{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T03:24:38Z","timestamp":1790479478575,"version":"4.1.0"},"reference-count":26,"publisher":"American Society for Microbiology","issue":"12","license":[{"start":{"date-parts":[[2011,12,1]],"date-time":"2011-12-01T00:00:00Z","timestamp":1322697600000},"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":["J Clin Microbiol"],"published-print":{"date-parts":[[2011,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            Data on fungemia epidemiology and antifungal susceptibility of isolates from children are scarce, leading frequently to pediatric empirical treatment based on available adult data. The present study was designed to update the epidemiological, mycological, and\n            <jats:named-content content-type=\"genus-species\">in vitro<\/jats:named-content>\n            susceptibility data on fungal isolates from children with fungemia in Spain. All fungemia episodes were identified prospectively by blood culture over 13 months at 30 hospitals. Tests of susceptibility to amphotericin B, flucytosine, fluconazole, itraconazole, posaconazole, voriconazole, anidulafungin, caspofungin, and micafungin were performed at participant institutions by a microdilution colorimetric method. New species-specific clinical breakpoints for fluconazole, voriconazole, and echinocandins were also applied. A total of 203 episodes of fungemia in 200 children were identified. A higher proportion of fungal isolates was from general wards than intensive care units (ICU).\n            <jats:named-content content-type=\"genus-species\">Candida parapsilosis<\/jats:named-content>\n            (46.8%),\n            <jats:named-content content-type=\"genus-species\">Candida albicans<\/jats:named-content>\n            (36.5%),\n            <jats:named-content content-type=\"genus-species\">Candida tropicalis<\/jats:named-content>\n            (5.9%),\n            <jats:named-content content-type=\"genus-species\">Candida glabrata<\/jats:named-content>\n            (3.9%), and\n            <jats:named-content content-type=\"genus-species\">Candida guilliermondii<\/jats:named-content>\n            (2.5%) were the leading species.\n            <jats:named-content content-type=\"genus-species\">C. parapsilosis<\/jats:named-content>\n            was the predominant species except in neonates.\n            <jats:named-content content-type=\"genus-species\">C. albicans<\/jats:named-content>\n            was the most frequent in neonatal ICU settings (51.9%). Intravascular catheter (79.3%), surgery (35%), prematurity (30%), and neutropenia (11%) were the most frequent predisposing factors. Most\n            <jats:italic>Candida<\/jats:italic>\n            isolates (95.1%) were susceptible to all antifungals. When the new species-specific clinical breakpoints were applied, all\n            <jats:named-content content-type=\"genus-species\">C. parapsilosis<\/jats:named-content>\n            isolates were susceptible to echinocandins except one, which was micafungin resistant. This is the largest published series of fungemia episodes in the pediatric setting.\n            <jats:named-content content-type=\"genus-species\">C. parapsilosis<\/jats:named-content>\n            is the most prevalent species in Spain, followed by\n            <jats:named-content content-type=\"genus-species\">C. albicans<\/jats:named-content>\n            and\n            <jats:named-content content-type=\"genus-species\">C. tropicalis<\/jats:named-content>\n            . Resistance to azole and echinocandin agents is extremely rare among\n            <jats:italic>Candida<\/jats:italic>\n            species. The fluconazole resistance rate in Spain has decreased in the last 10 years.\n          <\/jats:p>","DOI":"10.1128\/jcm.05474-11","type":"journal-article","created":{"date-parts":[[2011,10,20]],"date-time":"2011-10-20T02:42:29Z","timestamp":1319078549000},"page":"4158-4163","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":63,"title":["Epidemiology and Antifungal Susceptibility of Bloodstream Fungal Isolates in Pediatric Patients: a Spanish Multicenter Prospective Survey"],"prefix":"10.1128","volume":"49","author":[{"given":"Javier","family":"Pem\u00e1n","sequence":"first","affiliation":[{"name":"Hospital Universitario La Fe, Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilia","family":"Cant\u00f3n","sequence":"additional","affiliation":[{"name":"Hospital Universitario La Fe, Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Jos\u00e9","family":"Linares-Sicilia","sequence":"additional","affiliation":[{"name":"Hospital Reina Sof\u00eda, C\u00f3rdoba, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva Mar\u00eda","family":"Rosell\u00f3","sequence":"additional","affiliation":[{"name":"Hospital Valle Hebr\u00f3n, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuria","family":"Borrell","sequence":"additional","affiliation":[{"name":"Hospital Son Dureta, Palma de Mallorca, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Teresa","family":"Ruiz-P\u00e9rez-de-Pipaon","sequence":"additional","affiliation":[{"name":"Hospital Virgen del Roc\u00edo, Seville, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jes\u00fas","family":"Guinea","sequence":"additional","affiliation":[{"name":"Hospital Gregorio Mara\u00f1\u00f3n, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julio","family":"Garc\u00eda","sequence":"additional","affiliation":[{"name":"Hospital La Paz, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aurelio","family":"Porras","sequence":"additional","affiliation":[{"name":"Hospital Carlos Haya, M\u00e1laga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Mar\u00eda","family":"Garc\u00eda-Tapia","sequence":"additional","affiliation":[{"name":"Hospital Universitario Puerta del Mar, C\u00e1diz, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luisa","family":"P\u00e9rez-del-Molino","sequence":"additional","affiliation":[{"name":"Complejo Hospitalario, Santiago de Compostela, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anabel","family":"Su\u00e1rez","sequence":"additional","affiliation":[{"name":"Hospital Universitario Virgen de la Macarena, Seville, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Alcoba","sequence":"additional","affiliation":[{"name":"Hospital Universitario N. S. de la Candelaria, Tenerife, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inmaculada","family":"Garc\u00eda-Garc\u00eda","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednico Universitario, Salamanca, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.44.5.1681-1685.2006"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01811-10"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2008-2055"},{"key":"e_1_3_2_5_2","volume-title":"CLSI document M27-A3.","author":"Clinical and Laboratory Standards Institute.","year":"2008","unstructured":"Clinical and Laboratory Standards Institute. 2008. Reference method for broth dilution antifungal susceptibility testing of yeasts, approved standard. CLSI document M27-A3. 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