ArticleMycoses2020
Fluconazole-resistant Candida parapsilosis strains with a Y132F substitution in the ERG11 gene causing invasive infections in a neonatal unit, South Africa.
Article in Mycoses, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 1 of them a synthesis that pooled it.
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Who cites it
47 citing papers in PubMed, 1 synthesis or guideline pooled it, 64 citations in OpenAlex.
- Candida parapsilosis: A systematic review to inform the World Health Organization fungal priority pathogens list.Medical mycology · 2024Pooled it
- Population genomics reveals a long-term increase in azole resistance associated with the emerging cluster AZR amongEmerging microbes & infections · 2026Article
- Identification of Clinically Relevant Yeasts from Avian Isolates Using API ID32C, MALDI-TOF MS, and ITS Sequencing: Potential Relevance from a One Health Perspective.Veterinary sciences · 2026Article
- Species-specific antifungal resistance trends in yeast bloodstream isolates causing candidemia before, during, and after the COVID-19 pandemic: insights from the INVIFAR Mexican multicenter network.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Article
- Persistence and spread of fluconazole-resistantMicrobial genomics · 2026Article
- Analysis of the risk factors associated with bloodstream infections caused by Candida parapsilosis in pediatric patients and the determinants of fluconazole non-susceptibility: a retrospective 15-year cohort study.BMC infectious diseases · 2026Article
- Six-month surveillance ofFrontiers in cellular and infection microbiology · 2026Article
- Emerging antifungal resistance in Candida parapsilosis: the end of the innocence.npj antimicrobials and resistance · 2025Review
- Antifungal treatment strategies and their impact on resistance development in clinical settings.The Journal of antimicrobial chemotherapy · 2025Review
- Comparative effectiveness of echinocandins and liposomal amphotericin B for fluconazole-resistantAntimicrobial agents and chemotherapy · 2025Observational
- Recent Systemic Antifungal Exposure and Nonsusceptible Candida in Hospitalized Patients, South Africa, 2012-2017.Emerging infectious diseases · 2025Article
- Clinical impact of fluconazole-resistantFuture microbiology · 2025Review
- Article
- Bixin fromACS omega · 2025Article
- Understanding the mechanisms of resistance to azole antifungals inJAC-antimicrobial resistance · 2025Review
- Article
- Resistance to Azoles inJournal of fungi (Basel, Switzerland) · 2025Article
- Phenotypic and genotypic characterization of Candida parapsilosis complex isolates from a Lebanese hospital.Scientific reports · 2025Article
- Clinical Characteristics of Candidemia Due toJournal of fungi (Basel, Switzerland) · 2024Article
- Twenty Years in EUCAST Anti-Fungal Susceptibility Testing: Progress & Remaining Challenges.Mycopathologia · 2024Review
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 2 countries.
Funding
Abstract
introductionThe prevalence of azole resistance in C parapsilosis is very low in most parts of the world. However, South Africa has reported an exceptionally high prevalence of azole resistance in C parapsilosis strains isolated from candidaemia cases. We aimed to determine the possible molecular mechanisms of fluconazole resistance in C parapsilosis isolates obtained through surveillance at a large neonatal unit at a South African academic hospital.
methodsWe sequenced the ERG11 and MRR1 genes of C parapsilosis isolates recovered from cases of neonatal candidemia, followed by microsatellite genotyping. A total of 73 isolates with antifungal susceptibility results were analysed.
resultsOf these, 57 (78%) were resistant, 11 (15%) susceptible dose-dependent and 5 (7%) susceptible. The most commonly identified amino acid substitution within the ERG11 gene was Y132F in 68% (39/57) of fluconazole-resistant isolates and none in susceptible isolates. Three amino acid substitutions (R405K, G583R and A619V) and 1 nucleotide deletion at position 1331 were identified within MRR1 gene in 19 (26%) isolates. Microsatellite genotyping grouped isolates into four clusters (50 isolates). Cluster 1 accounted for 23% (17/73) of all cases, cluster 2 for 22% (16/73), cluster 3 for 14% (10/73) and cluster 4 for 10% (7/73). We found an association between cluster type and fluconazole resistance (P-value = .004). Isolates harbouring the Y132F substitution were more likely to belong to a cluster than non-Y132F isolates.
conclusionFluconazole resistance in C parapsilosis strains from a single South African neonatal unit was associated with cluster type and predominantly driven by Y123F amino acid substitutions in the ERG11 gene.
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