:00Z","timestamp":1777161600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,26]],"date-time":"2026-04-26T00:00:00Z","timestamp":1777161600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003841","name":"Ilam University of Medical Sciences","doi-asserted-by":"publisher","award":["IR.MEDILAM.REC.1403.191"],"award-info":[{"award-number":["IR.MEDILAM.REC.1403.191"]}],"id":[{"id":"10.13039\/501100003841","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Wound Journal"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Diabetic foot ulcers (DFUs) are one of the most serious and common complications that, if not treated properly, can lead to potential damage and even amputation. The aim of this systematic review and meta\u2010analysis was to assess the drug\u2010resistant\n                    <jats:italic>Candida<\/jats:italic>\n                    species in DFU. PubMed, Web of Science, Scopus and Google Scholar databases were systematically searched for eligible articles up to 22 June 2024. All articles on\n                    <jats:italic>Candida<\/jats:italic>\n                    diabetic foot infections that reported data on drug resistance were included in the study. In addition to general information, data on the type and number of fungi and the percentage of resistance to each drug were collected for analysis. A total of 238 studies were screened and finally, 16 articles were selected and analysed.\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>Candida albicans<\/jats:italic>\n                    <\/jats:styled-content>\n                    was the most frequently isolated species in DFUs, followed by\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>Candida tropicalis<\/jats:italic>\n                    <\/jats:styled-content>\n                    and\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>Candida parapsilosis<\/jats:italic>\n                    <\/jats:styled-content>\n                    . For antifungal agents, the highest resistance was reported to Nystatin (32.48%,\n                    <jats:italic>p<\/jats:italic>\n                    \u2010value\u2009=\u20090.30), Itraconazole (19.46%,\n                    <jats:italic>p<\/jats:italic>\n                    \u2010value\u2009=\u20090.001) and Fluconazole (16.4%,\n                    <jats:italic>p<\/jats:italic>\n                    \u2010value\u2009=\u20090.001). Miconazole (1.18%,\n                    <jats:italic>p<\/jats:italic>\n                    \u2010value\u2009=\u20090.54) and Caspofungin (4.69%,\n                    <jats:italic>p<\/jats:italic>\n                    \u2010value\u2009=\u20090.01) had the lowest resistance rates. For all drugs, resistance was higher in\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>C. albicans<\/jats:italic>\n                    <\/jats:styled-content>\n                    than in non\u2010\n                    <jats:italic>albicans<\/jats:italic>\n                    . This study found that antifungal drug resistance in\n                    <jats:italic>Candida<\/jats:italic>\n                    species is high in patients with DFUs, especially to itraconazole and fluconazole. Caspofungin, micafungin and voriconazole were more effective. Antifungal treatment in these patients should prioritize agents with lower resistance rates to improve outcomes and reduce the risk of treatment failure.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Protocol Registration:<\/jats:bold>\n                    PROSPERO\u2014CRD42024567133.\n                  <\/jats:p>","DOI":"10.1111\/iwj.70900","type":"journal-article","created":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T06:18:40Z","timestamp":1777270720000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["<scp>\n                      <i>Candida<\/i>\n                    <\/scp>\n                    Drug Resistance in Patients With Diabetic Foot Ulcers: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"23","author":[{"given":"Mohammad Hossein","family":"Ekvan","sequence":"first","affiliation":[{"name":"Student Research Committee Ilam University of Medical Sciences  Ilam Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hojjat","family":"Sayyadi","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, School of Health, Non\u2010Communicable Diseases Research Center Ilam University of Medical Sciences  Ilam Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarina","family":"Alidadpour","sequence":"additional","affiliation":[{"name":"Student Research Committee Ilam University of Medical Sciences  Ilam Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masoume","family":"Karimi","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Faculty of Health Ilam University of Medical Sciences  Ilam Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0752-702X","authenticated-orcid":false,"given":"Muhammad Ibrahim","family":"Getso","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Parasitology, College of Health Sciences Bayero University  Kano Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad Reza","family":"Ebrahimi","sequence":"additional","affiliation":[{"name":"Student Research Committee Ilam University of Medical Sciences  Ilam Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Mirpanahi","sequence":"additional","affiliation":[{"name":"Student Research Committee Ilam University of Medical Sciences  Ilam Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2382-550X","authenticated-orcid":false,"given":"Omid","family":"Raiesi","sequence":"additional","affiliation":[{"name":"Department of Parasitology, School of Allied Medical Sciences Ilam University of Medical Sciences  Ilam Iran"},{"name":"Zoonotic Diseases Research Center Ilam University of Medical Sciences  Ilam Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,26]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc10-S062"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.5812\/jjm.11680"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1615439"},{"issue":"10","key":"e_1_2_13_5_1","first-page":"22.9","article-title":"Evaluation and Management of Diabetic Foot According to Wagner's Classification a Study of 100 Cases","volume":"66","author":"Rooh\u2010Ul\u2010Muqim S. 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