{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T06:13:51Z","timestamp":1770272031048,"version":"3.49.0"},"reference-count":60,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2023,8,13]],"date-time":"2023-08-13T00:00:00Z","timestamp":1691884800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico, Brazil","award":["408891\/2022-0"],"award-info":[{"award-number":["408891\/2022-0"]}]},{"name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico, Brazil","award":["306295\/2022-9"],"award-info":[{"award-number":["306295\/2022-9"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JoF"],"abstract":"<jats:p>The present study aimed to describe the clinical, epidemiological and laboratory characteristics of invasive candidiasis by C. parapsilosis complex (CPC) in a Brazilian tertiary pediatric hospital during the COVID-19 pandemic. Clinical samples were processed in the BACT\/ALERT\u00ae 3D system or on agar plates. Definitive identification was achieved by MALDI-TOF MS. Antifungal susceptibility was initially analyzed by the VITEK 2 system (AST-YS08 card) and confirmed by the CLSI protocol. Patient data were collected from the medical records using a structured questionnaire. CPC was recovered from 124 patients over an 18-month period, as follows: C. parapsilosis (83.87%), C. orthopsilosis (13.71%) and C. metapsilosis (2.42%). Antifungal resistance was not detected. The age of the patients with invasive CPC infections ranged from &lt;1 to 18 years, and most of them came from oncology-related sectors, as these patients were more affected by C. parapsilosis. C. orthopsilosis infections were significantly more prevalent in patients from critical care units. Invasive infections caused by different pathogens occurred in 75 patients up to 30 days after the recovery of CPC isolates. Overall, 23 (18.55%) patients died within 30 days of CPC diagnosis. Catheter removal and antifungal therapy were important measures to prevent mortality. COVID-19 coinfection was only detected in one patient.<\/jats:p>","DOI":"10.3390\/jof9080844","type":"journal-article","created":{"date-parts":[[2023,8,14]],"date-time":"2023-08-14T11:07:10Z","timestamp":1692011230000},"page":"844","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Clinical, Epidemiological and Laboratory Features of Invasive Candida parapsilosis Complex Infections in a Brazilian Pediatric Reference Hospital during the COVID-19 Pandemic"],"prefix":"10.3390","volume":"9","author":[{"given":"Paulo Henrique","family":"Peixoto","sequence":"first","affiliation":[{"name":"Department of Pathology and Legal Medicine, Federal University of Cear\u00e1, Fortaleza 60430-160, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria La\u00edna","family":"Silva","sequence":"additional","affiliation":[{"name":"Department of Pathology and Legal Medicine, Federal University of Cear\u00e1, Fortaleza 60430-160, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernando Victor","family":"Portela","sequence":"additional","affiliation":[{"name":"Department of Pathology and Legal Medicine, Federal University of Cear\u00e1, Fortaleza 60430-160, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruno","family":"da Silva","sequence":"additional","affiliation":[{"name":"Department of Pathology and Legal Medicine, Federal University of Cear\u00e1, Fortaleza 60430-160, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edl\u00e2ny","family":"Milanez","sequence":"additional","affiliation":[{"name":"Department of Pathology and Legal Medicine, Federal University of Cear\u00e1, Fortaleza 60430-160, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denis","family":"de Oliveira","sequence":"additional","affiliation":[{"name":"Department of Pathology and Legal Medicine, Federal University of Cear\u00e1, Fortaleza 60430-160, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alda\u00edza","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Albert Sabin Children Hospital, Fortaleza 60410-794, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henrique","family":"de Almeida","sequence":"additional","affiliation":[{"name":"Department of Tropical Medicine, Federal University of Pernambuco, Recife 50670-901, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8846-877X","authenticated-orcid":false,"given":"Reginaldo","family":"Lima-Neto","sequence":"additional","affiliation":[{"name":"Department of Tropical Medicine, Federal University of Pernambuco, Recife 50670-901, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5469-8120","authenticated-orcid":false,"given":"Glaucia Morgana","family":"Guedes","sequence":"additional","affiliation":[{"name":"Department of Pathology and Legal Medicine, Federal University of