title: Rapid emergence of echinocandin resistance during Candida kefyr fungemia treatment with caspofungin.
abstract: Echinocandin drugs are widely used for the treatment of candidemia. Resistance is considered rare, and only a few cases of breakthrough candidiasis in patients receiving echinocandin have been reported worldwide. We report here for the first time a Candida kefyr isolate that acquired echinocandin resistance very rapidly after the initiation of caspofungin treatment for candidemia. We characterized the FKS gene mutation responsible for the resistance via the comparison of isolates sampled before and during treatment.
authors: Service de Parasitologie Mycologie, Groupe Hospitalier Pitié-Salpêtrière, Paris, France. arnaud.fekkar@psl.aphp.fr
authors: A
authors: A
authors: Fekkar
authors: I
authors: I
authors: Meyer
authors: J Y
authors: JY
authors: Brossas
authors: E
authors: E
authors: Dannaoui
authors: M
authors: M
authors: Palous
authors: M
authors: M
authors: Uzunov
authors: S
authors: S
authors: Nguyen
authors: V
authors: V
authors: Leblond
authors: D
authors: D
authors: Mazier
authors: A
authors: A
authors: Datry
mesh_terms: D000595:Amino Acid Sequence; D000935:Antifungal Agents / Q000009:adverse effects*; D002175:Candida / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D058387:Candidemia / Q000188:drug therapy / Q000382:microbiology*; D002177:Candidiasis / Q000188:drug therapy / Q000382:microbiology*; D000077336:Caspofungin; D025141:Drug Resistance, Fungal; D054714:Echinocandins / Q000009:adverse effects*; D017809:Fatal Outcome; D005260:Female; D005656:Fungal Proteins / Q000235:genetics*; D005964:Glucosyltransferases / Q000235:genetics*; D006801:Humans; D007716:Kluyveromyces / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D055666:Lipopeptides; D008875:Middle Aged; D008969:Molecular Sequence Data; D009154:Mutation
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D005656:Fungal Proteins; D055666:Lipopeptides; D005964:Glucosyltransferases; C020570:1,3-beta-glucan synthase; D000077336:Caspofungin