{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T15:24:44Z","timestamp":1790954684897,"version":"4.1.0"},"reference-count":30,"publisher":"American Society for Microbiology","issue":"5","license":[{"start":{"date-parts":[[2012,5,1]],"date-time":"2012-05-01T00:00:00Z","timestamp":1335830400000},"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":[[2012,5]]},"abstract":"ABSTRACT<\/jats:title>\n \n Recent exposure to azoles is an important risk factor for infection with fluconazole-resistant\n Candida<\/jats:named-content>\n spp., but little is known about the role of antibacterial drug exposure in the emergence of drug-resistant\n Candida<\/jats:named-content>\n . We did a prospective nationwide surveillance study of candidemia in Israel and analyzed the propensity score-adjusted association between antifungal and antibacterial drug exposure and bloodstream infection with\n C. glabrata<\/jats:named-content>\n and fluconazole-resistant\n Candida<\/jats:named-content>\n isolates. Four hundred forty-four episodes of candidemia (450\n Candida<\/jats:named-content>\n isolates, 69 [15%]\n C. glabrata<\/jats:named-content>\n isolates, and 38 [8.5%] fluconazole-resistant isolates) from 18 medical centers in Israel were included.\n C. glabrata<\/jats:named-content>\n bloodstream infection was strongly associated with recent metronidazole exposure (odds ratio [OR], 3.2;\n P<\/jats:italic>\n < 0.001). Infection with a fluconazole-resistant isolate was associated with exposure to carbapenems, trimethoprim-sulfamethoxazole, clindamycin, and colistin (odds ratio, 2.8;\n P<\/jats:italic>\n = 0.01). The inclusion of antibacterial drug exposure in a multivariable model significantly enhanced the model's predictive accuracy for fluconazole-resistant\n Candida<\/jats:named-content>\n bloodstream infection. Our findings may be relevant to the selection of empirical antifungal treatment and broaden the scope of antibiotic-associated collateral damage.\n <\/jats:p>","DOI":"10.1128\/aac.05947-11","type":"journal-article","created":{"date-parts":[[2012,2,7]],"date-time":"2012-02-07T05:51:54Z","timestamp":1328593914000},"page":"2518-2523","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":152,"title":["Antibiotic Exposure as a Risk Factor for Fluconazole-Resistant Candida Bloodstream Infection"],"prefix":"10.1128","volume":"56","author":[{"given":"Ronen","family":"Ben-Ami","sequence":"first","affiliation":[{"name":"Tel Aviv Sourasky Medical Center, Tel Aviv"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keren","family":"Olshtain-Pops","sequence":"additional","affiliation":[{"name":"Hadassah-Hebrew University Medical Center, Jerusalem"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michal","family":"Krieger","sequence":"additional","affiliation":[{"name":"Chaim Sheba Medical Center, Tel Hashomer"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilana","family":"Oren","sequence":"additional","affiliation":[{"name":"Rambam Medical Center, Haifa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jihad","family":"Bishara","sequence":"additional","affiliation":[{"name":"Rabin Medical Center and Schneider Children's Hospital, Petah Tikva"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Dan","sequence":"additional","affiliation":[{"name":"Wolfson Medical Center, Holon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yonit","family":"Wiener-Well","sequence":"additional","affiliation":[{"name":"Shaare Zedek Medical Center, Jerusalem"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Weinberger","sequence":"additional","affiliation":[{"name":"Assaf Harofeh Medical Center, Zerifin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oren","family":"Zimhony","sequence":"additional","affiliation":[{"name":"Kaplan Medical Center, Rehovot"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michal","family":"Chowers","sequence":"additional","affiliation":[{"name":"Meir Medical Center, Kfar Saba"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Weber","sequence":"additional","affiliation":[{"name":"Carmel Medical Center, Haifa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Israel","family":"Potasman","sequence":"additional","affiliation":[{"name":"Bnai Zion Medical Center, Haifa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bibiana","family":"Chazan","sequence":"additional","affiliation":[{"name":"Emek Medical Center, Afula, and Ziv Medical Center, Zefat, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Imad","family":"Kassis","sequence":"additional","affiliation":[{"name":"Rambam Medical Center, Haifa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Itamar","family":"Shalit","sequence":"additional","affiliation":[{"name":"Rabin Medical Center and Schneider Children's Hospital, Petah Tikva"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin","family":"Block","sequence":"additional","affiliation":[{"name":"Hadassah-Hebrew University Medical Center, Jerusalem"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"Keller","sequence":"additional","affiliation":[{"name":"Chaim Sheba Medical Center, Tel Hashomer"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios P.","family":"Kontoyiannis","sequence":"additional","affiliation":[{"name":"M. D. Anderson Cancer Center, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Giladi","sequence":"additional","affiliation":[{"name":"Tel Aviv Sourasky Medical Center, Tel Aviv"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the Israeli Candidemia Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1007\/s10096-003-0947-x","article-title":"Antifungal activity of nonantifungal drugs","volume":"22","author":"Afeltra J","year":"2003","unstructured":"AfeltraJ VerweijPE. 2003. Antifungal activity of nonantifungal drugs. Eur. J. Clin. Microbiol. Infect. Dis. 22:397\u2013407.","journal-title":"Eur. J. Clin. Microbiol. Infect. 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