ArticleAntimicrobial agents and chemotherapy2010
Risk factors for fluconazole-resistant candidemia.
Article in Antimicrobial agents and chemotherapy, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 2 of them syntheses that pooled it.
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Who cites it
50 citing papers in PubMed, 2 syntheses or guidelines pooled it, 125 citations in OpenAlex.
- Global prevalence and trends of fluconazole resistance in non-albicans Candida species: a systematic review and meta-analysis.BMC infectious diseases · 2026Pooled it
- A research agenda on the management of intra-abdominal candidiasis: results from a consensus of multinational experts.Intensive care medicine · 2013Guideline
- Clinical factors associated with fluconazole resistance in oral Candida from xerostomic head and neck cancer patients.Odontology · 2026Article
- Oral nystatin for the prevention of antibiotic-related fungal peritonitis in peritoneal dialysis patients: a systematic review and meta-analysis of randomized and observational studies.JAC-antimicrobial resistance · 2026Review
- First Case of Candidemia With Fluconazole-ResistantCase reports in infectious diseases · 2026Article
- Prognostic Factors for 28-Day Mortality in Pediatric Patients with Acute Leukemia and Candidemia Following Intensive Chemotherapy: A Retrospective Study.Hematology reports · 2025Article
- Systemic Antifolate Chemotherapy Does Not Select for Fluconazole-ResistantPathogens (Basel, Switzerland) · 2025Article
- Evaluating antimicrobial stewardship strategies in candidemia: a novel desirability of outcome ranking (DOOR) analysis comparing blood culture versus T2Candida diagnostic approaches.Journal of clinical microbiology · 2025Observational
- Risk factors and outcome for bloodstream infections due to fluconazole-resistant Candida parapsilosis: a 22-year single-center retrospective study.Antimicrobial resistance and infection control · 2025Article
- Exploring the effects of culture conditions on Yapsin (Open life sciences · 2024Article
- Establishment and Validation of a Nomogram Clinical Prediction Model for Nosocomial Candidemia: An 18-Year Retrospective Analysis.Infection and drug resistance · 2024Article
- A 14-Year Cohort of Candidemia in the Pediatric Population in a Tertiary Center in Jerusalem: Clinical Characteristics, Antifungal Susceptibility, and Risk Factors for Mortality.Journal of fungi (Basel, Switzerland) · 2023Article
- Clinical, epidemiological, and mycological features of patients with candidemia: Experience in two tertiary referral centers in Iran.Current medical mycology · 2022Article
- Creation and Internal Validation of a Clinical Predictive Model for Fluconazole Resistance in Patients WithOpen forum infectious diseases · 2022Article
- High frequency ofCurrent medical mycology · 2022Article
- Article
- Deciphering the epidemiology of invasive candidiasis in the intensive care unit: is it possible?Infection · 2021Review
- Species Distribution of Candidemia and Their Susceptibility in a Single Japanese University Hospital: Prior Micafungin Use Affects the Appearance ofJournal of fungi (Basel, Switzerland) · 2021Article
- Epidemiology, clinical characteristics, and outcome of candidemia in critically ill patients in Germany: a single-center retrospective 10-year analysis.Annals of intensive care · 2020Article
- Isolation ofCurrent medical mycology · 2020Article
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Previous studies have sought to determine the risk factors associated with candidemia caused by non-albicans Candida spp. or with potentially fluconazole-resistant Candida spp. (C. glabrata and C. krusei). Non-albicans Candida strains are a heterogeneous group that includes species with different levels of virulence, and only a limited number of C. glabrata isolates are resistant to fluconazole. We set out to identify the risk factors associated with microbiologically proven fluconazole-resistant candidemia. A prospective study including adult patients with candidemia was performed. Data were collected on patient demographics; underlying diseases; exposure to corticosteroids, antibiotics, or fluconazole; and invasive procedures. Risk factors associated either with non-albicans Candida spp. or potentially fluconazole-resistant Candida spp. (C. glabrata or C. krusei) or with Candida spp. with microbiologically confirmed fluconazole resistance were assessed using logistic regressions. We included 226 candidemia episodes. Non-albicans Candida isolates accounted for 53.1% of the fungal isolates, but only 18.2% of the cases were caused by potentially fluconazole-resistant organisms. Thirty isolates exhibited microbiologically confirmed fluconazole resistance. The multivariate analysis revealed that independent predictors associated with fluconazole-resistant Candida spp. were neutropenia (odds ratio [OR]=4.94; 95% confidence interval [CI]=1.50 to 16.20; P=0.008), chronic renal disease (OR=4.82; 95% CI=1.47 to 15.88; P=0.01), and previous fluconazole exposure (OR=5.09; 95% CI=1.66 to 15.6; P=0.004). Independently significant variables associated with non-albicans Candida bloodstream infection or with potentially fluconazole-resistant Candida spp. did not include previous fluconazole exposure. We concluded that prior fluconazole treatment is an independent risk factor only for candidemia caused by microbiologically confirmed fluconazole resistant species. Our findings may be of value for selecting empirical antifungal therapy.
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