Breakthrough Candidemia Due to Multidrug-Resistant Candida glabrata during Prophylaxis with a Low Dose of Micafungin
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We identified a case of breakthrough candidemia in a 25-year-old patient receiving micafungin prophylaxis (50 mg/day). Five Candida glabrata isolates were obtained from blood cultures and were classified as multidrug-resistant isolates, since all of them exhibited high MICs for echinocandin and azole drugs. A mutation (S663F) in hot spot 1 of the FKS 2 gene was found in all five isolates. This mutation yielded a 1,3-β- d -glucan synthase enzyme with highly reduced sensitivities to echinocandin drugs.
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A review of the most recent data suggests that many, but not all, breakthrough Candida infections occur due to organisms that are resistant to one or more antifungals, and are dominated by non-albicans Candida species, especially C. glabrata, C. krusei, C. parapsilosis, and C. tropicalis.
“A review of the most recent data pertaining to BT Candida infections suggests that many, but not all, of these infections occur due to organisms that are resistant to one or more antifungals, and accordingly are dominated by non-albicans Candida species, especially C. glabrata, C. krusei, C. parapsilosis, and C. tropicalis.89–92”
From Epidemiology of Invasive Candidiasis (2024) · cites this paper as [91]
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Treviño‐Rangel, R. D. J., Espinosa-Pérez, J. F., Villanueva‐Lozano, H., Soto-Quintana, L. A., Montoya, A. M., Luna-Rodríguez, C. E., & González, G. M. (2019) · Jundishapur Journal of Microbiology · doi:10.5812/jjm.85092 · Cited by 2 · see citing works
EPICO 3.0. Empirical antifungal therapy in critically-ill hematology patients
Llinares, P., Ruíz-Camps, I., Zaragoza, R., Ferrer, R., Rodríguez, A. H., Maseda, E., & Grau, S. (2016) · Revista Iberoamericana de Micología · doi:10.1016/j.riam.2016.06.002 · Cited by 1 · see citing works
Perlin, D. S. (2017) · Springer eBooks · doi:10.1007/978-3-319-46718-4_29
Self-citation
- Authors
- Bizerra, F. C., Jimenez-Ortigosa, C., Souza, A. C. R., Breda, G. L., Queiroz-Telles, F., Perlin, D. S., & Colombo, A. L.
- Affiliations
- Universidade Federal de São Paulo (BR)
- Public Health Research Institute, New Jersey Medical School–Rutgers, The State University of New Jersey, Newark, New Jersey, USA
- Hospital das Clínicas, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
- Rutgers, The State University of New Jersey (US)
- Venue
- Antimicrobial Agents and Chemotherapy
- Publisher
- American Society for Microbiology
- Published
- 2014-04
- Volume
- 58
- Issue
- 4
- Pages
- 2438-2440
- ISSN
- 0066-4804 (ISSN-L)
- 1098-6596
- PMC
- PMC4023795
- OpenAlex
- W2149702858
- Cited by
- 63
- References
- 28
- Citations by year
- 2025: 1 · 2024: 2 · 2023: 5 · 2022: 1 · 2021: 2 · 2020: 6 · 2019: 13 · 2018: 5 · 2017: 9 · 2016: 9 · 2015: 3 · 2014: 7
- FWCI
- 6.54
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Antimicrobial Agents and Chemotherapy (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Americanae (AECID Library) (publishedVersion, other-oa)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, other-oa)
- Funders
- National Institute of Allergy and Infectious Diseases (R01AI069397)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Life Sciences › Agricultural and Biological Sciences › Ecology, Evolution, Behavior and Systematics › Fungal Plant Pathogen Control
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Fungal and yeast genetics research
- Keywords
- Candida glabrata, micafungin, antifungal prophylaxis, multidrug resistance, echinocandin resistance, azole resistance, 1,3-β-D-glucan synthase
- MeSH terms
- Micafungin, Adult, Amphotericin B, Antifungal Agents, Azoles, Fungal Proteins, Humans, Male, Microbial Sensitivity Tests, Molecular Sequence Data, Mutation, Drug Resistance, Fungal, Candida glabrata, Echinocandins, Lipopeptides, Candidemia
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