Amphotericin B and caspofungin resistance in Candida glabrata isolates recovered from a critically ill patient
- PMID: 16511756
- DOI: 10.1086/500939
Amphotericin B and caspofungin resistance in Candida glabrata isolates recovered from a critically ill patient
Abstract
Background: Consecutive Candida glabrata isolates recovered from a patient in an intensive care unit were resistant to amphotericin B (minimum inhibitory concentration, up to 32 mu g/mL; determined by Etest [AB Biodisk]). Analyses at the national reference laboratory showed that some isolates were also resistant to azoles and caspofungin. In this study, 4 isolates were studied thoroughly using susceptibility assays and a mouse model and to determine clonality.
Methods: Different broth microdilution tests, Etests, and time-kill studies for antifungals were performed in different media. Three of the 4 isolates were examined in an in vivo experiment, in which mice were challenged intravenously with 1 of 3 isolates and treated daily with amphotericin B, caspofungin, or saline. For the clonality studies, arbitrarily primed polymerase chain reaction (PCR) was performed with the 4 isolates, 8 isolates obtained from nonrelated patients, and a reference strain.
Results: The murine model indicated that 1 isolate was resistant to amphotericin B, 1 had intermediate susceptibility, and 1 was fully susceptible. Two of the 3 isolates were resistant to caspofungin. Microdilution methods did not reliably differentiate between amphotericin B-susceptible and -resistant isolates. All assays identified caspofungin-susceptible and -resistant isolates. Arbitrarily primed PCR showed that the 4 isolates probably were of clonal origin.
Conclusions: We have documented the emergence of amphotericin B-resistant and caspofungin-resistant C. glabrata isolates during treatment of a critically ill liver transplant recipient. Only the Etest predicted amphotericin B resistance in the isolates. We recommend that important fungal strains recovered from patients who are receiving antifungal therapy should be tested for susceptibility to the antifungal drug used, because resistance can be present initially or may occur during treatment.
Similar articles
-
Activity of Combined Antifungal Agents Against Multidrug-Resistant Candida glabrata Strains.Mycopathologia. 2017 Oct;182(9-10):819-828. doi: 10.1007/s11046-017-0141-9. Epub 2017 May 10. Mycopathologia. 2017. PMID: 28493006
-
In vitro Synergistic Activity of Caspofungin Plus Polymyxin B Against Fluconazole-Resistant Candida glabrata.Am J Med Sci. 2016 Mar;351(3):265-70. doi: 10.1016/j.amjms.2015.12.014. Am J Med Sci. 2016. PMID: 26992255
-
Candida and candidaemia. Susceptibility and epidemiology.Dan Med J. 2013 Nov;60(11):B4698. Dan Med J. 2013. PMID: 24192246 Review.
-
Caspofungin activity against clinical isolates of azole cross-resistant Candida glabrata overexpressing efflux pump genes.J Antimicrob Chemother. 2006 Aug;58(2):458-61. doi: 10.1093/jac/dkl237. Epub 2006 Jun 6. J Antimicrob Chemother. 2006. PMID: 16757500
-
[Systemic antifungals. Pharmacodynamics and pharmacokinetics].Rev Iberoam Micol. 2006 Mar;23(1):39-49. doi: 10.1016/s1130-1406(06)70012-2. Rev Iberoam Micol. 2006. PMID: 16499430 Review. Spanish.
Cited by
-
Whole-Genome Sequence Analysis of Candida glabrata Isolates from a Patient with Persistent Fungemia and Determination of the Molecular Mechanisms of Multidrug Resistance.J Fungi (Basel). 2023 Apr 26;9(5):515. doi: 10.3390/jof9050515. J Fungi (Basel). 2023. PMID: 37233226 Free PMC article.
-
Potential inhibitory activity of phytoconstituents against black fungus: In silico ADMET, molecular docking and MD simulation studies.Comput Toxicol. 2022 Nov;24:100247. doi: 10.1016/j.comtox.2022.100247. Epub 2022 Sep 24. Comput Toxicol. 2022. PMID: 36193218 Free PMC article.
-
Investigation of the Defective Growth Pattern and Multidrug Resistance in a Clinical Isolate of Candida glabrata Using Whole-Genome Sequencing and Computational Biology Applications.Microbiol Spectr. 2022 Aug 31;10(4):e0077622. doi: 10.1128/spectrum.00776-22. Epub 2022 Jul 18. Microbiol Spectr. 2022. PMID: 35867406 Free PMC article.
-
Antifungal Susceptibility Testing: A Primer for Clinicians.Open Forum Infect Dis. 2021 Sep 9;8(11):ofab444. doi: 10.1093/ofid/ofab444. eCollection 2021 Nov. Open Forum Infect Dis. 2021. PMID: 34778489 Free PMC article. Review.
-
Emerging Prospects for Combating Fungal Infections by Targeting Phosphatidylinositol Transfer Proteins.Int J Mol Sci. 2021 Jun 23;22(13):6754. doi: 10.3390/ijms22136754. Int J Mol Sci. 2021. PMID: 34201733 Free PMC article. Review.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical
Research Materials