{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T08:47:25Z","timestamp":1771922845000,"version":"3.50.1"},"reference-count":60,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T00:00:00Z","timestamp":1768953600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Nosocomial outbreaks of fluconazole-resistant\n                      <jats:italic>Candida parapsilosis<\/jats:italic>\n                      are concerning. Here we characterised a cluster of fluconazole-resistant\n                      <jats:italic>C. parapsilosis<\/jats:italic>\n                      utilising whole-genome sequencing (WGS) and correlate phenotypic azole resistance with resistome-based WGS analysis of azole resistance-conferring mutations.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>\n                      Seventeen\n                      <jats:italic>C. parapsilosis<\/jats:italic>\n                      isolates were studied. Group 1: seven fluconazole-resistant isolates from a hospital intensive care unit (ICU) outbreak (2023\u20132024), Group 2: six isolates from a historical case cluster, Group 3: four additional unrelated isolates. Minimum inhibitory concentrations (MICs) were determined using SENSITITRE AUSNMRC1 (TREK Diagnostics). Single nucleotide polymorphism (SNP)-based phylogenomic analysis was undertaken using two (MycoSNP and custom-based) bioinformatic pipelines to assess relatedness. Target-gene mutations for azole resistance were evaluated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      ICU patient risks for fluconazole-resistant\n                      <jats:italic>C. parapsilosis<\/jats:italic>\n                      included presence of intravascular device and recent broad-spectrum antimicrobial use. Core SNP-based analysis showed clustering of Group 1, and separately, of Group 2 isolates. With greater genetic similarity (range &amp;lt;2\u20139 SNP difference) between isolates within Group 1, than between these and Group 2 and 3 isolates (1700\u20133,000 SNPs); the in-house pipeline yielded the same phylogenetic pattern with isolates within both Group 1 and 2 clusters separated by \u2245100 SNPs (range 47\u2013124). The eight fluconazole-resistant (MIC &amp;gt;64\u202fmg\/L) isolates had\n                      <jats:italic>ERG11<\/jats:italic>\n                      Y132F and\n                      <jats:italic>TAC1<\/jats:italic>\n                      D444Y mutations which were absent in fluconazole-susceptible isolates. The mutation\n                      <jats:italic>ERG11<\/jats:italic>\n                      R398I was present in azole-resistant and azole-susceptible strains.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Genomic relatedness amongst clustered isolates was confirmed in this first fluconazole-resistant\n                      <jats:italic>C. parapsilosis<\/jats:italic>\n                      outbreak in Australia. Fluconazole-resistant isolates harboured\n                      <jats:italic>ERG11<\/jats:italic>\n                      Y132F and\n                      <jats:italic>TAC1<\/jats:italic>\n                      D444Y mutations. The protracted outbreak underscores the need to prioritise enhanced surveillance.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmicb.2025.1742871","type":"journal-article","created":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T18:26:50Z","timestamp":1769020010000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Emerging fluconazole-resistant Candida parapsilosis in Australia: a case cluster and insights into the genetic diversity of this species"],"prefix":"10.3389","volume":"16","author":[{"given":"Manoshi","family":"Perera","sequence":"first","affiliation":[{"name":"Mycology Reference Laboratory, Royal North Shore Hospital, New South Wales Health Pathology","place":["St Leonards, NSW, Australia"]},{"name":"Clinical Mycology Reference Laboratory, Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital","place":["Westmead, NSW, Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Winkie","family":"Fong","sequence":"additional","affiliation":[{"name":"Centre for Infectious Diseases and Microbiology \u2013 Public Health, Westmead Hospital","place":["Westmead, NSW, Australia"]},{"name":"Sydney Infectious Diseases Institute, The University of Sydney","place":["Camperdown, NSW, Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rose","family":"Haywood","sequence":"additional","affiliation":[{"name":"Mycology Reference Laboratory, Royal North Shore Hospital, New South Wales Health Pathology","place":["St Leonards, NSW, Australia"]},{"name":"Department of Microbiology, Royal Prince Alfred Hospital, New South Wales Health Pathology","place":["Camperdown, NSW, Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geraldine J.","family":"Sullivan","sequence":"additional","affiliation":[{"name":"Clinical Mycology Reference Laboratory, Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital","place":["Westmead, NSW, Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qinning","family":"Wang","sequence":"additional","affiliation":[{"name":"Clinical