{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T11:56:32Z","timestamp":1787313392576,"version":"build-2736575974"},"reference-count":63,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T00:00:00Z","timestamp":1766016000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004881","name":"Instituto Mexicano del Seguro Social","doi-asserted-by":"crossref","award":["09 B5 6161 2800\/2025\/647"],"award-info":[{"award-number":["09 B5 6161 2800\/2025\/647"]}],"id":[{"id":"10.13039\/501100004881","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JoF"],"abstract":"<jats:p>Background: Nosocomial infections represent a significant clinical burden due to high morbidity, mortality and healthcare costs. Invasive fungal infections, particularly those caused by Candida species, are of growing concern due to increasing antifungal resistance, which limits therapeutic options and worsens patient outcomes. This study aimed to characterize the prevalence, species distribution, antifungal susceptibility profiles, and molecular mechanisms of resistance in clinical Candida isolates from hospitalized patients. Methods: A cross-sectional study was conducted involving 55 hospitalized patients, yielding 60 isolates from blood, secretions, fluids, and catheter tips. Species identification was performed using chromogenic media and confirmed by MALDI-TOF MS. Antifungal susceptibility testing followed CLSI M27-A4 broth microdilution guidelines for amphotericin B, fluconazole and 5-flucytosine. Gene expression of ERG2, ERG11 and MDR1 was evaluated by RT-qPCR after exposure to subinhibitory antifungal concentrations using the 2\u2212\u2206\u2206Ct method. Results:Candida albicans was the most frequent species, followed by Nakaseomyces glabratus, C. tropicalis and C. parapsilosis. Resistance varied among species, with elevated rates for fluconazole. ERG2 was notably overexpressed in amphotericin B-resistant isolates, while ERG11 and MDR1 showed species-dependent variation. Conclusions: Resistance mechanisms in Candida are species-specific and drug-dependent. Accurate species identification and understanding their molecular profiles are essential to guide targeted antifungal therapy and improve clinical outcomes.<\/jats:p>","DOI":"10.3390\/jof11120895","type":"journal-article","created":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T10:06:56Z","timestamp":1766052416000},"page":"895","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Antifungal Susceptibility and Resistance-Associated Gene Expression in Nosocomial Candida Isolates"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-0919-9947","authenticated-orcid":false,"given":"Fabiola Berenice","family":"Hernandez-Reyes","sequence":"first","affiliation":[{"name":"Programa de Maestr\u00eda en Microbiolog\u00eda M\u00e9dica, Departamento de Microbiolog\u00eda y Patolog\u00eda, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3964-7170","authenticated-orcid":false,"given":"Luis Alfonso","family":"Mu\u00f1oz-Miranda","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n en Enfermedades Infectocontagiosas, Departamento de Microbiolog\u00eda y Patolog\u00eda, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico"},{"name":"Unidad de Biotecnolog\u00eda Industrial, Centro de Investigaci\u00f3n y Asistencia en Tecnolog\u00eda y Dise\u00f1o del Estado de Jalisco A.C. (CIATEJ), Subsede Zapopan, Zapopan 45019, Jalisco, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7585-230X","authenticated-orcid":false,"given":"Manuel R.","family":"Kirchmayr","sequence":"additional","affiliation":[{"name":"Unidad de Biotecnolog\u00eda Industrial, Centro de Investigaci\u00f3n y Asistencia en Tecnolog\u00eda y Dise\u00f1o del Estado de Jalisco A.C. (CIATEJ), Subsede Zapopan, Zapopan 45019, Jalisco, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9045-7052","authenticated-orcid":false,"given":"Pablo C\u00e9sar","family":"Ortiz-Lazareno","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica de Occidente, Divisi\u00f3n de Inmunolog\u00eda, Instituto Mexicano del Seguro Social (IMSS), Guadalajara 44340, Jalisco, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2290-1999","authenticated-orcid":false,"given":"Rafael","family":"Cort\u00e9s-Z\u00e1rate","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n en Enfermedades Infectocontagiosas, Departamento de Microbiolog\u00eda y Patolog\u00eda, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9538-6935","authenticated-orcid":false,"given":"Maricarmen","family":"I\u00f1iguez-Moreno","sequence":"additional","affiliation":[{"name":"Department of Physics and Mathematics, School of Engineering and Technology, Universidad de Monterrey, San Pedro Garza Garc\u00eda 66238, Nuevo Le\u00f3n, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7813-7467","authenticated-orcid":false,"given":"Heriberto","family":"Jacobo-Cuevas","sequence":"additional","affiliation":[{"name":"Programa de Posdoctorado, Departamento de Psicolog\u00eda B\u00e1sica, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara\u00a044340, Jalisco, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3562-7033","authenticated-orcid":false,"given":"Cesar Arturo","family":"Nava-Valdivia","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n en Enfermedades Infectocontagiosas, Departamento de Microbiolog\u00eda y Patolog\u00eda, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,18]]},"reference":[{"key":"ref_1","first-page":"31","article-title":"Prevalence and antifungal drug resistance of nosocomial Candida species isolated from two university hospitals in Egypt","volume":"7","author":"Yossef","year":"2021","journal-title":"Curr. 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