title: Recurrent episodes of candidemia due to Candida glabrata with a mutation in hot spot 1 of the FKS2 gene developed after prolonged therapy with caspofungin.
abstract: We report two episodes of recurrent candidemia caused by echinocandin-resistant Candida glabrata in a 69-year-old patient who underwent repeated abdominal surgery. In the first episode of candidemia, an echinocandin-susceptible Candida glabrata strain was isolated, and the patient was treated with caspofungin. The isolates from the later episodes showed resistance to echinocandins. Analysis of the HS1 region of the FKS2 gene showed the amino acid substitution S663P. Microsatellite analysis demonstrated a strong genetic relationship between the isolates.
authors.affiliation: Servicio de Microbiología, Hospital Universitario de Móstoles, Madrid, Spain.
authors.forename: María Teresa
authors.initials: MT
authors.lastname: Durán-Valle
authors.forename: Sara
authors.initials: S
authors.lastname: Gago
authors.forename: Alicia
authors.initials: A
authors.lastname: Gómez-López
authors.forename: Manuel
authors.initials: M
authors.lastname: Cuenca-Estrella
authors.forename: Leticia
authors.initials: L
authors.lastname: Jiménez Díez-Canseco
authors.forename: José Luis
authors.initials: JL
authors.lastname: Gómez-Garcés
authors.forename: Oscar
authors.initials: O
authors.lastname: Zaragoza
mesh_terms: D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use*; D041221:Candida glabrata / Q000235:genetics / Q000472:pathogenicity*; D058387:Candidemia / Q000188:drug therapy / Q000382:microbiology*; D000077336:Caspofungin; D054714:Echinocandins / Q000627:therapeutic use*; D005656:Fungal Proteins / Q000235:genetics*; D006801:Humans; D055666:Lipopeptides; D008297:Male; D009154:Mutation
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D005656:Fungal Proteins; D055666:Lipopeptides; D000077336:Caspofungin