{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T05:53:30Z","timestamp":1791179610507,"version":"4.1.0"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"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. Public Health"],"abstract":"\n Background<\/jats:title>\n \n Candidemia poses a growing global health threat, with rising fluconazole resistance complicating clinical management. This study aimed to investigate the species distribution and fluconazole resistance profiles of\n Candida<\/jats:italic>\n bloodstream infections and identify risk factors associated with fluconazole resistance.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A retrospective study was conducted at a tertiary care hospital in Guangzhou, China, from 2023 to 2025. Candida isolates from blood cultures were identified using MALDI-TOF MS, and antifungal susceptibility testing was performed using the VITEK 2 system. Patients were categorized into fluconazole-resistant and non-resistant groups based on species-specific MIC breakpoints.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 94\n Candida<\/jats:italic>\n bloodstream infection cases were analyzed. The species distribution was:\n Candida albicans<\/jats:italic>\n (26.60%),\n Candida glabrata<\/jats:italic>\n (23.40%),\n Candida auris<\/jats:italic>\n (20.21%),\n Candida tropicalis<\/jats:italic>\n (15.96%),\n Candida parapsilosis<\/jats:italic>\n (11.70%), and others (2.12%). Fluconazole resistance rates were highest in\n Candida auris<\/jats:italic>\n (68.42%), followed by\n Candida tropicalis<\/jats:italic>\n (46.67%) and\n Candida parapsilosis<\/jats:italic>\n (9.09%). For\n Candida auris<\/jats:italic>\n infections, indwelling medical devices (\n p<\/jats:italic>\n \u202f=\u202f0.017), antifungal use (\n p<\/jats:italic>\n \u202f=\u202f0.044), and antibacterial use (\n p<\/jats:italic>\n \u202f=\u202f0.004) were associated with fluconazole resistance. For\n Candida tropicalis<\/jats:italic>\n infections, surgical history (\n p<\/jats:italic>\n \u202f=\u202f0.041) was the only factor associated with fluconazole resistance.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n Candida auris<\/jats:italic>\n and\n Candida tropicalis<\/jats:italic>\n demonstrated alarmingly high fluconazole resistance rates, while\n Candida albicans<\/jats:italic>\n and\n Candida glabrata<\/jats:italic>\n remained susceptible. Indwelling medical devices, prior antimicrobial exposure and antibacterial exposure were identified as factors associated with fluconazole resistance, particularly in\n Candida auris<\/jats:italic>\n infections. These findings indicate that enhanced infection control measures are warranted.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1963129","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T05:32:07Z","timestamp":1791178327000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical correlates for fluconazole resistance in Candida bloodstream infections"],"prefix":"10.3389","volume":"14","author":[{"given":"Zihuan","family":"Li","sequence":"first","affiliation":[{"name":"Department of Infection Prevention and Control, The Affiliated Guangdong Second Provincial General Hospital of Jinan University","place":["Guangzhou, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tian","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Infection Prevention and Control, The Affiliated Guangdong Second Provincial General Hospital of Jinan University","place":["Guangzhou, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengdie","family":"Zhang","sequence":"additional","affiliation":[{"name":"Outpatient Department, Longtan Community Health Service Station","place":["Guangzhou, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu","family":"Cao","sequence":"additional","affiliation":[{"name":"Outpatient Department, South China University of Technology School of Medicine","place":["Guangzhou, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baohong","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Infection Prevention and Control, The Affiliated Guangdong Second Provincial General Hospital of Jinan University","place":["Guangzhou, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cuiqiong","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Infection Prevention and Control, The Affiliated Guangdong Second Provincial General Hospital of Jinan University","place":["Guangzhou, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guanwen","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Infection Prevention and Control, The Affiliated Guangdong Second Provincial General Hospital of Jinan University","place":["Guangzhou, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanfen","family":"Ming","sequence":"additional","affiliation":[{"name":"Discipline Inspection Office, The Affiliated Guangdong Second Provincial General Hospital of Jinan University","place":["Guangzhou, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"563","DOI":"10.3201\/eid3204.251407","article-title":"Accelerated increase in candida auris bloodstream infections during covid-19 pandemic, South Africa","volume":"32","author":"Ismail","year":"2026","journal-title":"Emerg Infect Dis"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"717","DOI":"10.1016\/S2666-5247(24)00042-9","article-title":"The WHO fungal priority pathogens list: a crucial reappraisal to review the prioritisation","volume":"5","author":"Casalini","year":"2024","journal-title":"Lancet Microbe"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"e428","DOI":"10.1016\/S1473-3099(23)00692-8","article-title":"Global incidence and mortality of severe fungal disease","volume":"24","author":"Denning","year":"2024","journal-title":"Lancet Infect 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