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

Antimicrob Agents Chemother. 2012 Jun;56(6):3417-9. doi: 10.1128/AAC.06100-11. Epub 2012 Mar 5.

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.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Antifungal Agents / therapeutic use*
  • Candida glabrata / genetics
  • Candida glabrata / pathogenicity*
  • Candidemia / drug therapy
  • Candidemia / microbiology*
  • Caspofungin
  • Echinocandins / therapeutic use*
  • Fungal Proteins / genetics*
  • Humans
  • Lipopeptides
  • Male
  • Mutation

Substances

  • Antifungal Agents
  • Echinocandins
  • Fungal Proteins
  • Lipopeptides
  • Caspofungin