title: [A case of micafungin-hyposensitive Candida glabrata due to FKS2 gene mutation].
abstract: Candida glabrata was continuously isolated in cultured urine samples from a subject with thrombotic thrombocytopenic purpura. Yeast-like fungal phagocytosis found in gram staining led to agents being tested for antifungal susceptibility, revealing hyposensitivity to micafungin (MCFG) of MIC <2 mg/mL. MCFG administered for 10 days failed to cure C. glabrata infection. To clarify why hyposensitivity occurred, we analyzed the FKS gene sequence using the PCR, finding a deficit of 3 bases coding phenylalanine at FKS2 gene amino acid 659. MCFG hyposensitivity may thus occur in long-term candin-class anti-fungal agent treatment. Candin-class agents have potent anti-fungal activity with fewer adverse effects and are widely used clinically. Hyposensitivity due to resistant C. glabrata species showed thus be considered in fungal infection treatment.
authors.affiliation: Department of Clinical Laboratory, Kansai Medical University Hirakata Hospital.
authors.forename: Sachiko
authors.initials: S
authors.lastname: Inui
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Nakamura
authors.forename: Kouichi
authors.initials: K
authors.lastname: Tanabe
authors.forename: Hideaki
authors.initials: H
authors.lastname: Ohno
authors.forename: Chihiro
authors.initials: C
authors.lastname: Koike
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Okuda
authors.forename: Chiyo
authors.initials: C
authors.lastname: Nakata
authors.forename: Hiroko
authors.initials: H
authors.lastname: Fujimoto
authors.forename: Hiroe
authors.initials: H
authors.lastname: Ohkura
authors.forename: Yoshitsugu
authors.initials: Y
authors.lastname: Miyazaki
authors.forename: Hakuo
authors.initials: H
authors.lastname: Takahashi
mesh_terms: D000368:Aged; D000935:Antifungal Agents / Q000494:pharmacology*; D041221:Candida glabrata / Q000187:drug effects / Q000235:genetics*; D025141:Drug Resistance, Fungal / Q000235:genetics; D054714:Echinocandins / Q000494:pharmacology*; D005260:Female; D005656:Fungal Proteins / Q000235:genetics*; D006801:Humans; D055666:Lipopeptides / Q000494:pharmacology*; D000077551:Micafungin; D009154:Mutation
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D005656:Fungal Proteins; D055666:Lipopeptides; D000077551:Micafungin