{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T03:15:45Z","timestamp":1792293345204,"version":"4.4.0"},"reference-count":33,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,3,20]],"date-time":"2020-03-20T00:00:00Z","timestamp":1584662400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003968","name":"Iran National Science Foundation","doi-asserted-by":"publisher","award":["97008852"],"award-info":[{"award-number":["97008852"]}],"id":[{"id":"10.13039\/501100003968","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Nosocomial bloodstream candidaemia is a life\u2010threatening fungal infection with high morbidity and mortality, especially among paediatric patients undergoing intensive immunosuppressive therapy. Limited data on the epidemiology of candidaemia and susceptibility profiles are available for Iran. To characterise candidaemia epidemiology, comorbidity risk factors, species distribution, and antifungal susceptibility profiles among paediatric patients in Iran. This observational cross\u2010sectional study enrolled 26\u00a0189 patients &lt;18\u00a0years old at three reference paediatric hospitals in Mazandaran and Tehran over 2\u00a0years. Blood samples from patients with suspected fungal bloodstream infection were analysed using the BACTEC culture system. Fungal isolates were identified using matrix\u2010assisted laser desorption ionisation time\u2010of\u2010flight mass spectrometry (MALDI\u2010TOF) and DNA sequencing. Antifungal susceptibility testing was performed using the Clinical and Laboratory Standards Institute broth microdilution guideline. We observed 109 episodes of nosocomial candidaemia in paediatric patients with or without immunosuppressive therapy. The most common healthcare\u2010associated factor was central vascular catheter use (97%). The all\u2010cause mortality rate was 40%, of which 48% was attributable to candidaemia. While <jats:italic>Candida albicans<\/jats:italic> was the most frequent causative agent (49%), emerging and uncommon <jats:italic>Candida<\/jats:italic> species were also isolated. Candidaemia mortality by non\u2010<jats:italic>albicans Candida<\/jats:italic> species was significantly higher than that by <jats:italic>C. albicans<\/jats:italic> (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.05). All fluconazole\u2010resistant species were non\u2010<jats:italic>albicans Candida<\/jats:italic> species. Uncommon <jats:italic>Candida<\/jats:italic> species with reduced susceptibility to antifungals are emerging as major agents of nosocomial candidaemia in high\u2010risk paediatric patients in Iran. Appropriate source control, antifungal regimens and improved antifungal stewardship are warranted for managing and decreasing the burden of nosocomial candidaemia.<\/jats:p>","DOI":"10.1111\/myc.13053","type":"journal-article","created":{"date-parts":[[2020,1,27]],"date-time":"2020-01-27T12:18:50Z","timestamp":1580127530000},"page":"382-394","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Epidemiological features of nosocomial candidaemia in neonates, infants and children: A multicentre study in Iran"],"prefix":"10.1111","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3629-7446","authenticated-orcid":false,"given":"Fatemeh","family":"Ahangarkani","sequence":"first","affiliation":[{"name":"Student Research Committee Mazandaran University of Medical Sciences Sari Iran"},{"name":"Invasive Fungi Research Center Mazandaran University of Medical Sciences Sari Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3094-8436","authenticated-orcid":false,"given":"Tahereh","family":"Shokohi","sequence":"additional","affiliation":[{"name":"Invasive Fungi Research Center Mazandaran University of Medical Sciences Sari Iran"},{"name":"Department of Medical Mycology School of Medicine Mazandaran University of Medical Sciences Sari Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4585-9954","authenticated-orcid":false,"given":"Mohammad Sadegh","family":"Rezai","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Diseases Research Center Mazandaran University of Medical Sciences Sari Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1174-4182","authenticated-orcid":false,"given":"Macit","family":"Ilkit","sequence":"additional","affiliation":[{"name":"Division of Mycology Department of Microbiology Faculty of Medicine University of \u00c7ukurova Adana Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hassan","family":"Mahmoodi Nesheli","sequence":"additional","affiliation":[{"name":"Non\u2010Communicable Pediatrics Disease Research Center Babol University of Medical Sciences Babol Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hossein","family":"Karami","sequence":"additional","affiliation":[{"name":"Thalassemia Research Center Hemoglobinopathy Institute Mazandaran University of Medical Sciences Sari Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad","family":"Tamaddoni","sequence":"additional","affiliation":[{"name":"Non\u2010Communicable Pediatrics Disease Research Center Babol University of Medical Sciences Babol Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0580-000X","authenticated-orcid":false,"given":"Reza","family":"Alizadeh\u2010Navaei","sequence":"additional","affiliation":[{"name":"Gastrointestinal Cancer Research Center Mazandaran University of Medical Sciences Sari Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8039-4991","authenticated-orcid":false,"given":"Sadegh","family":"Khodavaisy","sequence":"additional","affiliation":[{"name":"Department of Medical Parasitology and Mycology School of Public Health Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3253-6080","authenticated-orcid":false,"given":"Jacques F.","family":"Meis","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Infectious Diseases Canisius\u2010Wilhelmina Hospital (CWZ) Nijmegen 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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,3,20]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1086\/421946"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.12792"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000002186"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/jpids\/pix046"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0b013e3182737427"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1086\/655698"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000002530"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.12013"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.12714"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2010.06.015"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2019.08.013"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.12956"},{"issue":"3","key":"e_1_2_8_14_1","doi-asserted-by":"crossref","DOI":"10.3390\/jof3030041","article-title":"Strategies 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