{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T07:26:53Z","timestamp":1772177213454,"version":"3.50.1"},"reference-count":36,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T00:00:00Z","timestamp":1771977600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003593","name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico","doi-asserted-by":"crossref","award":["408891\/2022-0"],"award-info":[{"award-number":["408891\/2022-0"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Canisius-Wilhelmina Hospital","award":["CWZ_001421"],"award-info":[{"award-number":["CWZ_001421"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Background: While Candida auris is well known to cause hospital outbreaks, other species in the C. haemulonii complex are less well documented but gained attention as opportunistic pathogens. Only one documented outbreak has been published. We describe the second, silent, fungemia outbreak due to antifungal-susceptible C. duobushaemulonii. Methods: We retrospectively genotyped six C. duobushaemulonii bloodstream isolates, collected in a 4-month-period in 2022 (n = 4) and during a week in 2024 (n = 2) in pediatric patients in Brazil. Whole genome sequencing (WGS) was done and compared to n = 33 publicly available genomes, including four cases from an outbreak in Panama. Antifungal susceptibility was performed with the reference CLSI method. Results: MALDI-TOF-MS identified isolates as either C. pseudohaemulonii or C. duobushaemulonii albeit with low scores. ITS sequence analyses confirmed all isolates as C. duobushaemulonii. WGS proved the presence of an outbreak among four pediatric patients in 2022 and a genetically distinct cluster of two cases in 2024. All six isolates were susceptible to azoles and echinocandins and were interpreted as being resistant to amphotericin B with a MIC at breakpoint of 2 \u00b5g\/mL. Conclusions: This study describes the second documented outbreak due to the rare yeast C. duobushaemulonii, belonging to the C. haemulonii species complex, during 2022\u20132024 in patients admitted to a pediatric oncology ward in a Brazilian hospital.<\/jats:p>","DOI":"10.3390\/antibiotics15030237","type":"journal-article","created":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T09:42:22Z","timestamp":1772012542000},"page":"237","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Silent Outbreaks of Candida duobushaemulonii in a Pediatric Ward in Brazil"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4946-911X","authenticated-orcid":false,"given":"Daniel","family":"Wagner de Castro Lima Santos","sequence":"first","affiliation":[{"name":"Instituto D\u2019Or de Pesquisa e Ensino (IDOR), S\u00e3o Lu\u00eds 65076-820, MA, Brazil"},{"name":"Hospital Universit\u00e1rio, Universidade Federal do Maranh\u00e3o, S\u00e3o Lu\u00eds 65020-070, MA, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6734-361X","authenticated-orcid":false,"given":"Bram","family":"Spruijtenburg","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands"},{"name":"Radboudumc-CWZ Center of Expertise for Mycology, 6532 SZ Nijmegen, The Netherlands"},{"name":"Department of Medical Microbiology and Immunology, Canisius-Wilhelmina Hospital\/Dicoon, 6532 SZ Nijmegen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0226-024X","authenticated-orcid":false,"given":"Eelco F. J.","family":"Meijer","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands"},{"name":"Radboudumc-CWZ Center of Expertise for Mycology, 6532 SZ Nijmegen, The Netherlands"},{"name":"Department of Medical Microbiology and Immunology, Canisius-Wilhelmina Hospital\/Dicoon, 6532 SZ Nijmegen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dayse","family":"Azevedo Coelho de Souza","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s Gradua\u00e7\u00e3o em Ci\u00eancias da Sa\u00fade, Universidade Federal do Maranh\u00e3o (UFMA), S\u00e3o Lu\u00eds 65020-070, MA, Brazil"},{"name":"Hospital de Cancer Aldenora Bello(HCAB), S\u00e3o Lu\u00eds 65031-630, MA, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0712-1852","authenticated-orcid":false,"given":"Concei\u00e7\u00e3o","family":"de Maria Pedrozo e Silva de Azevedo","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s Gradua\u00e7\u00e3o em Ci\u00eancias da Sa\u00fade, Universidade Federal do Maranh\u00e3o (UFMA), S\u00e3o Lu\u00eds 65020-070, MA, Brazil"},{"name":"Hospital de Cancer Aldenora Bello(HCAB), S\u00e3o Lu\u00eds 65031-630, MA, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3253-6080","authenticated-orcid":false,"given":"Jacques F.","family":"Meis","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands"},{"name":"Radboudumc-CWZ Center of Expertise for Mycology, 6532 SZ Nijmegen, The Netherlands"},{"name":"Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD) and Excellence Center for Medical Mycology, University of Cologne, 50923 Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1924","DOI":"10.1056\/NEJMra2402635","article-title":"Candida auris Infections","volume":"391","author":"Lionakis","year":"2024","journal-title":"N. 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Spectr."}],"container-title":["Antibiotics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-6382\/15\/3\/237\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T05:14:17Z","timestamp":1772169257000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-6382\/15\/3\/237"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,25]]},"references-count":36,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["antibiotics15030237"],"URL":"https:\/\/doi.org\/10.3390\/antibiotics15030237","relation":{},"ISSN":["2079-6382"],"issn-type":[{"value":"2079-6382","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,25]]}}}