{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T22:47:53Z","timestamp":1780094873723,"version":"3.54.0"},"reference-count":29,"publisher":"American Society for Microbiology","issue":"2","license":[{"start":{"date-parts":[[2015,2,1]],"date-time":"2015-02-01T00:00:00Z","timestamp":1422748800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2015,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">Candida parapsilosis<\/jats:named-content>\n            is the second or third most common cause of candidemia in many countries. The Infectious Diseases Society of America recommends fluconazole as the primary therapy for\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">C. parapsilosis<\/jats:named-content>\n            candidemia. Although the rate of fluconazole resistance among\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">C. parapsilosis<\/jats:named-content>\n            isolates is low in most U.S. institutions, the resistance rate can be as high as 7.5%. This study was designed to assess the mechanisms of fluconazole resistance in 706 incident bloodstream isolates from U.S. hospitals. We sequenced the\n            <jats:italic>ERG11<\/jats:italic>\n            and\n            <jats:italic>MRR1<\/jats:italic>\n            genes of 122\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">C. parapsilosis<\/jats:named-content>\n            isolates with resistant (30 isolates; 4.2%), susceptible dose-dependent (37 isolates; 5.2%), and susceptible (55 isolates) fluconazole MIC values and used real-time PCR of RNA from 17 isolates to investigate the regulation of\n            <jats:italic>MDR1<\/jats:italic>\n            . By comparing these isolates to fully fluconazole-susceptible isolates, we detected at least two mechanisms of fluconazole resistance: an amino acid substitution in the 14-\u03b1-demethylase gene\n            <jats:italic>ERG11<\/jats:italic>\n            and overexpression of the efflux pump\n            <jats:italic>MDR1<\/jats:italic>\n            , possibly due to point mutations in the\n            <jats:italic>MRR1<\/jats:italic>\n            transcription factor that regulates\n            <jats:italic>MDR1<\/jats:italic>\n            . The\n            <jats:italic>ERG11<\/jats:italic>\n            single nucleotide polymorphism (SNP) was found in 57% of the fluconazole-resistant isolates and in no susceptible isolates. The\n            <jats:italic>MRR1<\/jats:italic>\n            SNPs were more difficult to characterize, as not all resulted in overexpression of\n            <jats:italic>MDR1<\/jats:italic>\n            and not all\n            <jats:italic>MDR1<\/jats:italic>\n            overexpression was associated with an SNP in\n            <jats:italic>MRR1<\/jats:italic>\n            . Further work to characterize the\n            <jats:italic>MRR1<\/jats:italic>\n            SNPs and search for overexpression of other efflux pumps is needed.\n          <\/jats:p>","DOI":"10.1128\/aac.04613-14","type":"journal-article","created":{"date-parts":[[2014,12,2]],"date-time":"2014-12-02T04:56:55Z","timestamp":1417496215000},"page":"1030-1037","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":98,"title":["Molecular Mechanisms of Fluconazole Resistance in Candida parapsilosis Isolates from a U.S. Surveillance System"],"prefix":"10.1128","volume":"59","author":[{"given":"Nina T.","family":"Grossman","sequence":"first","affiliation":[{"name":"Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cau D.","family":"Pham","sequence":"additional","affiliation":[{"name":"Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela A.","family":"Cleveland","sequence":"additional","affiliation":[{"name":"Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shawn R.","family":"Lockhart","sequence":"additional","affiliation":[{"name":"Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.meegid.2012.09.006"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01179-12"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00029-06"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01283-12"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/myc.12206"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0101510"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00013-08"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0b013e3182863a1c"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1086\/596757"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/lt.23467"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis697"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(02)00181-0"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01127-10"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.meegid.2012.06.012"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1471-8286.2003.00351.x"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02300753"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1186\/gb-2007-8-2-r19"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.45.10.2676-2684.2001"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1111\/1567-1364.12042"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2009.11.006"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00477-13"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0378-1097(99)00478-4"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drup.2010.09.002"},{"key":"e_1_3_2_25_2","volume-title":"M27-S4 reference method for broth dilution antifungal susceptibility testing of yeasts; fourth informational supplement","author":"Clinical and Laboratory Standards Institute","year":"2012","unstructured":"Clinical and Laboratory Standards Institute. 2012. 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