{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T06:57:54Z","timestamp":1791615474122,"version":"4.3.4"},"reference-count":77,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T00:00:00Z","timestamp":1755561600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JoF"],"abstract":"<jats:p>This study aimed to systematically evaluate the resistance rates of Candida albicans to various antifungals based on studies conducted in T\u00fcrkiye and published between 2005 and 2025 and to analyze the factors contributing to resistance. A systematic literature search was conducted using various keywords in electronic databases (PubMed, Embase, Web of Science, EBSCO, Scopus, Turk Medline and Google Scholar). A total of 42 studies were included in the meta-analysis according to the determined criteria. The quality of the studies was assessed using the Joanna Briggs Institute checklist, and the analyses were performed using appropriate statistical software. The highest resistance rates for fluconazole, itraconazole, and voriconazole were observed in the Aegean and Marmara regions. In the analyses performed with the random-effects model, heterogeneity was found to be high for itraconazole, fluconazole, posaconazole, voriconazole, and caspofungin, and the strongest explanatory variable of this heterogeneity was the geographical region variable. In our study, we determined that antifungal resistance in C. albicans strains in T\u00fcrkiye is generally low; however, an increasing trend has been observed over the years, especially in amphotericin B resistance. Although the low resistance rates to major antifungal agents such as fluconazole, voriconazole and echinocandins are promising, regional differences and methodological heterogeneity necessitate the development of treatment strategies based on local data.<\/jats:p>","DOI":"10.3390\/jof11080603","type":"journal-article","created":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T13:08:51Z","timestamp":1755608931000},"page":"603","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Twenty-Year Course of Antifungal Resistance in Candida albicans in T\u00fcrkiye: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"11","author":[{"given":"Imdat","family":"Kilbas","sequence":"first","affiliation":[{"name":"Medical Microbiology Doctorate Program, Institute of Health Sciences, Istanbul University, 34093 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1348-625X","authenticated-orcid":false,"given":"Elmas Pinar","family":"Kahraman Kilbas","sequence":"additional","affiliation":[{"name":"Department of Medical Laboratory Techniques, Health Services Vocational School, Fenerbahce University, 34758 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6133-0204","authenticated-orcid":false,"given":"Florin George","family":"Horhat","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Victor Babes University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ihsan Hakki","family":"Ciftci","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Faculty of Medicine, Sakarya University, 54100 Sakarya, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1146\/annurev-micro-091014-104330","article-title":"Candida albicans biofilms and human disease","volume":"69","author":"Nobile","year":"2015","journal-title":"Annu. Rev. Microbiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1093\/jac\/dkz400","article-title":"Molecular and genetic basis of azole antifungal resistance in the opportunistic pathogenic fungus Candida albicans","volume":"75","author":"Nishimoto","year":"2020","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e470","DOI":"10.1016\/S2666-5247(23)00067-8","article-title":"Worldwide emergence of fluconazole-resistant Candida parapsilosis: Current framework and future research roadmap","volume":"4","author":"Daneshnia","year":"2023","journal-title":"Lancet Microbe"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1016\/j.mycmed.2017.02.007","article-title":"Epidemiological and mycological characteristics of candidemia in Iran: A systematic review and meta-analysis","volume":"27","author":"Vaezi","year":"2017","journal-title":"J. Mycol. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1080\/00365540701477550","article-title":"Epidemiology and clinical outcome of candidaemia among Jordanian newborns over a 10-year period","volume":"40","author":"Badran","year":"2008","journal-title":"Scand. J. Infect. Dis."