{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T05:51:39Z","timestamp":1788328299662,"version":"build-2803163510"},"reference-count":50,"publisher":"American Society for Microbiology","issue":"1","license":[{"start":{"date-parts":[[2024,1,17]],"date-time":"2024-01-17T00:00:00Z","timestamp":1705449600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/doi.org\/10.1128\/ASMCopyrightv2"},{"start":{"date-parts":[[2024,1,17]],"date-time":"2024-01-17T00:00:00Z","timestamp":1705449600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"name":"Ontario Agency for Health Protection and Promotion","award":["Routine Operational Work - Outbreak Support"],"award-info":[{"award-number":["Routine Operational Work - Outbreak Support"]}]},{"DOI":"10.13039\/100011094","name":"Public Health Agency of Canada","doi-asserted-by":"crossref","award":["Genomic Research and Development Initiative (GRDI) Round 7"],"award-info":[{"award-number":["Genomic Research and Development Initiative (GRDI) Round 7"]}],"id":[{"id":"10.13039\/100011094","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"published-print":{"date-parts":[[2024,1,17]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    <jats:italic>Candida parapsilosis<\/jats:italic>\n                    is a common cause of non\n                    <jats:italic>-<\/jats:italic>\n                    albicans candidemia. It can be transmitted in healthcare settings resulting in serious healthcare-associated infections and can develop drug resistance to commonly used antifungal agents. Following a significant increase in the percentage of fluconazole (FLU)-nonsusceptible isolates from sterile site specimens of patients in two Ontario acute care hospital networks, we used whole genome sequence (WGS) analysis to retrospectively investigate the genetic relatedness of isolates and to assess potential in-hospital spread. Phylogenomic analysis was conducted on all 19 FLU-resistant and seven susceptible-dose dependent (SDD) isolates from the two hospital networks, as well as 13 FLU susceptible\n                    <jats:italic>C. parapsilosis<\/jats:italic>\n                    isolates from the same facilities and 20 isolates from patients not related to the investigation. Twenty-five of 26 FLU-nonsusceptible isolates (resistant or SDD) and two susceptible isolates from the two hospital networks formed a phylogenomic cluster that was highly similar genetically and distinct from other isolates. The results suggest the presence of a persistent strain of FLU-nonsusceptible\n                    <jats:italic>C. parapsilosis<\/jats:italic>\n                    causing infections over a 5.5-year period. Results from WGS were largely comparable to microsatellite typing. Twenty-seven of 28 cluster isolates had a K143R substitution in lanosterol 14-\u03b1-demethylase (ERG11) associated with azole resistance. As the first report of a healthcare-associated outbreak of FLU-nonsusceptible\n                    <jats:italic>C. parapsilosis<\/jats:italic>\n                    in Canada, this study underscores the importance of monitoring local antimicrobial resistance trends and demonstrates the value of WGS analysis to detect and characterize clusters and outbreaks. Timely access to genomic epidemiological information can inform targeted infection control measures.\n                  <\/jats:p>","DOI":"10.1128\/jcm.01161-23","type":"journal-article","created":{"date-parts":[[2023,12,19]],"date-time":"2023-12-19T10:15:52Z","timestamp":1702980952000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":20,"title":["First Canadian report of transmission of fluconazole-resistant\n                    <i>Candida parapsilosis<\/i>\n                    within two hospital networks confirmed by genomic analysis"],"prefix":"10.1128","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-4073-3265","authenticated-orcid":false,"given":"Lisa R.","family":"McTaggart","sequence":"first","affiliation":[{"name":"Public Health Ontario, Toronto, Ontario, 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