Impact of Fluconazole Resistance on the Outcomes of Patients With Candida parapsilosis Bloodstream Infections: A Retrospective Multicenter Study.

This article examines the impact of fluconazole resistance on clinical outcomes in patients with bloodstream infections (BSI) caused by *Candida parapsilosis*. In a multicenter retrospective study of 457 adult patients from three hospitals in Italy and Spain (2018–2022), 42.9% had fluconazole-resistant *C. parapsilosis* (FLZR-CP) and 57.1% had fluconazole-susceptible strains (FLZS-CP). The study found no significant difference in 30-day all-cause mortality between FLZR-CP patients treated with echinocandins and FLZS-CP patients treated with fluconazole, after adjusting for confounders; factors such as age, solid tumors, previous antifungal treatment, septic shock, and appropriate source control were more predictive of mortality. However, fluconazole resistance was associated with a significantly higher risk of 1-year recurrence of *C. parapsilosis* BSI. These findings suggest that while fluconazole resistance does not increase short-term mortality when appropriate antifungal therapy is administered, it may contribute to increased long-term infection recurrence.