Rapid emergence of echinocandin resistance in Candida glabrata resulting in clinical and microbiologic failure

Antimicrob Agents Chemother. 2013 Sep;57(9):4559-61. doi: 10.1128/AAC.01144-13. Epub 2013 Jul 1.

Abstract

We report a case of Candida glabrata candidemia that developed resistance to micafungin within 8 days of initiation of therapy in a patient without previous echinocandin exposure or other known risk factors for clinical or microbiological failure. Pre- and postresistant isolates were confirmed to be isogenic, and sequencing of hot spots known to confer echinocandin resistance revealed a phenylalanine deletion at codon 659 within FKS2.

Publication types

  • Case Reports

MeSH terms

  • Antifungal Agents / pharmacology*
  • Candida glabrata / drug effects*
  • Candida glabrata / enzymology
  • Candida glabrata / genetics
  • Candidemia / drug therapy*
  • Candidemia / microbiology
  • Drug Resistance, Fungal / drug effects
  • Drug Resistance, Fungal / genetics*
  • Echinocandins / pharmacology*
  • Female
  • Fungal Proteins / genetics*
  • Fungal Proteins / metabolism
  • Glucosyltransferases / genetics*
  • Glucosyltransferases / metabolism
  • Humans
  • Microbial Sensitivity Tests
  • Middle Aged
  • Mutation
  • Sequence Analysis, DNA
  • Time Factors

Substances

  • Antifungal Agents
  • Echinocandins
  • Fungal Proteins
  • Glucosyltransferases