},{"key":"ref_6","first-page":"290","article-title":"Antifungal resistance of clinical Candida albicans isolates in Iran: A systematic review and meta-analysis","volume":"52","author":"Kermani","year":"2023","journal-title":"Iran. J. Public Health"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"165rv13","DOI":"10.1126\/scitranslmed.3004404","article-title":"Hidden killers: Human fungal infections","volume":"4","author":"Brown","year":"2012","journal-title":"Sci. Transl. Med."},{"key":"ref_8","doi-asserted-by":"crossref","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. Dis."},{"key":"ref_9","first-page":"44","article-title":"A comprehensive meta-analysis of antifungal resistance in Candida albicans in Turkey","volume":"4","year":"2017","journal-title":"Int. J. Clin. Med. Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"S79","DOI":"10.1093\/ofid\/ofy358","article-title":"Twenty years of the SENTRY antifungal surveillance program: Results for Candida species from 1997\u20132016","volume":"6","author":"Pfaller","year":"2019","journal-title":"Open Forum Infect. Dis."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Peron, I.H., Reichert-Lima, F., Busso-Lopes, A.F., Nagasako, C.K., Lyra, L., Moretti, M.L., and Schreiber, A.Z. (2016). Resistance surveillance in Candida albicans: A five-year antifungal susceptibility evaluation in a Brazilian university hospital. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0158126"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/2046-4053-4-1","article-title":"Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement","volume":"4","author":"Moher","year":"2015","journal-title":"Syst. Rev."},{"key":"ref_13","unstructured":"Aromataris, E., and Munn, Z. (2020). Systematic reviews of prevalence and incidence. JBI Manual for Evidence Synthesis, JBI. Chapter 5."},{"key":"ref_14","first-page":"195","article-title":"Klinik \u00f6rneklerden izole edilen kandida t\u00fcrleri ve antifungal duyarl\u0131l\u0131klar\u0131","volume":"12","author":"Bayram","year":"2005","journal-title":"Van. T\u0131p Derg."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Yenisehirli, G., Bulut, N., Yenisehirli, A., and Bulut, Y. (2015). In vitro susceptibilities of Candida albicans isolates to antifungal agents in Tokat, Turkey. Jundishapur J. Microbiol., 8.","DOI":"10.5812\/jjm.28057"},{"key":"ref_16","first-page":"146","article-title":"Yo\u011fun bak\u0131m \u00fcnitesinde yatan hastalar\u0131n kan k\u00fclt\u00fcrlerinden izole edilen Candida albicans su\u015flar\u0131nda antifungallere duyarl\u0131l\u0131k","volume":"21","author":"Yenisehirli","year":"2007","journal-title":"ANKEM Derg."},{"key":"ref_17","first-page":"170","article-title":"Identification and antifungal susceptibility of Candida isolates from various clinical specimens in Doctor Beh\u00e7et Uz Hospital","volume":"3","author":"Erdem","year":"2009","journal-title":"Anatol. J. Clin. Investig."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"860","DOI":"10.7205\/MILMED-D-04-7808","article-title":"Species distribution and in vitro susceptibility of Candida bloodstream isolates to six new and current antifungal agents in a Turkish tertiary care military hospital, recovered through 2001 and 2006","volume":"174","author":"Saracli","year":"2009","journal-title":"Mil. Med."},{"key":"ref_19","first-page":"593","article-title":"Neonatal Candida infections and the antifungal susceptibilities of the related Candida species","volume":"44","author":"Altuncu","year":"2010","journal-title":"Mikrobiyol. Bul."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"126","DOI":"10.3109\/13693786.2010.503195","article-title":"Species distribution and in vitro antifungal susceptibility of clinical Candida isolates from a university hospital in Turkey over a 5-year period","volume":"49","author":"Kiraz","year":"2011","journal-title":"Med. Mycol."},{"key":"ref_21","first-page":"489","article-title":"Invasive Candida infections in children: The clinical characteristics and species distribution and antifungal susceptibility of Candida spp.","volume":"53","author":"Belet","year":"2011","journal-title":"Turk. J. Pediatr."