Breakthrough candidemia due to multidrug-resistant Candida glabrata during prophylaxis with a low dose of micafungin.

Antimicrob Agents Chemother

Laboratório Especial de Micologia, Disciplina de Infectologia, Universidade Federal de São Paulo, São Paulo, Brazil.

Published: November 2014

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.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4023795PMC
http://dx.doi.org/10.1128/AAC.02189-13DOI Listing

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