The genetic portrait of an emerging strain: from clinical fungal epidemiology of Aspergillus spp. and Candida spp to dissection of the drug resistance mechanisms of an azole resistant Candida parapsilosis

Multiple reports from all over the world have described the emergence of non-albicans Candida species in the form of clinical outbreaks, caused mainly by Candida parapsilosis, Candida auris and Candida glabrata with an associated increase in drug resistance rates. According to the WHO fungal priority list recommendations and in consideration of this evolving scenario, evaluation of local epidemiology of invasive fungal infections and associated antifungal susceptibility profiles is mandatory. Plus, authors from all over Italy are currently reporting several clinical outbreaks of azole resistant Candida parapsilosis and Candida auris especially in University Hospitals from north to south. Therefore, considering that the Azienda Ospedaliero-Universitaria Pisana is a tertiary level-care center of central Italy, studying the epidemiology of invasive fungal infections is of outmost importance. Aim of this PhD thesis was to evaluate from a clinical to a genomic perspective, trends in invasive fungal infections and associated antifungal resistance profiles.