{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T15:02:50Z","timestamp":1773068570619,"version":"3.50.1"},"reference-count":29,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T00:00:00Z","timestamp":1711497600000},"content-version":"vor","delay-in-days":26,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Candida species are among the most important invasive pathogens in intensive care units (ICUs). Non\u2010albicans species including <jats:italic>Candida parapsilosis<\/jats:italic> (<jats:italic>C. parapsilosis<\/jats:italic>) has increased in recent years. Fluconazole is the leading antifungal agent but resistance is a concern among <jats:italic>C. parapsilosis<\/jats:italic> species.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The aim of this study was to determine the factors associated with fluconazole resistance in patients with candidemia due to <jats:italic>C. parapsilosis<\/jats:italic> in ICUs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This case\u2013case study was conducted in a 750\u2010bed, tertiary hospital between 2015 and 2021. Patients with fluconazole\u2010resistant <jats:italic>C. parapsilosis<\/jats:italic> candidemia constituted the \u2018cases of interest\u2019 group and patients with fluconazole\u2010susceptible <jats:italic>C. parapsilosis<\/jats:italic> candidemia constituted the \u2018comparison cases\u2019 group. Demographic and clinical data of the patients were recorded. Logistic regression analysis was performed using the backward elimination method to determine the independent predictors of fluconazole\u2010resistant <jats:italic>C. parapsilosis<\/jats:italic> bloodstream infections.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study included 177 patients. In the cultures of these patients, 76 (43%) fluconazole\u2010resistant, 13 (7.3%) fluconazole\u2010reduced susceptible, and 88 (49.7%) fluconazole\u2010susceptible isolates were found. In the regression analysis the risk factors for fluconazole\u2010resistant <jats:italic>C. parapsilosis<\/jats:italic> bloodstream infection, malignancy, immunosuppressive treatment, history of intra\u2010abdominal surgery, hypoalbunemia, previous fluconazole use, and SOFA score were found to be associated in univariate analysis. In multivariate regression analysis, history of intra\u2010abdominal surgery (OR: 2.16; 95% CI: 1.05\u20134.44), hypoalbuminemia (OR: 2.56; 95% CI: 1.06\u20136.17) and previous fluconazole use (OR: 3.35; 95% CI: 1.02\u201311) were found to be independent predictors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this study, a significant correlation was found between candidemia due to fluconazole\u2010resistant <jats:italic>C. parapsilosis<\/jats:italic> in ICUs and intra\u2010abdominal surgery, hypoalbuminemia, and previous fluconazole use. <jats:italic>C. parapsilosis<\/jats:italic> isolates and fluconazole resistance should be continuously monitored, strict infection control measures should be taken and antifungal stewardship programs should be implemented.<\/jats:p><\/jats:sec>","DOI":"10.1111\/myc.13717","type":"journal-article","created":{"date-parts":[[2024,3,28]],"date-time":"2024-03-28T05:22:11Z","timestamp":1711603331000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Risk factors associated with fluconazole resistance in <i>Candida parapsilosis<\/i> candidemia: A case\u2013case study"],"prefix":"10.1111","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9076-428X","authenticated-orcid":false,"given":"Sabri","family":"Atalay","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases and Clinical Microbiology Tepecik Training and Research Hospital  Izmir Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Derya","family":"\u00c7a\u011flayan","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Diyarbak\u0131r Provincial Health Directorate  Diyarbak\u0131r Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eren","family":"Arkal\u0131","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Clinical Microbiology Siirt Training and Research Hospital  Siirt Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ufuk","family":"S\u00f6nmez","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Clinical Microbiology Bozyaka Training and Research Hospital  Izmir Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P\u0131nar","family":"\u015eaml\u0131o\u011flu","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology Tepecik Training and Research Hospital  Izmir Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,3,27]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2019.04.024"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00111\u201018"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/22221751.2022.2153086"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/21505594.2016.1247140"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/jof9010080"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofac605"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid1006.030873"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.7150\/ijms.4707"},{"issue":"2","key":"e_1_2_8_10_1","first-page":"107","article-title":"T\u00fcrkiye'nin Bat\u0131s\u0131nda 3. 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