title: Abdominal candidiasis is a hidden reservoir of echinocandin resistance.
abstract: FKS mutant Candida isolates were recovered from 24% (6/25) of abdominal candidiasis patients exposed to echinocandin. Candida glabrata (29%) and Candida albicans (14%) mutants were identified. Multidrug-resistant bacteria were recovered from 83% of FKS mutant infections. Mutations were associated with prolonged echinocandin exposure (P = 0.01), breakthrough infections (P = 0.03), and therapeutic failures despite source control interventions (100%). Abdominal candidiasis is a hidden reservoir for the emergence of echinocandin-resistant Candida.
authors.affiliation: Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA XDR Pathogen Laboratory, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
authors.forename: Ryan K
authors.initials: RK
authors.lastname: Shields
authors.affiliation: Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA XDR Pathogen Laboratory, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA mhn5@pitt.edu.
authors.forename: M Hong
authors.initials: MH
authors.lastname: Nguyen
authors.affiliation: Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Ellen G
authors.initials: EG
authors.lastname: Press
authors.affiliation: Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA.
authors.forename: Cornelius J
authors.initials: CJ
authors.lastname: Clancy
mesh_terms: D018784:Abdominal Abscess / Q000188:drug therapy / Q000382:microbiology* / Q000401:mortality / Q000473:pathology; D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use*; D002176:Candida albicans / Q000187:drug effects* / Q000235:genetics / Q000254:growth & development; D041221:Candida glabrata / Q000187:drug effects* / Q000235:genetics / Q000254:growth & development; D002177:Candidiasis / Q000188:drug therapy / Q000382:microbiology* / Q000401:mortality / Q000473:pathology; D025141:Drug Resistance, Fungal / Q000235:genetics; D054714:Echinocandins / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009154:Mutation; D010538:Peritonitis / Q000188:drug therapy / Q000382:microbiology* / Q000401:mortality / Q000473:pathology; D016019:Survival Analysis
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins