{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T15:46:59Z","timestamp":1783525619011,"version":"3.55.0"},"reference-count":52,"publisher":"American Society for Microbiology","issue":"10","license":[{"start":{"date-parts":[[2024,10,3]],"date-time":"2024-10-03T00:00:00Z","timestamp":1727913600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,10,3]],"date-time":"2024-10-03T00:00:00Z","timestamp":1727913600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"crossref","award":["NRF-2022R1A2B5B0100322"],"award-info":[{"award-number":["NRF-2022R1A2B5B0100322"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Microbiol Spectr"],"published-print":{"date-parts":[[2024,10,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:sec>\n            <jats:title\/>\n            <jats:p>\n              The clonal transmission of fluconazole-resistant\n              <jats:italic>Candida glabrata<\/jats:italic>\n              isolates within hospitals has seldom been analyzed by whole-genome sequencing (WGS). We performed WGS on 79\n              <jats:italic>C<\/jats:italic>\n              .\n              <jats:italic>glabrata<\/jats:italic>\n              isolates, comprising 31 isolates from three premature infants with persistent\n              <jats:italic>C. glabrata<\/jats:italic>\n              bloodstream infection despite antifungal treatment in the same neonatal intensive care unit (NICU) in 2022 and 48 (27 fluconazole-resistant and 21 fluconazole-susceptible dose-dependent) bloodstream isolates from 48 patients in 15 South Korean hospitals from 2010 to 2022. Phylogenetic analysis based on WGS single-nucleotide polymorphisms (SNPs) distinguished the 79 isolates according to multilocus sequence typing (MLST) (17 sequence type [ST]3, 13 ST7, two ST22, 41 ST26, four ST55, and two ST59 isolates) and unveiled two possible clusters of nosocomial transmission among ST26 isolates. One cluster from two premature infants with overlapping NICU hospitalizations in 2022 encompassed 15 fluconazole-resistant isolates harboring pleiotropic drug-resistance transcription factor (Pdr1p) P258L (13 isolates) or N1086I (two isolates), together with 10 fluconazole-susceptible dose-dependent isolates lacking Pdr1p SNPs. The other cluster indicated unforeseen clonal transmission of fluconazole-resistant bloodstream isolates among five patients (four post-lung transplantation and one with diffuse interstitial lung disease) in the same hospital over 8 months. Among these five isolates, four obtained after exposure to azole antifungals harbored distinct Pdr1p SNPs (N1091D, E388Q, K365E, and R376Q). The findings reveal the transmission patterns of clonal bloodstream isolates of\n              <jats:italic>C. glabrata<\/jats:italic>\n              among patients undergoing antifungal treatment, exhibiting different levels of fluconazole susceptibility or distinct Pdr1p SNP profiles.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>IMPORTANCE<\/jats:title>\n            <jats:p>\n              The prevalence of fluconazole-resistant bloodstream infections caused by\n              <jats:italic>Candida glabrata<\/jats:italic>\n              is increasing globally, but the transmission of these resistant strains within hospitals has rarely been documented. Through whole-genome sequencing and epidemiological analyses, this study identified two potential clusters of\n              <jats:italic>C. glabrata<\/jats:italic>\n              bloodstream infections within the same hospital, revealing the transmission of clonal\n              <jats:italic>C. glabrata<\/jats:italic>\n              strains with different levels of fluconazole susceptibility or distinct transcription factor pleiotropic drug resistance protein 1 (Pdr1p) single-nucleotide polymorphism profiles among patients receiving antifungal therapy.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1128\/spectrum.00883-24","type":"journal-article","created":{"date-parts":[[2024,8,20]],"date-time":"2024-08-20T13:05:01Z","timestamp":1724159101000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":5,"title":["Nosocomial transmission of fluconazole-resistant\n            <i>Candida glabrata<\/i>\n            bloodstream isolates revealed by whole-genome sequencing"],"prefix":"10.1128","volume":"12","author":[{"given":"In Ji","family":"Hwang","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Chonnam National University Medical School, Gwangju, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9342-0570","authenticated-orcid":false,"given":"Yong Jun","family":"Kwon","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ha Jin","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ki Ho","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyukmin","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1225-8477","authenticated-orcid":true,"given":"Dongeun","family":"Yong","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eun Jeong","family":"Won","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung A.","family":"Byun","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ga Yeong","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soo Hyun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eun Song","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Chonnam National University Medical School, Gwangju, South 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