Prevalent mutator genotype identified in fungal pathogen Candida glabrata promotes multi-drug resistance

Nat Commun. 2016 Mar 29:7:11128. doi: 10.1038/ncomms11128.

Abstract

The fungal pathogen Candida glabrata has emerged as a major health threat since it readily acquires resistance to multiple drug classes, including triazoles and/or echinocandins. Thus far, cellular mechanisms promoting the emergence of resistance to multiple drug classes have not been described in this organism. Here we demonstrate that a mutator phenotype caused by a mismatch repair defect is prevalent in C. glabrata clinical isolates. Strains carrying alterations in mismatch repair gene MSH2 exhibit a higher propensity to breakthrough antifungal treatment in vitro and in mouse models of colonization, and are recovered at a high rate (55% of all C. glabrata recovered) from patients. This genetic mechanism promotes the acquisition of resistance to multiple antifungals, at least partially explaining the elevated rates of triazole and multi-drug resistance associated with C. glabrata. We anticipate that identifying MSH2 defects in infecting strains may influence the management of patients on antifungal drug therapy.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Antifungal Agents / pharmacology
  • Antifungal Agents / therapeutic use
  • Candida glabrata / genetics*
  • Candida glabrata / isolation & purification
  • Candidiasis / drug therapy
  • Candidiasis / microbiology
  • Colony Count, Microbial
  • Disease Models, Animal
  • Drug Resistance, Fungal / drug effects
  • Drug Resistance, Fungal / genetics*
  • Drug Resistance, Multiple / drug effects
  • Drug Resistance, Multiple / genetics*
  • Echinocandins / pharmacology
  • Echinocandins / therapeutic use
  • Gene Deletion
  • Genes, Fungal
  • Genotype
  • Humans
  • Kidney / drug effects
  • Kidney / microbiology
  • Kidney / pathology
  • Mice
  • Mutation / genetics*
  • Phenotype

Substances

  • Antifungal Agents
  • Echinocandins