{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T20:33:57Z","timestamp":1790195637977,"version":"4.1.0"},"reference-count":29,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T00:00:00Z","timestamp":1758585600000},"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>Candida parapsilosis has emerged as a prominent cause of nosocomial candidemia, particularly among critically ill patients. The increasing prevalence of fluconazole-resistant C. parapsilosis (FR-Cp) poses major therapeutic challenges, especially in resource-limited settings. We conducted a retrospective study of 144 patients with C. parapsilosis candidemia admitted to two post-surgical ICUs at a Brazilian tertiary cardiothoracic hospital between 2016 and August 2024. Demographic, clinical, microbiological, and therapeutic data were analyzed. Predictors of 30-day mortality were identified through multivariate logistic regression. The incidence density of C. parapsilosis candidemia ranged from 2.93 to 8.31 per 1000 hospitalizations. Fluconazole resistance was identified in 81% of isolates. Overall 30-day mortality was 55%. Independent risk factors for mortality included cardiopathy (OR: 19.36, p = 0.006), higher SOFA scores (OR: 1.54, p = 0.003), parenteral nutrition (OR: 29.77, p = 0.013), and dialysis (OR: 6.59, p = 0.043), while longer treatment duration was protective (OR: 0.81, p &lt; 0.001). Fluconazole resistance was not independently associated with increased mortality. In this cohort of critically ill patients, C. parapsilosis candidemia was associated with high mortality and a high prevalence of fluconazole resistance. Clinical outcomes were mainly driven by host-related and therapeutic factors rather than antifungal resistance alone.<\/jats:p>","DOI":"10.3390\/jof11100692","type":"journal-article","created":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T10:27:53Z","timestamp":1758623273000},"page":"692","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Nine-Year Surveillance of Candida parapsilosis Candidemia in a Cardiothoracic ICU: Insights into Mortality and Resistance"],"prefix":"10.3390","volume":"11","author":[{"given":"Caio Trevelin","family":"Sambo","sequence":"first","affiliation":[{"name":"Division of Infectious and Parasitic Diseases, Hospital das Cl\u00ednicas, Faculdade de Medicina, Universidade de S\u00e3o Paulo, S\u00e3o Paulo 05403-010, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bianca Leal","family":"de Almeida","sequence":"additional","affiliation":[{"name":"Hospital Infection Control and Infectious Diseases Service, Instituto do Cancer do Estado de Sao Paulo, Faculdade de Medicina, Universidade de S\u00e3o Paulo, S\u00e3o Paulo 01246-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3638-454X","authenticated-orcid":false,"given":"Gabriel","family":"Fialkovitz","sequence":"additional","affiliation":[{"name":"Infection Control Department, Instituto do Cora\u00e7\u00e3o, Hospital das Cl\u00ednicas, Universidade de S\u00e3o Paulo, S\u00e3o Paulo 05403-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3306-3118","authenticated-orcid":false,"given":"Tiago Alexandre","family":"Cocio","sequence":"additional","affiliation":[{"name":"Laboratory of Medical Mycology-LIM53, Instituto de Medicina Tropical, Divis\u00e3o de Dermatologia, Hospital das Cl\u00ednicas, Faculdade de Medicina, Universidade de S\u00e3o Paulo, S\u00e3o Paulo 05403-900, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9509-9248","authenticated-orcid":false,"given":"Afonso Rafael","family":"da Silva Junior","sequence":"additional","affiliation":[{"name":"Pathology Department, Laborat\u00f3rio de Microbiologia da Divis\u00e3o de Laborat\u00f3rio Central, Hospital das Cl\u00ednicas da Faculdade de Medicina USP (FMUSP), S\u00e3o Paulo 05403-010, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lumena Pereira Machado","family":"Siqueira","sequence":"additional","affiliation":[{"name":"Pathology Department, Laborat\u00f3rio de Microbiologia da Divis\u00e3o de Laborat\u00f3rio Central, Hospital das Cl\u00ednicas da Faculdade de Medicina USP (FMUSP), S\u00e3o Paulo 05403-010, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabela Cristina Oliveira","family":"Silva","sequence":"additional","affiliation":[{"name":"Division of Infectious and Parasitic Diseases, Hospital das Cl\u00ednicas, Faculdade de Medicina, Universidade de S\u00e3o Paulo, S\u00e3o Paulo 05403-010, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavia","family":"Rossi","sequence":"additional","affiliation":[{"name":"Pathology Department, Laborat\u00f3rio de Microbiologia da Divis\u00e3o de Laborat\u00f3rio Central, Hospital das Cl\u00ednicas da Faculdade de Medicina USP (FMUSP), S\u00e3o Paulo 05403-010, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7282-5453","authenticated-orcid":false,"given":"Tha\u00eds","family":"Guimar\u00e3es","sequence":"additional","affiliation":[{"name":"Infection Control Department, Hospital das Cl\u00ednicas, University of S\u00e3o Paulo, S\u00e3o Paulo 05403-010, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rinaldo Focaccia","family":"Siciliano","sequence":"additional","affiliation":[{"name":"Infection Control Department, Instituto do Cora\u00e7\u00e3o, Hospital das Cl\u00ednicas, Universidade de S\u00e3o Paulo, S\u00e3o Paulo 05403-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evangelina da Motta Pacheco","family":"de Ara\u00fajo","sequence":"additional","affiliation":[{"name":"Pathology Department, Laborat\u00f3rio de Microbiologia da Divis\u00e3o de Laborat\u00f3rio Central, Hospital das Cl\u00ednicas da Faculdade de Medicina USP (FMUSP), S\u00e3o Paulo 05403-010, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4322-312X","authenticated-orcid":false,"given":"Gilda Maria Barbaro","family":"Del Negro","sequence":"additional","affiliation":[{"name":"Laboratory of Medical Mycology-LIM53, Instituto de Medicina Tropical, Divis\u00e3o de Dermatologia, Hospital das Cl\u00ednicas, Faculdade de Medicina, Universidade de S\u00e3o Paulo, S\u00e3o Paulo 05403-900, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5469-3602","authenticated-orcid":false,"given":"Gil","family":"Benard","sequence":"additional","affiliation":[{"name":"Laboratory of Medical Mycology-LIM53, Instituto de Medicina Tropical, Divis\u00e3o de Dermatologia, Hospital das Cl\u00ednicas, Faculdade de Medicina, Universidade de S\u00e3o Paulo, S\u00e3o Paulo 05403-900, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tania Mara Varej\u00e3o","family":"Strabelli","sequence":"additional","affiliation":[{"name":"Infection Control Department, Instituto do Cora\u00e7\u00e3o, Hospital das Cl\u00ednicas, Universidade de S\u00e3o Paulo, S\u00e3o Paulo 05403-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7996-8265","authenticated-orcid":false,"given":"Marcello Mihailenko Chaves","family":"Magri","sequence":"additional","affiliation":[{"name":"Division of 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