Cear\u00e1, Fortaleza 60430-160, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6045-2354","authenticated-orcid":false,"given":"D\u00e9bora","family":"Castelo-Branco","sequence":"additional","affiliation":[{"name":"Department of Pathology and Legal Medicine, Federal University of Cear\u00e1, Fortaleza 60430-160, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rossana","family":"Cordeiro","sequence":"additional","affiliation":[{"name":"Department of Pathology and Legal Medicine, Federal University of Cear\u00e1, Fortaleza 60430-160, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Riera, F.O., Caeiro, J.P., Angiolini, S.C., Vigezzi, C., Rodriguez, E., Icely, P.A., and Sotomayor, C.E. (2022). Invasive candidiasis: Update and current challenges in the management of this mycosis in South America. Antibiotics, 11.","DOI":"10.3390\/antibiotics11070877"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1346","DOI":"10.1038\/s41598-018-19453-4","article-title":"Investigation of Candida parapsilosis virulence regulatory factors during host-pathogen interaction","volume":"8","author":"Cabral","year":"2018","journal-title":"Sci. Rep."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1111\/myc.12695","article-title":"Prevalence, virulence factors and antifungal susceptibility of Candida spp. isolated from bloodstream infections in a tertiary care hospital in Brazil","volume":"61","author":"Canela","year":"2018","journal-title":"Mycoses"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1016\/j.ijmm.2015.08.003","article-title":"Candida parapsilosis (sensu lato) isolated from hospitals located in the Southeast of Brazil: Species distribution, antifungal susceptibility and virulence attributes","volume":"305","author":"Ziccardi","year":"2015","journal-title":"Int. J. Med. Microbiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1099\/jmm.0.037812-0","article-title":"Prevalence, distribution and antifungal susceptibility profiles of Candida parapsilosis, Candida orthopsilosis and Candida metapsilosis bloodstream isolates","volume":"61","author":"Bonfietti","year":"2012","journal-title":"J. Med. Microbiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1080\/1120009X.2019.1595895","article-title":"Epidemiology and antifungal susceptibility patterns of candidemia from a tertiary centre in Western Australia","volume":"31","author":"Boan","year":"2019","journal-title":"J. Chemother."},{"key":"ref_7","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_8","doi-asserted-by":"crossref","first-page":"1994","DOI":"10.1093\/jac\/dkw091","article-title":"TRAC-South Africa group. Emergence of azole-resistant Candida parapsilosis causing bloodstream infection: Results from laboratory-based sentinel surveillance in South Africa","volume":"71","author":"Govender","year":"2016","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"812","DOI":"10.1111\/myc.13106","article-title":"Candida spp. bloodstream infections in a Latin American Pediatric Oncology Reference Center: Epidemiology and associated factors","volume":"63","author":"Petrilli","year":"2020","journal-title":"Mycoses"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1097\/INF.0000000000002530","article-title":"EUROCANDY Study Group. Etiology and outcome of candidemia in neonates and children in Europe: An 11-year Multinational Retrospective Study","volume":"39","author":"Warris","year":"2020","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1097\/INF.0000000000003027","article-title":"Breakthrough candidemia in pediatric patients with cancer from a Brazilian Center","volume":"40","author":"Barrientos","year":"2021","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1097\/INF.0000000000003151","article-title":"Epidemiology of culture-confirmed candidemia among hospitalized children in South Africa, 2012\u20132017","volume":"40","author":"Shuping","year":"2021","journal-title":"Pediatr Infect Dis J"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"5590","DOI":"10.1128\/AAC.00466-11","article-title":"Prospective multicenter study of the epidemiology, molecular identification, and antifungal susceptibility of Candida parapsilosis, Candida orthopsilosis, and Candida metapsilosis isolated from patients with candidemia","volume":"55","author":"Eraso","year":"2011","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"644000","DOI":"10.3389\/fmicb.2021.644000","article-title":"Prevalence and antifungal susceptibility of Candida parapsilosis species complex in Eastern China: A 15-year retrospective study by ECIFIG","volume":"12","author":"Guo","year":"2021","journal-title":"Front. Microbiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"264","DOI":"10.3389\/fcimb.2019.00264","article-title":"Molecular identification, genotypic diversity, antifungal susceptibility, and clinical outcomes of infections caused by clinically underrated yeasts, Candida orthopsilosis, and Candida metapsilosis: An Iranian Multicenter Study (2014\u20132019)","volume":"9","author":"Arastehfar","year":"2019","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.mycmed.2017.12.008","article-title":"Emergence of non-Candida albicans species: Epidemiology, phylogeny and fluconazole susceptibility profile","volume":"28","author":"Sadeghi","year":"2018","journal-title":"J. Mycol. