Development of caspofungin resistance following prolonged therapy for invasive candidiasis secondary to Candida glabrata infection.
We report a case of Candida glabrata invasive candidiasis that developed reduced susceptibility to caspofungin during prolonged therapy. Pre- and posttreatment isolates were confirmed to be isogenic, and sequencing of hot spots known to confer echinocandin resistance revealed an F659V substitution within the FKS2 region of the glucan synthase complex.
Thompson
George R
GR
Department of Internal Medicine, Division of Infectious Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA. thompsong2@uthscsa.edu
Wiederhold
Nathan P
NP
Vallor
Ana C
AC
Villareal
Nyria C
NC
Lewis
James S
JS
Patterson
Thomas F
TF
D000328:Adult; D019943:Amino Acid Substitution; D000935:Antifungal Agents / Q000494:pharmacology*; D001483:Base Sequence; D041221:Candida glabrata / Q000187:drug effects* / Q000201:enzymology / Q000235:genetics; D002177:Candidiasis / Q000188:drug therapy* / Q000382:microbiology*; D000077336:Caspofungin; D017931:DNA Primers / Q000235:genetics; D004271:DNA, Fungal / Q000235:genetics; D025141:Drug Resistance, Fungal / Q000235:genetics; D054714:Echinocandins / Q000494:pharmacology*; D005800:Genes, Fungal; D005964:Glucosyltransferases / Q000235:genetics; D006801:Humans; D055666:Lipopeptides
D000935:Antifungal Agents; D017931:DNA Primers; D004271:DNA, Fungal; D054714:Echinocandins; D055666:Lipopeptides; D005964:Glucosyltransferases; C040232:glucan synthase; D000077336:Caspofungin