{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:35:21Z","timestamp":1792787721990,"version":"4.5.0"},"reference-count":29,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T00:00:00Z","timestamp":1773360000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Oklahoma City VA Health Care System","id":[{"id":"https:\/\/ror.org\/03k6yxq48","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Veterans Health Administration Corporate Data Warehouse","id":[{"id":"https:\/\/ror.org\/05eq41471","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Pharmacother"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>\n                      Antifungal-resistant\n                      <jats:italic toggle=\"yes\">Candida species<\/jats:italic>\n                      have become increasingly prevalent in recent years, posing significant therapeutic challenges in the inpatient setting. Despite their clinical relevance, comprehensive data evaluating risk factors for the development of invasive infections caused by\n                      <jats:italic toggle=\"yes\">Candida<\/jats:italic>\n                      sp. with antifungal resistance are limited.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>\n                      This study aims to identify independent predictors for the development of invasive clinical infections caused by fluconazole-resistant or echinocandin-resistant\n                      <jats:italic toggle=\"yes\">Candida<\/jats:italic>\n                      sp. in hospitalized veterans across the United States Veterans Health Administration.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      This retrospective, observational, nationwide analysis included adults \u226518 years admitted to any Veterans Affairs Medical Center between January 1, 2009, and September 30, 2024, with culture-positive or rapid diagnostic test-confirmed invasive\n                      <jats:italic toggle=\"yes\">Candida<\/jats:italic>\n                      sp. infection from otherwise-sterile sites. Data were gathered on baseline demographics, baseline laboratory data, comorbid conditions, and exposure to antibacterial agents, antifungal agents, \u03b2-Hydroxy \u03b2-methylglutaryl-CoA (HMG-CoA) reductase inhibitors, and immunosuppressant drug therapy. Univariate and multivariate logistic regression models were used to assess associations between clinical variables and the development of invasive fluconazole-resistant and echinocandin-resistant\n                      <jats:italic toggle=\"yes\">Candida<\/jats:italic>\n                      sp. infections.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Eligible cases were found from 25 Veterans Affairs Medical Center facilities; 1651 episodes had available fluconazole susceptibility data, and 1117 episodes had echinocandin susceptibility data. Fluconazole non-susceptibility was independently associated with at least 7 days of recent exposure to either fluconazole or an echinocandin, among a few other variables. Echinocandin resistance, while less common, was strongly linked to the receipt of dialysis, prolonged Gram-positive antibacterial exposure, and any prior antifungal use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and Relevance:<\/jats:title>\n                    <jats:p>\n                      These findings can inform antifungal stewardship efforts to curb the rise of resistant\n                      <jats:italic toggle=\"yes\">Candida<\/jats:italic>\n                      sp.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10600280261424286","type":"journal-article","created":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T17:28:24Z","timestamp":1773422904000},"page":"1058-1065","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Predictors for the Development of Invasive Infection of Fluconazole Non-Susceptible or Echinocandin Non-Susceptible\n                    <i>Candida Species<\/i>\n                    Across the Veterans Health Administration"],"prefix":"10.1177","volume":"60","author":[{"given":"Cailyn","family":"Evans","sequence":"first","affiliation":[{"name":"Pharmacy Service, Oklahoma City Veterans Affairs Health Care System, Oklahoma City, OK, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9022-5363","authenticated-orcid":false,"suffix":"II","given":"Riley J.","family":"Williams","sequence":"additional","affiliation":[{"name":"Pharmacy Service, Oklahoma City Veterans Affairs Health Care System, Oklahoma City, OK, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharanjeet","family":"Thind","sequence":"additional","affiliation":[{"name":"Department of Medicine, Oklahoma University Health Sciences Center College of Medicine, Oklahoma City, OK, USA"},{"name":"Section of Infectious Diseases, Medical Service, Oklahoma City Veterans Affairs Health Care System, Oklahoma City, OK, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9502-5443","authenticated-orcid":false,"given":"Chris A.","family":"Gentry","sequence":"additional","affiliation":[{"name":"Pharmacy Service, Oklahoma City Veterans Affairs Health Care System, Oklahoma City, OK, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,3,13]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/QCO.0000000000000411"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jix131"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2025.106513"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00099-20"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ791"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.05947-11"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofac447"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.36104\/amc.2024.2734"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.10575"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.20273"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiph.2023.11.021"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.169.4.379"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid2011.140685"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00479-10"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-019-4710-z"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2666-5247(23)00067-8"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268818002480"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofab444"},{"key":"e_1_3_3_20_2","unstructured":"Center for Disease Control and Prevention. 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