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1016\/j.eimc.2014.06.008","article-title":"Prevalencia de Candida orthopsilosis y Candida metapsilosis en muestras cl\u00ednicas [Prevalence of Candida orthopsilosis and Candida metapsilosis in clinical samples]","volume":"33","author":"Sena","year":"2015","journal-title":"Enferm. Infecc. Microbiol. Clin."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"101110","DOI":"10.1016\/j.mycmed.2020.101110","article-title":"High colonization by Candida parapsilosis sensu stricto on hands and surfaces in an adult intensive care unit","volume":"31","author":"Fiorini","year":"2021","journal-title":"J. Mycol. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1128\/CMR.00013-08","article-title":"Candida parapsilosis, an emerging fungal pathogen","volume":"21","author":"Trofa","year":"2008","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2299","DOI":"10.1128\/jcm.32.9.2299-2300.1994","article-title":"High frequency of yeast carriage on hands of hospital personnel","volume":"32","author":"Strausbaugh","year":"1994","journal-title":"J. Clin. Microbiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1093\/clinids\/14.3.756","article-title":"Candida parapsilosis: Epidemiology, pathogenicity, clinical manifestations, and antimicrobial susceptibility","volume":"14","author":"Weems","year":"1992","journal-title":"Clin. Infect. Dis."},{"key":"ref_22","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_23","doi-asserted-by":"crossref","first-page":"27099","DOI":"10.1038\/srep27099","article-title":"Investigation of an unrecognized large-scale outbreak of Candida parapsilosis sensu stricto fungaemia in a tertiary-care hospital in China","volume":"6","author":"Wang","year":"2016","journal-title":"Sci. Rep."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1590\/S0036-46652006000100004","article-title":"Candidemia in a Brazilian hospital: The importance of Candida parapsilosis","volume":"48","author":"Medrano","year":"2006","journal-title":"Rev. Inst. Med. Trop. Sao Paulo"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/j.mycmed.2004.12.002","article-title":"Fungemia by yeasts in Brazil: Occurrence and phenotypic study of strains isolated at the Public Hospital, Botucatu, S\u00e3o Paulo","volume":"15","author":"Ruiz","year":"2005","journal-title":"J. Mycol. Medicale"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"101041","DOI":"10.1016\/j.bjid.2020.11.006","article-title":"Clinical and epidemiological aspects of Candidemia in eight medical centers in the state of Parana, Brazil: Parana Candidemia Network","volume":"25","author":"Colombo","year":"2021","journal-title":"Braz. J. Infect. Dis."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Thomaz, D.Y., de Almeida, J.N., Sejas, O.N.E., Del Negro, G.M.B., Carvalho, G.O.M.H., Gimenes, V.M.F., de Souza, M.E.B., Arastehfar, A., and Camargo, C.H. (2021). Environmental clonal spread of azole-resistant Candida parapsilosis with Erg11-Y132F mutation causing a large candidemia outbreak in a Brazilian cancer referral center. J. Fungi, 7.","DOI":"10.3390\/jof7040259"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e000992","DOI":"10.1136\/bmjopen-2012-000992","article-title":"Candida parapsilosis candidaemia in a neonatal unit over 7 years: A case series study","volume":"2","author":"Costa","year":"2012","journal-title":"BMJ Open"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1080\/13693780500421476","article-title":"Clinical and microbiological aspects of candidemia due to Candida parapsilosis in Brazilian tertiary care hospitals","volume":"44","author":"Brito","year":"2006","journal-title":"Med. Mycol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1097\/ANA.0000000000000803","article-title":"COVID-19 in pediatric patients: A systematic review","volume":"34","author":"Jackson","year":"2022","journal-title":"J. Neurosurg. Anesthesiol."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Kitano, T., Kitano, M., Krueger, C., Jamal, H., Al Rawahi, H., Lee-Krueger, R., Sun, R.D., Isabel, S., Garc\u00eda-Ascaso, M.T., and Hibino, H. (2021). The differential impact of pediatric COVID-19 between high-income countries and low- and middle-income countries: A systematic review of fatality and ICU admission in children worldwide. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0246326"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1016\/S2352-4642(21)00134-6","article-title":"Clinical characteristics and risk factors for death among hospitalised children and adolescents with COVID-19 in Brazil: An analysis of a nationwide database","volume":"5","author":"Oliveira","year":"2021","journal-title":"Lancet Child. Adolesc. Health"},{"key":"ref_33","unstructured":"Instituto Brasileiro de Geografia e Estat\u00edstica (IBGE) (2023, May 22). Fortaleza (CE)\/Cidades e Estados. [S.l.]: Gov.br, Available online: https:\/\/www.ibge.gov.br\/cidades-e-estados\/ce\/fortaleza.html."},{"key":"ref_34","unstructured":"Instituto de Pesquisa e Estrat\u00e9gia Econ\u00f4mica do Cear\u00e1 (IPECE) (2023, May 22). Indicadores sociais do Cear\u00e1. Fortaleza\u2014Cear\u00e1: IPCE, Available online: https:\/\/www.ipece.ce.gov.br\/wp-content\/uploads\/sites\/45\/2022\/04\/Indicadores_Sociais_2019_.pdf."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2233","DOI":"10.1128\/JCM.00189-16","article-title":"Diagnosis of urinary tract infections in children","volume":"54","author":"Doern","year":"2016","journal-title":"J. Clin. Microbiol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.1056\/NEJM197706092962301","article-title":"A semiquantitative culture method for identifying intravenous-catheter-related infection","volume":"296","author":"Maki","year":"1977","journal-title":"N. Engl. J. Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1590\/S1517-83822014005000044","article-title":"Application of MALDI-TOF MS for requalification of a Candida clinical isolates culture collection","volume":"45","author":"Santos","year":"2014","journal-title":"Braz. J. Microbiol."},{"key":"ref_38","unstructured":"Clinical and Laboratory Standards Institute (CLSI) (2017). M27\u2014Reference Method for Broth Dilution Antifungal Susceptibility Testing of Yeasts, Clinical and Laboratory Standards Institute (CLSI). [4th ed.]."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"681","DOI":"10.3109\/13693780802549594","article-title":"Biofilms of non-Candida albicans Candida species: Quantification, structure and matrix composition","volume":"47","author":"Silva","year":"2009","journal-title":"Med. Mycol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1494","DOI":"10.1038\/nprot.2008.141","article-title":"A simple and reproducible 96-well plate-based method for the formation of fungal biofilms and its application to antifungal susceptibility testing","volume":"3","author":"Pierce","year":"2008","journal-title":"Nat. Protoc."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1111\/j.1600-0463.2007.apm_630.x","article-title":"Quantification of biofilm in microtiter plates: Overview of testing conditions and practical recommendations for assessment of biofilm production by staphylococci","volume":"115","author":"Hola","year":"2007","journal-title":"APMIS"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1111\/myc.12792","article-title":"Candidemia in children: Epidemiology, prevention and management","volume":"61","author":"Mantadakis","year":"2018","journal-title":"Mycoses"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"e0045321","DOI":"10.1128\/Spectrum.00453-21","article-title":"Epidemiology of candidemia in children over 7 years in a Medical Center in Turkey","volume":"9","author":"Baran","year":"2021","journal-title":"Microbiol. Spectr."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1097\/INF.0000000000003082","article-title":"Candidemia in children: A 16-year longitudinal epidemiologic study","volume":"40","author":"Silvester","year":"2021","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1097\/INF.0000000000002912","article-title":"Pediatric and neonatal invasive candidiasis: Species distribution and mortality rate in a Thai Tertiary Care Hospital","volume":"40","author":"Jantarabenjakul","year":"2021","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1111\/myc.13564","article-title":"Evaluation of candidemia in children at a university hospital: A retrospective cohort","volume":"66","author":"Avcu","year":"2023","journal-title":"Mycoses"},{"key":"ref_47","first-page":"29","article-title":"Epidemiology and associated risk factors for candidemia in a Canadian tertiary paediatric hospital: An 11-year review","volume":"8","author":"Liu","year":"2023","journal-title":"J. Assoc. Med. Microbiol. Infect. Dis. Can."