Mycology Reference Laboratory, Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital","place":["Westmead, NSW, Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catriona L.","family":"Halliday","sequence":"additional","affiliation":[{"name":"Clinical Mycology Reference Laboratory, Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital","place":["Westmead, NSW, Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharn","family":"Dowsett-Moeahu","sequence":"additional","affiliation":[{"name":"NSW Tissue Bank, NSW Organ and Tissue Donation Service, Incorporating the Lions NSW Eye Bank, NSW Bone Bank and the Australian Ocular Biobank","place":["Sydney, NSW, Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chayanika","family":"Biswas","sequence":"additional","affiliation":[{"name":"Commercial, Vaccines and Countermeasures Delivery, UK Health Security Agency","place":["London, United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolina","family":"Firacative","sequence":"additional","affiliation":[{"name":"Studies in Translational Microbiology and Emerging Diseases (MICROS) Research Group, School of Medicine and Health Sciences, Universidad del Rosario","place":["Bogota, Colombia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie-Claire","family":"Liu","sequence":"additional","affiliation":[{"name":"Mycology Reference Laboratory, Royal North Shore Hospital, New South Wales Health Pathology","place":["St Leonards, NSW, Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kerry","family":"Weeks","sequence":"additional","affiliation":[{"name":"Mycology Reference Laboratory, Royal North Shore Hospital, New South Wales Health Pathology","place":["St Leonards, NSW, Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robyn","family":"Hardiman","sequence":"additional","affiliation":[{"name":"Mycology Reference Laboratory, Royal North Shore Hospital, New South Wales Health Pathology","place":["St Leonards, NSW, Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jen","family":"Kok","sequence":"additional","affiliation":[{"name":"Clinical Mycology Reference Laboratory, Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital","place":["Westmead, NSW, Australia"]},{"name":"Centre for Infectious Diseases and Microbiology \u2013 Public Health, Westmead Hospital","place":["Westmead, NSW, Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kerri","family":"Basile","sequence":"additional","affiliation":[{"name":"Clinical Mycology Reference Laboratory, Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital","place":["Westmead, NSW, Australia"]},{"name":"Centre for Infectious Diseases and Microbiology \u2013 Public Health, Westmead Hospital","place":["Westmead, NSW, Australia"]},{"name":"Sydney Infectious Diseases Institute, The University of Sydney","place":["Camperdown, NSW, Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wieland","family":"Meyer","sequence":"additional","affiliation":[{"name":"Westerdjik Fungal Biodiversity Institute - KNAW","place":["Utrecht, Netherlands"]},{"name":"Curtin Medical School, Faculty of Health Sciences, Curtin University","place":["Perth, WA, Australia"]},{"name":"Sydney School of Veterinary Sciences, The University of Sydney","place":["Sydney, NSW, Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vitali","family":"Sintchenko","sequence":"additional","affiliation":[{"name":"Clinical Mycology Reference Laboratory, Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital","place":["Westmead, NSW, Australia"]},{"name":"Centre for Infectious Diseases and Microbiology \u2013 Public Health, Westmead Hospital","place":["Westmead, NSW, Australia"]},{"name":"Sydney Infectious Diseases Institute, The University of Sydney","place":["Camperdown, NSW, Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharon C-A","family":"Chen","sequence":"additional","affiliation":[{"name":"Clinical Mycology Reference Laboratory, Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital","place":["Westmead, NSW, Australia"]},{"name":"Centre for Infectious Diseases and Microbiology \u2013 Public Health, Westmead Hospital","place":["Westmead, NSW, Australia"]},{"name":"Sydney Infectious Diseases Institute, The University of Sydney","place":["Camperdown, NSW, Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alice","family":"Kizny Gordon","sequence":"additional","affiliation":[{"name":"Mycology Reference Laboratory, Royal North Shore Hospital, New South Wales Health Pathology","place":["St Leonards, NSW, Australia"]},{"name":"Northern Clinical School, Sydney Medical School, Faculty of Medicine and Health, University of Sydney","place":["Sydney, NSW, Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,21]]},"reference":[{"key":"ref3","doi-asserted-by":"publisher","first-page":"673","DOI":"10.3390\/jof7080673","article-title":"Epidemiology of candidemia in Kuwait: a Nationwide, population-based study","volume":"7","author":"Alobaid","year":"2021","journal-title":"J. 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