Changes in Karyotype and Azole Susceptibility of Sequential Bloodstream Isolates from Patients with Candida glabrata Candidemia
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We examined the changes in genotypes and azole susceptibilities among sequential bloodstream isolates of Candida glabrata during the course of fungemia and the relationship of these changes to antifungal therapy. Forty-one isolates were obtained from 15 patients (9 patients who received antifungal therapy and 6 patients who did not) over periods of up to 36 days. The isolates were analyzed using pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) and tested for antifungal susceptibility to fluconazole, itraconazole, and voriconazole. PFGE typing consisted of electrophoretic karyotyping and restriction endonuclease analysis of genomic DNA by use of NotI (REAG-N). The 41 isolates yielded 23 different karyotypes and 11 different REAG-N patterns but only 3 MLST types. The sequential strains from each patient had identical or similar REAG-N patterns. However, they had two or three different karyotypes in 6 (40%) of 15 patients. The isolates from these six patients exhibited the same or similar azole susceptibilities, and five patients did not receive antifungal therapy. Development of acquired azole resistance in sequential isolates was detected for only one patient. For this patient, an isolate of the same genotype obtained after azole therapy showed three- or fourfold increases in the MICs of all three azole antifungals and exhibited increased expression of the CgCDR1 efflux pump. This study shows that karyotypic changes can develop rapidly among sequential bloodstream strains of C. glabrata from the same patient without antifungal therapy. In addition, we confirmed that C. glabrata could acquire azole resistance during the course of fungemia in association with azole therapy.
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C. glabrata can undergo genomic re-arrangements as an adaptive survival mechanism.
“Previous studies found that C. glabrata can undergo genomic re-arrangements as an adaptive survival mechanism (Shin et al., 2007; Muller et al., 2009; Poláková et al., 2009).”
From Genome Comparisons of Candida glabrata Serial Clinical Isolates Reveal Patterns of Genetic Variation in Infecting Clonal Populations (2019) · cites this paper as Shin et al., 2007
The C. glabrata genome shows plasticity, and alterations in karyotype and chromosome size have been observed in clinical isolates and the reference strain CBS138.
“The C. glabrata genome shows plasticity, and alterations in karyotype and chromosome size have been observed in clinical isolates and the reference strain CBS138 [19,20,21].”
From Candida glabrata: A Lot More Than Meets the Eye (2019) · cites this paper as [19]
Genome plasticity has been connected with antifungal drug resistance in C. glabrata.
“Since genome plasticity has been connected with antifungal drug resistance in C. glabrata (Shin et al., 2007; Polakova et al., 2009)”
From Genetic Drivers of Multidrug Resistance in Candida glabrata (2016) · cites this paper as Shin et al., 2007
Candida glabrata has been frequently reported as exhibiting variable karyotypes between isolates.
“C. glabrata has been frequently reported as exhibiting variable karyotypes between isolates [57,58,59,60,61,62,63,64]”
From Candida glabrata Biofilms: How Far Have We Come? (2017) · cites this paper as [64]
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References 28 · Cited by 86
Research works printed but not linked: 1
- [9]Dodgson, A. R., C. Pujol, D. W. Denning, D. R. Soll, and A. J. Fox. 2003. Multilocus sequence typing of Candida glabrata reveals geographically enriched clades. J. Clin. Microbiol. 41:5709-5717. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Authors
- Shin, J. H., Chae, M. J., Song, J. W., Jung, S.-I., Cho, D., Kee, S. J., Kim, S. H., Shin, M. G., Suh, S. P., & Ryang, D. W.
- Affiliations
- Departments of Laboratory Medicine
- Chonnam National University (KR)
- Corresponding author
- Shin, Jong Hee
- Venue
- Journal of Clinical Microbiology
- Publisher
- American Society for Microbiology
- Published
- 2007-08
- Volume
- 45
- Issue
- 8
- Pages
- 2385-2391
- ISSN
- 0095-1137 (ISSN-L)
- 1098-660X
- PMC
- PMC1951250
- OpenAlex
- W2156441608
- Cited by
- 86
- References
- 28
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 4 · 2023: 3 · 2021: 5 · 2020: 4 · 2019: 8 · 2018: 5 · 2017: 3 · 2016: 6 · 2015: 4 · 2014: 9 · 2013: 6 · 2012: 5
- FWCI
- 3.36
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Clinical Microbiology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Chonnam National University
- Terveyden ja hyvinvoinnin laitos
- National Institutes of Health
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Fungal and yeast genetics research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Yeasts and Rust Fungi Studies
- Keywords
- Candida glabrata, candidemia, fungemia, karyotype changes, azole resistance, antifungal therapy, fluconazole, itraconazole, voriconazole, multilocus sequence typing, pulsed-field gel electrophoresis, genotypic variation
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Antifungal Agents, Azoles, Candidiasis, Child, Preschool, DNA, Fungal, Female, Genotype, Humans, Karyotyping, Longitudinal Studies, Male, Microbial Sensitivity Tests, Middle Aged, Polymorphism, Restriction Fragment Length, Fungemia, Electrophoresis, Gel, Pulsed-Field, Mycological Typing Techniques, Sequence Analysis, DNA, ATP-Binding Cassette Transporters, Drug Resistance, Fungal, Candida glabrata
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