ArticleJournal of medical microbiology2013
Invasive candidiasis in Pakistan: clinical characteristics, species distribution and antifungal susceptibility.
Article in Journal of medical microbiology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 58 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
- Validation of molecular detection ofMicrobiology spectrum · 2026Article
- First Case of Candidemia With Fluconazole-ResistantCase reports in infectious diseases · 2026Article
- Impact ofPathogens (Basel, Switzerland) · 2025Observational
- Article
- Progress on the Global Research Agenda for Antimicrobial Resistance in Human Health in Pakistan: Findings and Implications.Infection and drug resistance · 2025Review
- Advanced genetic techniques in fungal pathogen research.mSphere · 2024Review
- Candidaemia: A 9-Year Retrospective Analysis of Epidemiology and Antimicrobial Susceptibility in Tertiary Care Hospitals in Western China.Infection and drug resistance · 2024Article
- The emerging threat antifungal-resistantFrontiers in fungal biology · 2022Review
- Continual Decline in Azole Susceptibility Rates inFrontiers in microbiology · 2021Article
- Article
- Spatial inter-centromeric interactions facilitated the emergence of evolutionary new centromeres.eLife · 2020Article
- Molecular and genetic basis of azole antifungal resistance in the opportunistic pathogenic fungus Candida albicans.The Journal of antimicrobial chemotherapy · 2020Review
- Species Distribution and Antifungal Susceptibility of Invasive Candidiasis: A 2016-2017 Multicenter Surveillance Study in Beijing, China.Infection and drug resistance · 2020Article
- An Association of an eBURST Group With Triazole Resistance ofFrontiers in microbiology · 2020Article
- Surveillance study of the prevalence, species distribution, antifungal susceptibility, risk factors and mortality of invasive candidiasis in a tertiary teaching hospital in Southwest China.BMC infectious diseases · 2019Article
- Article
- Changes in the epidemiological landscape of invasive candidiasis.The Journal of antimicrobial chemotherapy · 2018Review
- Serious fungal infections in Pakistan.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2017Article
- Simultaneous Emergence of Multidrug-Resistant Candida auris on 3 Continents Confirmed by Whole-Genome Sequencing and Epidemiological Analyses.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2017Article
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Authors and funding
9 authors at 2 institutions in 2 countries.
Funding
Abstract
This study reports for the first time, to our knowledge, descriptive epidemiological data for 188 invasive Candida isolates from Pakistan, including species identification and antifungal susceptibility against fluconazole, itraconazole, voriconazole, caspofungin, micafungin, anidulafungin and amphotericin. Risk factors for invasive candidiasis (IC) were determined for 96 patients from Karachi, Pakistan. In adults and neonates, Candida tropicalis (38 and 36 %, respectively) was the most common species, followed in adults by Candida parapsilosis (17.8 %), Candida glabrata (15.9 %) and Candida albicans (12.3 %). C. albicans (21 %) was the second most common in neonates. In children, C. albicans (31.9 %), C. tropicalis (26.4 %) and C. parapsilosis (19.4 %) were the most common. C. albicans IC was significantly associated with paediatric age [crude odds ratio (COR) 3.46, 95 % confidence interval (CI) 1.63-7.32]. Rare species made up 17.5 % of the total isolates studied. Resistance to fluconazole was seen in C. glabrata (15 .0%) and Candida krusei (100 .0%). Only one isolate (C. glabrata) was resistant to all three echinocandins. Low MICs of fluconazole for 98 % (184/188) of isolates tested support its continued use as an empiric therapy for IC. Non-C. albicans IC was associated with the use of β-lactam inhibitor combinations (COR 3.16, 95 % CI 1.05-9.57). Use of healthcare devices was documented in 85.4 % of IC patients, whilst 75 .0% had been admitted to special care units. Surprisingly, 66.7 % of patients with IC were not obviously immunosuppressed. The high frequency of modifiable risk factors in this population indicates that candidaemia can be reduced with stringent antibiotic and infection control measures. These data will be useful for empiric selection of antifungals in Karachi, and contribute to global assessments of antifungal resistance.
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