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Rapid Emergence of Echinocandin Resistance in Candida glabrata Resulting in Clinical and Microbiologic Failure |
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| Authors: | James S. Lewis II Nathan P. Wiederhold Brian L. Wickes Thomas F. Patterson James H. Jorgensen |
| Affiliation: | University Health System, Department of Pharmacy, San Antonio, Texas, USAa;Department of Medicine, University of Texas Health Science Center, San Antonio, Texas, USAb;Department of Pathology, University of Texas Health Science Center, San Antonio, Texas, USAc;Department of Microbiology and Immunology, University of Texas Health Science Center, San Antonio, Texas, USAd;South Texas Veterans Health Care System, San Antonio, Texas, USAe |
| Abstract: | We report a case of Candida glabrata candidemia that developed resistance to micafungin within 8 days of initiation of therapy in a patient without previous echinocandin exposure or other known risk factors for clinical or microbiological failure. Pre- and postresistant isolates were confirmed to be isogenic, and sequencing of hot spots known to confer echinocandin resistance revealed a phenylalanine deletion at codon 659 within FKS2. |
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