Cited by 63Antifungal resistance and susceptibilityFungal Plant Pathogen ControlFungal and yeast genetics research

Breakthrough Candidemia Due to Multidrug-Resistant Candida glabrata during Prophylaxis with a Low Dose of Micafungin

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Bizerra, Fernando César, Jimenez-Ortigosa, Cristina, Souza, Ana Carolina R., Breda, Giovanni Luis, Queiroz-Telles, Flávio, Perlin, David S., Colombo, Arnaldo L.·2014·Antimicrobial Agents and Chemotherapy

Abstract

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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  1. [8]8. cal. Braz J. Infect. Dis. 17: 283-312. http://dx.doi.org/10.1016/j.bjid.2013 .02.001. · DOI

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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
Published
2014-04
Volume
58
Issue
4
Pages
2438-2440
ISSN
  • 0066-4804 (ISSN-L)
  • 1098-6596
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
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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