{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T20:33:59Z","timestamp":1790195639649,"version":"4.1.0"},"reference-count":37,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,11,15]],"date-time":"2024-11-15T00:00:00Z","timestamp":1731628800000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Worldwide emergence of clonal outbreaks caused by fluconazole\u2010resistant (FLCR) and the recent emergence of echinocandin\u2010 and multidrug\u2010resistant (ECR and MDR) <jats:styled-content style=\"fixed-case\"><jats:italic>Candida parapsilosis<\/jats:italic><\/jats:styled-content> isolates pose serious threats to modern clinics. Conducting large\u2010scale epidemiological studies aimed at determining the genetic composition and antifungal resistance rates is necessary to devise antifungal stewardship and infection control strategies at international, national and local levels. Despite being severely hit by outbreaks due to FLCR <jats:styled-content style=\"fixed-case\"><jats:italic>C.\u2009parapsilosis<\/jats:italic><\/jats:styled-content> isolates, such knowledge at the national level is lacking in T\u00fcrkiye. Herein, we conducted a prospective multicentre study involving five major clinical centres in T\u00fcrkiye to determine antifungal resistance rates, underlying mechanisms and genetic composition of all isolates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In total, 341 isolates were collected from 265 patients including clinical information. Antifungal susceptibility testing against common antifungals was performed in addition to sequencing of <jats:italic>ERG11<\/jats:italic> and <jats:italic>FKS1<\/jats:italic>. Last, isolates were genotyped with short tandem repeat (STR) genotyping to investigate potential nosocomial transmission.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The FLCR rate was 26.7% (91\/341), out of which 75.8% (69\/91) harboured the <jats:italic>ERG11<\/jats:italic><jats:sup><jats:italic>Y132F<\/jats:italic><\/jats:sup> mutation. Patients infected with FLCR isolates had a higher mortality rate compared to their susceptible counterparts (49% for FLCR vs. 42% for susceptible). ECR rate was 2.1% (7\/341) and isolates carried <jats:italic>FKS1<\/jats:italic><jats:sup><jats:italic>F652L\/R658G\/W1370R<\/jats:italic><\/jats:sup> mutations. Concerningly, four ECR isolates were MDR. FLCR isolates grouped in distinct clusters without evidence of inter\u2010hospital transmission, whereas large clusters containing susceptible isolates from all centres were noted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Overall, the increasing prevalence of FLCR <jats:styled-content style=\"fixed-case\"><jats:italic>C.\u2009parapsilosis<\/jats:italic><\/jats:styled-content> at national level and the emergence of ECR and MDR isolates pose serious clinical challenges in T\u00fcrkiye. Therefore, conducting large\u2010scale epidemiological studies are critical to determine the trend of antifungal resistance and to tailor pertinent antifungal stewardship and infection control strategies to effectively curb the spread of drug\u2010resistant <jats:styled-content style=\"fixed-case\"><jats:italic>C.\u2009parapsilosis<\/jats:italic><\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/myc.70000","type":"journal-article","created":{"date-parts":[[2024,11,16]],"date-time":"2024-11-16T03:34:37Z","timestamp":1731728077000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Multicentre Study of <i>Candida parapsilosis<\/i> Blood Isolates in T\u00fcrkiye Highlights an Increasing Rate of Fluconazole Resistance and Emergence of Echinocandin and Multidrug Resistance"],"prefix":"10.1111","volume":"67","author":[{"given":"Nevzat","family":"\u00dcnal","sequence":"first","affiliation":[{"name":"Division of Mycology, Department of Microbiology, Faculty of Medicine \u00c7ukurova University  Adana Turkey"},{"name":"Adana City Training and Research Hospital, Laboratory of Medical Microbiology University of Health Sciences  Adana Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bram","family":"Spruijtenburg","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology Radboudumc  Nijmegen The Netherlands"},{"name":"Radboudumc\u2010CWZ Center of Expertise for Mycology  Nijmegen The Netherlands"},{"name":"Department of Medical Microbiology and Immunology Canisius\u2010Wilhelmina Hospital (CWZ)\/Dicoon  Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir","family":"Arastehfar","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Massachusetts General Hospital, Harvard Medical School  Boston Massachusetts USA"},{"name":"Department of Medicine Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramazan","family":"G\u00fcmral","sequence":"additional","affiliation":[{"name":"Division of Mycology, Department of Microbiology, Gulhane Training and Research Hospital University of Health Sciences  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theun","family":"de Groot","sequence":"additional","affiliation":[{"name":"Radboudumc\u2010CWZ Center of Expertise for Mycology  Nijmegen The Netherlands"},{"name":"Department of Medical Microbiology and Immunology Canisius\u2010Wilhelmina Hospital (CWZ)\/Dicoon  Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eelco F. J.","family":"Meijer","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology Radboudumc  Nijmegen The Netherlands"},{"name":"Radboudumc\u2010CWZ Center of Expertise for Mycology  Nijmegen The Netherlands"},{"name":"Department of Medical Microbiology and Immunology Canisius\u2010Wilhelmina Hospital (CWZ)\/Dicoon  Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hatice","family":"T\u00fcrk\u2010Da\u011f\u0131","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Faculty of Medicine Selcuk University  Konya Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asuman","family":"Birinci","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Faculty of Medicine Ondokuz May\u0131s University  Samsun Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8850-2715","authenticated-orcid":false,"given":"S\u00fcleyha","family":"Hilmio\u011flu\u2010Polat","sequence":"additional","affiliation":[{"name":"Department of Microbiology Ege University Faculty of Medicine  Izmir Turkey"}],"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 Radboudumc  Nijmegen The Netherlands"},{"name":"Radboudumc\u2010CWZ Center of Expertise for Mycology  Nijmegen The Netherlands"},{"name":"Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Response in Aging\u2010Associated Diseases (CECAD), Excellence Center for Medical Mycology (ECMM) University of Cologne  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2946-7785","authenticated-orcid":false,"given":"Cornelia","family":"Lass\u2010Fl\u00f6rl","sequence":"additional","affiliation":[{"name":"Medical University of Innsbruck  Innsbruck Austria"}],"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 \u00c7ukurova University  Adana Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,11,15]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofac097"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473\u20103099(23)00692\u20108"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10096\u2010018\u20103312\u20109"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/jof6030138"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkx444"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2666\u20105247(23)00067\u20108"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofae264"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkz029"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/22221751.2024.2322655"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/jof8090931"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/22221751.2022.2153086"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkad112"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkaa419"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.3390\/jof7040259"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2021.676177"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2020.00232"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010018\u201037855\u20102"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2666\u20105247(23)00294\u2010X"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00262\u201008"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2023.106831"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1080\/22221751.2022.2117093"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00651\u201017"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.3109\/13693786.2012.745953"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.13296"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01001\u201020"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00389\u201009"},{"key":"e_1_2_7_28_1","volume-title":"Reference Method for Broth Dilution Antifungal Susceptibility Testing of Yeasts; 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