title: Breakthrough fungemia due to Candida fermentati with fks1p mutation under micafungin treatment in a cord blood transplant recipient.
abstract: The prophylactic use of antifungal drugs in allogeneic hematopoietic cell transplant recipients has revealed that the rate of non-albicans candidemia has increased. We herein report the case of a patient with adult T-cell leukemia who developed candidemia due to Candida fermentati during micafungin treatment after cord blood transplantation. The isolate was identified on day 47 by sequencing of the internal transcribed spacer region of the ribosomal RNA gene. The sequencing of the hot spot region of fks1p of isolate revealed naturally occurring amino acid substitutions, which conferred reduced echinocandin susceptibility. This case highlights that breakthrough candidemia due to C. fermentati occurred in a patient receiving micafungin treatment.
authors.affiliation: Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Konuma
authors.affiliation: TechnoSuruga Laboratory Co., Ltd., Shizuoka, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Takahashi
authors.affiliation: TechnoSuruga Laboratory Co., Ltd., Shizuoka, Japan.
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Kiyuna
authors.affiliation: Department of Laboratory Medicine, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
authors.forename: Yuta
authors.initials: Y
authors.lastname: Miharu
authors.affiliation: Department of Laboratory Medicine, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Suzuki
authors.affiliation: Department of Laboratory Medicine, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Shibata
authors.affiliation: Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
authors.forename: Seiko
authors.initials: S
authors.lastname: Kato
authors.affiliation: Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Takahashi
authors.affiliation: Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
authors.forename: Arinobu
authors.initials: A
authors.lastname: Tojo
mesh_terms: D000368:Aged; D019072:Antibiotic Prophylaxis / Q000009:adverse effects; D000935:Antifungal Agents / Q000494:pharmacology* / Q000627:therapeutic use; D002175:Candida / Q000235:genetics / Q000302:isolation & purification / Q000502:physiology*; D058387:Candidemia / Q000382:microbiology*; D062905:Central Venous Catheters / Q000009:adverse effects / Q000382:microbiology; D036101:Cord Blood Stem Cell Transplantation / Q000009:adverse effects*; D004271:DNA, Fungal / Q000302:isolation & purification; D025141:Drug Resistance, Fungal / Q000235:genetics*; D054714:Echinocandins / Q000494:pharmacology* / Q000627:therapeutic use; D005656:Fungal Proteins / Q000235:genetics; D006086:Graft vs Host Disease / Q000517:prevention & control; D006801:Humans; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000601:surgery*; D055666:Lipopeptides / Q000494:pharmacology* / Q000627:therapeutic use; D008297:Male; D000077551:Micafungin; D008826:Microbial Sensitivity Tests; D009154:Mutation; D017422:Sequence Analysis, DNA; D066027:Transplant Recipients; D019172:Transplantation Conditioning / Q000009:adverse effects / Q000379:methods
chemical_list: D000935:Antifungal Agents; D004271:DNA, Fungal; D054714:Echinocandins; D005656:Fungal Proteins; D055666:Lipopeptides; D000077551:Micafungin
keywords: 
  Candida fermentati
  ; candidemia; echinocandin; fks1; hematopoietic cell transplantation; micafungin