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"316","DOI":"10.3109\/13693786.2010.512023","article-title":"Bloodstream yeast infections in a university hospital in Northeast Turkey: A 4-year survey","volume":"49","author":"Aydin","year":"2011","journal-title":"Med. Mycol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"207","DOI":"10.5798\/diclemedj.0921.2012.02.0128","article-title":"Antifungal resistance of Candida isolates obtained from various specimens of intensive care unit patients","volume":"39","author":"Tekay","year":"2012","journal-title":"Dicle Med. J."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"25","DOI":"10.5222\/ankem.2013.025","article-title":"Distribution and antifungal susceptibilities of Candida species detected in blood cultures","volume":"27","author":"Dede","year":"2013","journal-title":"ANKEM Derg."},{"key":"ref_25","first-page":"236903","article-title":"In Vitro Susceptibility of Candida Species to Four Antifungal Agents Assessed by the Reference Broth Microdilution Method","volume":"2013","author":"Eksi","year":"2013","journal-title":"Sci. J."},{"key":"ref_26","first-page":"67","article-title":"Kan k\u00fclt\u00fcrlerinden izole edilen mikroorganizmalar ve antimikrobiyal duyarl\u0131l\u0131klar\u0131","volume":"71","author":"Aksoy","year":"2014","journal-title":"Turk. Hij. Den. Biyol. Derg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"131","DOI":"10.5505\/TurkHijyen.2014.05658","article-title":"Activities of amphotericin B, fluconazole and voriconazole against Candida bloodstream isolates determined by broth microdilution and disk diffusion methods","volume":"71","year":"2014","journal-title":"Turk. Hij. Den. Biyol. Derg."},{"key":"ref_28","first-page":"261","article-title":"Distribution and antifungal susceptibilities with VITEK 2 system of yeast isolated from blood cultures","volume":"12","year":"2015","journal-title":"Harran \u00dcniversitesi T\u0131p Fak\u00fcltesi Derg."},{"key":"ref_29","first-page":"17","article-title":"Yatan hasta \u00f6rneklerinden izole edilen Candida izolatlar\u0131n\u0131n t\u00fcr da\u011f\u0131l\u0131mlar\u0131n\u0131n ve antifungal duyarl\u0131l\u0131k profillerinin de\u011ferlendirilmesi","volume":"72","author":"Baran","year":"2015","journal-title":"Turk. Hij. Den. Biyol. Derg."},{"key":"ref_30","first-page":"105","article-title":"Kan k\u00fclt\u00fcrlerinden izole edilen Candida t\u00fcrlerinin da\u011f\u0131l\u0131m\u0131n\u0131n ve antifungal duyarl\u0131l\u0131klar\u0131n\u0131n retrospektif olarak de\u011ferlendirilmesi","volume":"29","author":"Etiz","year":"2015","journal-title":"ANKEM Derg."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"49","DOI":"10.5152\/dcbybd.2016.1050","article-title":"Yo\u011fun bak\u0131m \u00fcnitelerinde yatan hastalara ait \u00e7e\u015fitli klinik \u00f6rneklerden izole edilen Candida su\u015flar\u0131nda t\u00fcr da\u011f\u0131l\u0131m\u0131n\u0131n ve antifungal duyarl\u0131l\u0131klar\u0131n ara\u015ft\u0131r\u0131lmas\u0131","volume":"7","author":"Pelit","year":"2016","journal-title":"Yo\u011fun Bak\u0131m Derg."},{"key":"ref_32","first-page":"438","article-title":"\u00dc\u00e7\u00fcnc\u00fc basamak bir hastanede, geriatrik olgularda izole edilen Candida t\u00fcrlerinin tiplendirilmesi ve kanda \u00fcreyen mayalarda antifungal duyarl\u0131l\u0131k","volume":"42","author":"Derici","year":"2015","journal-title":"Dicle T\u0131p Derg."},{"key":"ref_33","first-page":"8","article-title":"Evaluation of species distribution and antifungal resistance of Candida isolates from hospitalized patients","volume":"6","author":"Cekin","year":"2015","journal-title":"J. Clin. Anal. Med."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"T\u00fcrk Dagi, H.T., Findik, D., Senkeles, C., and Arslan, U. (2016). Identification and antifungal susceptibility of Candida species isolated from bloodstream infections in Konya, Turkey. Ann. Clin. Microbiol. Antimicrob., 15.","DOI":"10.1186\/s12941-016-0153-1"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1016\/j.jiac.2016.06.012","article-title":"Antifungal susceptibilities of Candida species isolated from urine culture","volume":"22","author":"Durmaz","year":"2016","journal-title":"J. Infect. Chemother."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"750","DOI":"10.15537\/smj.2016.7.13412","article-title":"Identification of Candida species and susceptibility testing with Sensititre YeastOne microdilution panel to 9 antifungal agents","volume":"37","author":"Kucukates","year":"2016","journal-title":"Saudi Med. J."},{"key":"ref_37","first-page":"1","article-title":"Emergence of non-albicans Candida species: Evaluation of Candida species and antifungal susceptibilities according to years","volume":"28","author":"Aydemir","year":"2017","journal-title":"Biomed. Res."},{"key":"ref_38","first-page":"85","article-title":"\u00c7e\u015fitli \u00f6rneklerden izole edilen Candidalar\u0131n t\u00fcr da\u011f\u0131l\u0131m\u0131 ve antifungal diren\u00e7 oranlar\u0131","volume":"8","year":"2017","journal-title":"Turk. J. Clin. Lab."},{"key":"ref_39","first-page":"269","article-title":"Yo\u011fun bak\u0131m \u00fcnitelerinde yatan hastalar\u0131n kan k\u00fclt\u00fcrlerinden izole edilen mikroorganizmalar ve antibiyotik duyarl\u0131l\u0131klar\u0131","volume":"74","author":"Bayram","year":"2017","journal-title":"Turk. Hij. Den. Biyol. Derg."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"97","DOI":"10.3855\/jidc.9698","article-title":"Distribution and antifungal susceptibility patterns of Candida species at a university hospital in Northern Turkey","volume":"12","author":"Calgin","year":"2018","journal-title":"J. Infect. Dev. Ctries."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"130","DOI":"10.21601\/ortadogutipdergisi.277948","article-title":"Yo\u011fun bak\u0131m \u00fcnitesinde yatan hastalar\u0131n klinik \u00f6rneklerinden izole edilen Candida t\u00fcrlerinin da\u011f\u0131l\u0131m\u0131 ve antifungal duyarl\u0131l\u0131klar\u0131","volume":"10","author":"Cesur","year":"2018","journal-title":"Ortado\u011fu T\u0131p Derg."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1016\/j.jgar.2019.04.003","article-title":"First multicentre report of in vitro resistance rates in Candidaemia isolates in Turkey","volume":"18","author":"Birinci","year":"2019","journal-title":"J. Glob. Antimicrob. Resist."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"105992","DOI":"10.1016\/j.ijantimicag.2020.105992","article-title":"Effect of initial antifungal therapy on mortality among patients with bloodstream infections with different Candida species and resistance to antifungal agents: A multicentre observational study by the Turkish Fungal Infections Study Group","volume":"56","author":"Kapmaz","year":"2020","journal-title":"Int. J. Antimicrob. Agents"},{"key":"ref_44","first-page":"77","article-title":"Kan k\u00fclt\u00fcrlerinde tespit edilen Candida izolatlar\u0131n\u0131n da\u011f\u0131l\u0131m\u0131 ve antifungal duyarl\u0131l\u0131klar\u0131","volume":"34","author":"Beder","year":"2020","journal-title":"ANKEM Derg."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1007\/s10096-020-03994-6","article-title":"Change in species distribution and antifungal susceptibility of candidemias in an intensive care unit of a university hospital (10-year experience)","volume":"40","author":"Mete","year":"2021","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"101082","DOI":"10.1016\/j.mycmed.2020.101082","article-title":"Antifungal susceptibility, species distribution and risk factors associated with mortality of invasive candidiasis in children in Turkey: A six-year retrospective, single-centre study","volume":"31","author":"Yakut","year":"2021","journal-title":"J. Mycol. Med."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Y\u0131lmaz-Ciftdo\u011fan, D., Kara-Aksay, A., Erba\u015f, G., Sark\u0131\u015f, \u00dc.B., Karada\u011f-Oncel, E., An\u0131l, A.B., Baran, M., Er, H., and Y\u0131lmaz, N. (2021). Epidemiology of candidemia in children over 7 years in a medical center in Turkey. Microbiol. Spectr., 9.","DOI":"10.1128\/Spectrum.00453-21"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"e14820","DOI":"10.1111\/ijcp.14820","article-title":"Genotyping, drug resistance and virulence factors of Candida species isolated from patients using long-term inhaled steroids","volume":"75","author":"Dikmen","year":"2021","journal-title":"Int. J. Clin. Pract."},{"key":"ref_49","first-page":"150","article-title":"Kandidemi etkenlerinin t\u00fcr da\u011f\u0131l\u0131m\u0131 ve duyarl\u0131l\u0131klar\u0131: Hastanemizde ampirik antifungal tedavi politikas\u0131 de\u011fi\u015ftirilmeli mi?","volume":"51","author":"Er","year":"2021","journal-title":"Turk. Mikrobiyol. Cemiy. Derg."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"796","DOI":"10.5798\/dicletip.1037792","article-title":"Kan k\u00fclt\u00fcrlerinde \u00fcretilen yo\u011fun bak\u0131m \u00fcnitesi hastalar\u0131nda Candida epidemiyolojisi ve antifungal diren\u00e7 de\u011fi\u015fiminin incelenmesi, 2015\u20132019","volume":"48","year":"2021","journal-title":"Dicle Med. J."