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

作者：Fernando César Bizerra, Cristina Jiménez‐Ortigosa, Ana Carolina Remondi Souza, Giovanni Luís Breda, Flávio Queiroz‐Telles, David S. Perlin, Arnaldo Lopes Colombo · 发表于：Antimicrobial Agents and Chemotherapy · 年份：2014 · DOI：10.1128/aac.02189-13 · 被引用次数：64 · 研究领域：Antifungal resistance and susceptibility、Fungal Infections and Studies、Peptidase Inhibition and Analysis

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 FKS2 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.