title: Development of caspofungin resistance following prolonged therapy for invasive candidiasis secondary to Candida glabrata infection.
abstract: 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.
authors.affiliation: 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
authors.forename: George R
authors.initials: GR
authors.lastname: Thompson
authors.forename: Nathan P
authors.initials: NP
authors.lastname: Wiederhold
authors.forename: Ana C
authors.initials: AC
authors.lastname: Vallor
authors.forename: Nyria C
authors.initials: NC
authors.lastname: Villareal
authors.forename: James S
authors.initials: JS
authors.lastname: Lewis
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Patterson
mesh_terms: 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
chemical_list: D000935:Antifungal Agents; D017931:DNA Primers; D004271:DNA, Fungal; D054714:Echinocandins; D055666:Lipopeptides; D005964:Glucosyltransferases; C040232:glucan synthase; D000077336:Caspofungin