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"92","DOI":"10.30934\/kusbed.1037788","article-title":"Distribution of Candida species isolated from different clinical specimens and their antifungal susceptibility profile: A 5 year retrospective analysis","volume":"8","year":"2022","journal-title":"KOU Sa\u011fl\u0131k Bil. Derg."},{"key":"ref_52","first-page":"105","article-title":"Pandemi d\u00f6neminde kan k\u00fclt\u00fcrlerinden izole edilen Candida t\u00fcrlerinin da\u011f\u0131l\u0131m\u0131 ve antifungal duyarl\u0131l\u0131klar\u0131n\u0131n de\u011ferlendirilmesi","volume":"13","author":"Samadzade","year":"2022","journal-title":"Mantar Derg."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"331","DOI":"10.5578\/flora.20239703","article-title":"Kan k\u00fclt\u00fcr\u00fcnden izole edilen Candida t\u00fcrlerinin da\u011f\u0131l\u0131m\u0131 ve antifungal duyarl\u0131l\u0131\u011f\u0131n\u0131n ara\u015ft\u0131r\u0131lmas\u0131","volume":"28","author":"Karvar","year":"2023","journal-title":"FLORA"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"53","DOI":"10.54962\/ankemderg.1471996","article-title":"Kan k\u00fclt\u00fcrlerinde tespit edilen Candida izolatlar\u0131n\u0131n da\u011f\u0131l\u0131m\u0131 ve antifungal duyarl\u0131l\u0131klar\u0131n\u0131n ticari bir s\u0131v\u0131 mikrodil\u00fcsyon testi ile belirlenmesi","volume":"38","author":"Tosun","year":"2024","journal-title":"ANKEM Derg."},{"key":"ref_55","first-page":"148","article-title":"Antifungal susceptibilities of Candida species isolated to clinical samples","volume":"5","author":"Atmaca","year":"2024","journal-title":"Hamidiye Med. J."},{"key":"ref_56","first-page":"494","article-title":"CLSI\u2019dan EUCAST\u2019e Ge\u00e7i\u015fte \u00dcriner Sistem Enfeksiyonu Etkeni Escherichia coli \u0130zolatlar\u0131n\u0131n Antibiyotik Duyarl\u0131l\u0131klar\u0131n\u0131n Kar\u015f\u0131la\u015ft\u0131r\u0131lmas\u0131","volume":"49","author":"Aksaray","year":"2015","journal-title":"Mikrobiyol. Bul."},{"key":"ref_57","unstructured":"EUCAST (2025, June 13). Breakpoint Tables for Interpretation of MICs for Antifungal Agents, Version 9.0, 2019. European Committee on Antimicrobial Susceptibility Testing. Available online: https:\/\/www.eucast.org\/newsiandr."},{"key":"ref_58","unstructured":"Cohen, L., Lawrence, M., and Keith, M. (2007). Research Methods in Education, Routledge. [6th ed.]."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"3390","DOI":"10.1021\/acs.chemrev.0c00199","article-title":"Antifungal drug resistance: Molecular mechanisms in Candida albicans and beyond","volume":"121","author":"Lee","year":"2021","journal-title":"Chem. Rev."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1126\/science.1222236","article-title":"Tackling human fungal infections","volume":"336","author":"Brown","year":"2012","journal-title":"Science"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1093\/cid\/civ933","article-title":"Clinical practice guideline for the management of candidiasis: 2016 update by the Infectious Diseases Society of America","volume":"62","author":"Pappas","year":"2016","journal-title":"Clin. Infect. Dis."},{"key":"ref_62","unstructured":"World Health Organization (2022). WHO Fungal Priority Pathogens List to Guide Research, Development and Public Health Action, World Health Organization."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"6479","DOI":"10.1007\/s00784-022-04716-2","article-title":"Resistance profiles to antifungal agents in Candida albicans isolated from human oral cavities: Systematic review and meta-analysis","volume":"26","author":"Kessler","year":"2022","journal-title":"Clin. Oral. Investig."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1016\/j.jinf.2023.08.001","article-title":"European Candidaemia is characterised by notable differential epidemiology and susceptibility pattern: Results from the ECMM Candida III study","volume":"87","author":"Arendrup","year":"2023","journal-title":"J. Infect."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1145","DOI":"10.1093\/mmy\/myab058","article-title":"A systematic review on distribution and antifungal resistance pattern of Candida species in the Indian population","volume":"59","author":"Verma","year":"2021","journal-title":"Med. Mycol."