{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T23:30:17Z","timestamp":1790638217593,"version":"4.1.0"},"reference-count":30,"publisher":"American Society for Microbiology","issue":"11","license":[{"start":{"date-parts":[[2023,11,15]],"date-time":"2023-11-15T00:00:00Z","timestamp":1700006400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/doi.org\/10.1128\/ASMCopyrightv2"},{"start":{"date-parts":[[2023,11,15]],"date-time":"2023-11-15T00:00:00Z","timestamp":1700006400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"name":"MEC | Instituto de Salud Carlos III","award":["PI18\/01155"],"award-info":[{"award-number":["PI18\/01155"]}]},{"name":"MEC | Instituto de Salud Carlos III","award":["PI19\/00074"],"award-info":[{"award-number":["PI19\/00074"]}]},{"name":"EC | European Regional Development Fund"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2023,11,15]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    We previously conducted a multicenter surveillance study on\n                    <jats:italic>Candida<\/jats:italic>\n                    epidemiology and antifungal resistance in Madrid (CANDIMAD study; 2019\u20132021), detecting an increase in fluconazole-resistant\n                    <jats:italic>Candida parapsilosis<\/jats:italic>\n                    . We here present data on isolates collected in 2022. Furthermore, we report the epidemiology and antifungal resistance trends during the entire period, including an analysis per ward of admission.\n                    <jats:italic>Candida<\/jats:italic>\n                    spp. incident isolates from blood cultures and intra-abdominal samples from patients cared for at 16 hospitals in Madrid, Spain, were tested with the EUCAST E.Def 7.3.2 method against amphotericin B, azoles, micafungin, anidulafungin, and ibrexafungerp and were molecularly characterized. In 2022, we collected 766\n                    <jats:italic>Candida<\/jats:italic>\n                    sp. isolates (686 patients; blood cultures, 48.8%).\n                    <jats:italic>Candida albicans<\/jats:italic>\n                    was the most common species found, and\n                    <jats:italic>Candida auris<\/jats:italic>\n                    was undetected. No resistance to amphotericin B was found. Overall, resistance to echinocandins was low (0.7%), whereas fluconazole resistance was 12.0%, being higher in blood cultures (16.0%) mainly due to fluconazole-resistant\n                    <jats:italic>C. parapsilosis<\/jats:italic>\n                    clones harboring the Y132F-R398I ERG11p substitutions. Ibrexafungerp showed\n                    <jats:italic>in vitro<\/jats:italic>\n                    activity against the isolates tested. Whereas\n                    <jats:italic>C. albicans<\/jats:italic>\n                    was the dominant species in most hospital wards, we observed increasing\n                    <jats:italic>C. parapsilosis<\/jats:italic>\n                    proportions in blood. During the entire period, echinocandin resistance rates remained steadily low, while fluconazole resistance increased in blood from 6.8% (2019) to 16% (2022), mainly due to fluconazole-resistant\n                    <jats:italic>C. parapsilosis<\/jats:italic>\n                    (2.6% in 2019 to 36.6% in 2022). Up to 7 out of 16 hospitals were affected by fluconazole-resistant\n                    <jats:italic>C. parapsilosis<\/jats:italic>\n                    . In conclusion, rampant clonal spreading of\n                    <jats:italic>C. parapsilosis<\/jats:italic>\n                    fluconazole-resistant genotypes is taking place in Madrid.\n                  <\/jats:p>","DOI":"10.1128\/aac.00986-23","type":"journal-article","created":{"date-parts":[[2023,10,18]],"date-time":"2023-10-18T08:43:29Z","timestamp":1697618609000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":37,"title":["Trends in antifungal resistance in\n                    <i>Candida<\/i>\n                    from a multicenter study conducted in Madrid (CANDIMAD study): fluconazole-resistant\n                    <i>C. parapsilosis<\/i>\n                    spreading has gained traction in 2022"],"prefix":"10.1128","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7216-8281","authenticated-orcid":true,"given":"Judith","family":"D\u00edaz-Garc\u00eda","sequence":"first","affiliation":[{"name":"Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Mara\u00f1\u00f3n , Madrid, Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n , Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Machado","sequence":"additional","affiliation":[{"name":"Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Mara\u00f1\u00f3n , Madrid, Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n , Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"Alcal\u00e1","sequence":"additional","affiliation":[{"name":"Clinical Microbiology and Infectious Diseases, Hospital 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