{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T10:25:27Z","timestamp":1787826327014,"version":"build-2784847793"},"reference-count":38,"publisher":"American Society for Microbiology","issue":"4","license":[{"start":{"date-parts":[[2017,4,1]],"date-time":"2017-04-01T00:00:00Z","timestamp":1491004800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2017,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            Few data on breakthrough candidemia (BC), defined as candidemia that develops on administration of antifungal agents (AFAs), in allogeneic hematopoietic stem cell transplant (allo-HSCT) recipients are available. The medical and microbiological records of recipients of an allo-HSCT obtained between December 2008 and December 2014 were reviewed. Of 768 allo-HSCT cases, 26 developed BC. Among the 26 causative strains, 22 strains were stored and identified by sequencing. The following species were isolated:\n            <jats:named-content content-type=\"genus-species\">Candida parapsilosis<\/jats:named-content>\n            (9 strains),\n            <jats:named-content content-type=\"genus-species\">C. glabrata<\/jats:named-content>\n            (4 strains),\n            <jats:named-content content-type=\"genus-species\">C. guilliermondii<\/jats:named-content>\n            (3 strains), and other\n            <jats:named-content content-type=\"genus-species\">Candida<\/jats:named-content>\n            species (6 strains). The AFAs being used when BC developed were micafungin (17 cases), liposomal amphotericin B (5 cases), itraconazole (2 cases), and voriconazole (2 cases). All 17 cases who developed BC during micafungin administration were administered 150 mg\/day of micafungin. The susceptibilities of the causative\n            <jats:named-content content-type=\"genus-species\">Candida<\/jats:named-content>\n            species to the administered AFAs when breakthrough occurred ranged from susceptible to resistant. Especially, 85% of the\n            <jats:named-content content-type=\"genus-species\">Candida<\/jats:named-content>\n            species that caused BC during micafungin administration were susceptible to micafungin. Additionally, 75% of the strains were wild type for susceptibility to the administered AFAs when breakthrough occurred. Systemic steroid administration and a longer severe neutropenic phase (\u22655 days) were independent risk factors for BC (\n            <jats:italic>P<\/jats:italic>\n            = 0.016 and\n            <jats:italic>P<\/jats:italic>\n            = 0.015, respectively). BC developed in allo-HSCT recipients even when they received a sufficient dose of AFA, including micafungin, to which the causative\n            <jats:named-content content-type=\"genus-species\">Candida<\/jats:named-content>\n            species were susceptible and\/or had wild-type susceptibility\n            <jats:italic>in vitro<\/jats:italic>\n            . Systemic steroid administration and a longer severe neutropenic phase were host-based factors associated with BC.\n          <\/jats:p>","DOI":"10.1128\/aac.01791-16","type":"journal-article","created":{"date-parts":[[2017,1,24]],"date-time":"2017-01-24T02:40:19Z","timestamp":1485225619000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":24,"title":["Clinical and Microbiological Characteristics of Breakthrough Candidemia in Allogeneic Hematopoietic Stem Cell Transplant Recipients in a Japanese Hospital"],"prefix":"10.1128","volume":"61","author":[{"given":"Muneyoshi","family":"Kimura","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Toranomon Hospital, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideki","family":"Araoka","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Toranomon Hospital, Tokyo, Japan"},{"name":"Okinaka 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