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Branco, J., Miranda, I.M., and Rodrigues, A.G. (2023). Candida parapsilosis virulence and antifungal resistance mechanisms: A comprehensive review of key determinants. J. Fungi, 9.","DOI":"10.3390\/jof9010080"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"110","DOI":"10.4103\/ijmm.IJMM_20_112","article-title":"Candidaemia in a tertiary care centre of developing country: Monitoring possible change in spectrum of agents and antifungal susceptibility","volume":"38","author":"Kaur","year":"2020","journal-title":"Indian J. Med. Microbiol."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Thomaz, D.Y., Del Negro, G.M.B., Ribeiro, L.B., da Silva, M., Carvalho, G.O.M.H., Camargo, C.H., de Almeida, J.N., Motta, A.L., Siciliano, R.F., and Sejas, O.N.E. (2022). A Brazilian inter-hospital candidemia outbreak caused by fluconazole-resistant Candida parapsilosis in the COVID-19 era. J. Fungi, 8.","DOI":"10.3390\/jof8020100"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"2997","DOI":"10.3389\/fmicb.2018.02997","article-title":"An azole-resistant Candida parapsilosis outbreak: Clonal persistence in the intensive care unit of a Brazilian teaching hospital","volume":"9","author":"Thomaz","year":"2018","journal-title":"Front. Microbiol."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Pinhati, H.M., Casulari, L.A., Souza, A.C., Siqueira, R.A., Damasceno, C.M., and Colombo, A.L. (2016). Outbreak of candidemia caused by fluconazole resistant Candida parapsilosis strains in an intensive care unit. BMC Infect. Dis., 16.","DOI":"10.1186\/s12879-016-1767-9"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1093\/mmy\/myw030","article-title":"Fungal peritonitis in patients undergoing peritoneal dialysis (PD) in Brazil: Molecular identification, biofilm production and antifungal susceptibility of the agents","volume":"54","author":"Giacobino","year":"2016","journal-title":"Med. Mycol."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Lee, W.J., Hsu, J.F., Chen, Y.N., Wang, S.H., Chu, S.M., Huang, H.R., Yang, P.H., Fu, R.H., and Tsai, M.H. (2022). Pediatric candida bloodstream infections complicated with mixed and subsequent bacteremia: The clinical characteristics and impacts on outcomes. J. Fungi, 8.","DOI":"10.3390\/jof8111155"},{"key":"ref_55","first-page":"225","article-title":"A 7-year study of the distribution of nosocomial candidemia in children with cancer","volume":"57","author":"Devrim","year":"2015","journal-title":"Turk. J. Pediatr."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1681","DOI":"10.1128\/JCM.44.5.1681-1685.2006","article-title":"Epidemiology, risk factors, and prognosis of Candida parapsilosis bloodstream infections: Case-control population-based surveillance study of patients in Barcelona, Spain, from 2002 to 2003","volume":"4","author":"Almirante","year":"2006","journal-title":"J. Clin. Microbiol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"ofu026","DOI":"10.1093\/ofid\/ofu026","article-title":"Candida pneumonia in intensive care unit?","volume":"1","author":"Schnabel","year":"2014","journal-title":"Open Forum. Infect. Dis."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.jcrc.2008.01.005","article-title":"The clinical significance of Candida colonization of respiratory tract secretions in critically ill patients","volume":"23","author":"Delisle","year":"2008","journal-title":"J. Crit. Care"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1007\/s00134-006-0422-0","article-title":"Impact of antifungal treatment on Candida-Pseudomonas interaction: A preliminary retrospective case-control study","volume":"33","author":"Nseir","year":"2007","journal-title":"Intensive Care Med."},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Su, K.C., Chou, K.T., Hsiao, Y.H., Tseng, C.M., Su, V.Y., Lee, Y.C., Perng, D.W., and Kou, Y.R. (2017). Measuring (1,3)-\u03b2-D-glucan in tracheal aspirate, bronchoalveolar lavage fluid, and serum for detection of suspected Candida pneumonia in immunocompromised and critically ill patients: A prospective observational study. BMC Infect. Dis., 17.","DOI":"10.1186\/s12879-017-2364-2"}],"container-title":["Journal of Fungi"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2309-608X\/9\/8\/844\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:32:33Z","timestamp":1760128353000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2309-608X\/9\/8\/844"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,13]]},"references-count":60,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2023,8]]}},"alternative-id":["jof9080844"],"URL":"https:\/\/doi.org\/10.3390\/jof9080844","relation":{},"ISSN":["2309-608X"],"issn-type":[{"value":"2309-608X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,13]]}}}