Echinocandin resistance due to simultaneous FKS mutation and increased cell wall chitin in a Candida albicans bloodstream isolate following brief exposure to caspofungin.
Echinocandins are first-line agents for treating severe invasive candidiasis. Glucan synthase gene (FKS1) mutations lead to echinocandin resistance but the role of enhanced chitin expression is not well recognized in clinical isolates. We report a case of bloodstream Candida albicans infection with both Fks1 hotspot mutation and elevated cell wall chitin.
John Lynch Renal Unit & Department of Microbiology, University Hospital Crosshouse, Kilmarnock, UK.
Toufeeq
T
Imtiaz
School of Medical Sciences, Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK.
Kathy K
KK
Lee
School of Medical Sciences, Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK.
Carol A
CA
Munro
School of Medical Sciences, Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK.
Donna M
DM
MacCallum
Department of Clinical Mycology, Yorkhill Hospital, Glasgow, UK.
Gillian S
GS
Shankland
Mycology Reference Laboratory, Health Protection Agency, Bristol, UK.
Elizabeth M
EM
Johnson
John Lynch Renal Unit & Department of Microbiology, University Hospital Crosshouse, Kilmarnock, UK.
Mark S
MS
MacGregor
John Lynch Renal Unit & Department of Microbiology, University Hospital Crosshouse, Kilmarnock, UK.
Abhijit M
AM
Bal
D002176:Candida albicans / Q000187:drug effects* / Q000201:enzymology / Q000235:genetics / Q000378:metabolism; D058387:Candidemia / Q000188:drug therapy / Q000382:microbiology*; D000077336:Caspofungin; D002473:Cell Wall / Q000378:metabolism; D002686:Chitin / Q000378:metabolism; D025141:Drug Resistance, Fungal / Q000235:genetics*; D054714:Echinocandins / Q000494:pharmacology* / Q000627:therapeutic use; D005260:Female; D005656:Fungal Proteins / Q000235:genetics; D005964:Glucosyltransferases / Q000235:genetics*; D006801:Humans; D055666:Lipopeptides; D008875:Middle Aged; D009154:Mutation
D054714:Echinocandins; D005656:Fungal Proteins; D055666:Lipopeptides; D002686:Chitin; D005964:Glucosyltransferases; C040232:glucan synthase; D000077336:Caspofungin