},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Mushi, M.F., Bader, O., Taverne-Ghadwal, L., Bii, C., Gro\u00df, U., and Mshana, S.E. (2017). Oral candidiasis among African human immunodeficiency virus-infected individuals: Ten years of systematic review and meta-analysis from sub-Saharan Africa. J. Oral. Microbiol., 9.","DOI":"10.1080\/20002297.2017.1317579"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"e00906","DOI":"10.1128\/AAC.00906-17","article-title":"Monitoring antifungal resistance in a global collection of invasive yeasts and molds: Application of CLSI epidemiological cutoff values and whole-genome sequencing analysis for detection of azole resistance in Candida albicans","volume":"61","author":"Castanheira","year":"2017","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1099\/jmm.0.071167-0","article-title":"Species distribution and antifungal susceptibility profile of Candida isolates from bloodstream infections in Lima, Peru","volume":"63","author":"Bustamante","year":"2014","journal-title":"J. Med. Microbiol."},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"Doi, A.M., Pignatari, A.C., Edmond, M.B., Marra, A.R., Camargo, L.F., Siqueira, R.A., da Mota, V.P., and Colombo, A.L. (2016). Epidemiology and microbiologic characterization of nosocomial candidemia from a Brazilian national surveillance program. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0146909"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"1794","DOI":"10.1128\/AAC.01757-10","article-title":"Frequency of voriconazole resistance in vitro among Spanish clinical isolates of Candida spp. according to breakpoints established by the Antifungal Subcommittee of the European Committee on Antimicrobial Susceptibility Testing","volume":"55","author":"Cuesta","year":"2011","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1128\/JCM.01915-07","article-title":"Candida krusei, a multidrug-resistant opportunistic fungal pathogen: Geographic and temporal trends from the ARTEMIS DISK Antifungal Surveillance Program, 2001 to 2005","volume":"46","author":"Pfaller","year":"2008","journal-title":"J. Clin. Microbiol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1016\/j.funbio.2023.04.003","article-title":"In vitro evaluation of virulence markers and antifungal resistance of clinical Candida albicans strains isolated from Karachi, Pakistan","volume":"127","author":"Jabeen","year":"2023","journal-title":"Fungal Biol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1016\/j.mycmed.2018.02.010","article-title":"The patterns of colonization and antifungal susceptibility of Candida isolated from preterm neonates in Khorramabad, South West of Iran","volume":"28","author":"Kooshki","year":"2018","journal-title":"J. Mycol. Med."},{"key":"ref_74","first-page":"18","article-title":"High incidence of azole resistance among Candida albicans and C. glabrata isolates in Northeastern Iran","volume":"7","author":"Zarrinfar","year":"2021","journal-title":"Curr. Med. Mycol."},{"key":"ref_75","first-page":"122","article-title":"Antifungal activity of posaconazole against Candida spp. and non-Candida clinical yeasts isolates","volume":"23","author":"Eraso","year":"2010","journal-title":"Rev. Esp. Quimioter."},{"key":"ref_76","doi-asserted-by":"crossref","unstructured":"Delma, F.Z., Al-Hatmi, A.M.S., Br\u00fcggemann, R.J.M., Melchers, W.J.G., de Hoog, S., Verweij, P.E., and Buil, J.B. (2021). Molecular mechanisms of 5-fluorocytosine resistance in yeasts and filamentous fungi. J. Fungi, 7.","DOI":"10.3390\/jof7110909"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1093\/jac\/45.3.408","article-title":"Primary resistance to flucytosine among clinical isolates of Candida spp.","volume":"45","author":"Barchiesi","year":"2000","journal-title":"J. Antimicrob. Chemother."}],"container-title":["Journal of Fungi"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2309-608X\/11\/8\/603\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:30:59Z","timestamp":1760034659000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2309-608X\/11\/8\/603"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,19]]},"references-count":77,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,8]]}},"alternative-id":["jof11080603"],"URL":"https:\/\/doi.org\/10.3390\/jof11080603","relation":{},"ISSN":["2309-608X"],"issn-type":[{"value":"2309-608X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,19]]}}}