Breakthrough invasive Candida glabrata in patients on micafungin: a novel FKS gene conversion correlated with sequential elevation of MIC

J Clin Microbiol. 2014 Jul;52(7):2709-12. doi: 10.1128/JCM.03593-13. Epub 2014 Apr 30.

Abstract

Candida glabrata strains sequentially isolated from blood developed resistance to micafungin (MICs from <0.015 to 4 μg/ml). A novel mutation identified in micafungin-resistant strains at bp 262 of FKS2 (containing a deletion of F659 [F659del]) was inserted into the homologous region in FKS1.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged, 80 and over
  • Antifungal Agents / pharmacology
  • Antifungal Agents / therapeutic use*
  • Base Sequence
  • Candida glabrata / drug effects*
  • Candida glabrata / genetics
  • Candida glabrata / isolation & purification
  • Candidemia / drug therapy*
  • Candidemia / microbiology*
  • Echinocandins / pharmacology
  • Echinocandins / therapeutic use*
  • Fungal Proteins / genetics*
  • Gene Conversion*
  • Humans
  • Lipopeptides / pharmacology
  • Lipopeptides / therapeutic use*
  • Male
  • Micafungin
  • Microbial Sensitivity Tests
  • Molecular Sequence Data
  • Mutagenesis, Insertional
  • Sequence Deletion

Substances

  • Antifungal Agents
  • Echinocandins
  • Fungal Proteins
  • Lipopeptides
  • Micafungin