Acquired flucytosine resistance during combination therapy with caspofungin and flucytosine for Candida glabrata cystitis
Open accessAbstract
Treatment of Candida glabrata cystitis remains a therapeutic challenge, and an antifungal combination using flucytosine is one option. We describe two patients with refractory C. glabrata cystitis who failed flucytosine combined with caspofungin with early-acquired high-level resistance to flucytosine due to nonsense mutations in the FUR1 gene. Rapidly acquired flucytosine resistance with microbiological failure should discourage combination of caspofungin and flucytosine during urinary candidiasis.
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Flucytosine is not used in monotherapy due to the rapid development of resistance towards this drug.
“Although the most effective and safest antimycotic in the health system [28], it is not used in monotherapy due to the rapid development of resistance towards this drug [24,29].”
From Evolutionary Emergence of Drug Resistance in Candida Opportunistic Pathogens (2018) · cites this paper as [29]
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- Authors
- Charlier, C., El Sissy, C., Bachelier-Bassi, S., Scemla, A., Quesne, G., Sitterlé, E., Legendre, C., Lortholary, O., & Bougnoux, M.-E.
- Affiliations
- Hôpital Necker-Enfants Malades (FR)
- Université Paris Descartes Sorbonne Paris Cité, Service de Microbiologie Clinique, Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France
- Unité Biologie et Pathogénicité Fongiques, INRA, USC2019, Institut Pasteur, Paris, France
- ORCID
- Venue
- Antimicrobial Agents and Chemotherapy
- Publisher
- American Society for Microbiology
- Published
- 2016-01
- Volume
- 60
- Issue
- 1
- Pages
- 662-665
- ISSN
- 0066-4804 (ISSN-L)
- 1098-6596
- PMC
- PMC4704181
- OpenAlex
- W1913561681
- Cited by
- 26
- References
- 14
- Citations by year
- 2025: 5 · 2024: 2 · 2023: 1 · 2022: 3 · 2021: 3 · 2020: 6 · 2019: 1 · 2018: 1 · 2017: 2 · 2016: 2
- FWCI
- 1.30
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Antimicrobial Agents and Chemotherapy (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- HAL (submittedVersion)
- 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
- Health Sciences › Medicine › Epidemiology › Urinary Tract Infections Management
- Keywords
- Candida glabrata, cystitis, urinary candidiasis, flucytosine resistance, caspofungin, combination antifungal therapy, nonsense mutation, acquired drug resistance
- MeSH terms
- Caspofungin, Aged, Antifungal Agents, Base Sequence, Urinary Bladder, Candidiasis, Cystitis, Drug Therapy, Combination, Female, Flucytosine, Fungal Proteins, Humans, Male, Molecular Sequence Data, Gene Expression, Treatment Failure, Codon, Nonsense, Drug Resistance, Fungal, Nucleobase Transport Proteins, Candida glabrata, Echinocandins, Lipopeptides
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