Development of High-Level Echinocandin Resistance in a Patient With Recurrent
| العنوان: | Development of High-Level Echinocandin Resistance in a Patient With Recurrent |
|---|---|
| المؤلفون: | Mark J, Biagi, Nathan P, Wiederhold, Connie, Gibas, Brian L, Wickes, Victoria, Lozano, Susan C, Bleasdale, Larry, Danziger |
| المصدر: | Open Forum Infectious Diseases |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | FKS, echinocandin, candidemia, Major Article, antifungal resistance, Candida auris |
| الوصف: | Objective Candida auris is a globally emerging pathogen associated with significant mortality. This pathogen frequently is misidentified by traditional biochemical methods and is resistant to commonly used antifungals. The echinocandins currently are recommended as the first-line treatment for C. auris infections. The objective of this work is to demonstrate the challenges associated with C. auris in the real-world setting. Methods A 54-year-old male presented to our institution for concerns of sepsis on multiple occasions over a 5-month period. Eleven urine cultures were positive over this timeframe for yeast (9 unidentified Candida isolates and 2 C. lusitaniae isolates). On day 27, the patient developed echinocandin-susceptible candidemia, which was initially identified as C. haemulonii but later accurately identified as C. auris at an outside mycology reference laboratory. Approximately 10 weeks later, the patient had a recurrence of candidemia, this time caused by an echinocandin-resistant C. auris strain. Results Genomic DNA sequencing performed at the outside mycology reference laboratory identified a single serine to proline base pair change at position 639 (S639P) in the hotspot 1 region of the FKS1 gene of the echinocandin-resistant strain. Conclusions Our experiences highlight 4 major concerns associated with C. auris: misidentification, persistent colonization, infection recurrence despite the receipt of appropriate initial therapy, and development of resistance. Clinicians should be aware of the diagnostic and therapeutic challenges associated with Candida auris. This unique case demonstrates 3 major issues of C. auris, misidentification, persistence, and resistance development, in a patient with recurrent C. auris candidemia. |
| تدمد: | 2328-8957 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=pmid________::f4902934b9e1a860162444782c8b6f71 https://pubmed.ncbi.nlm.nih.gov/31281859 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.pmid..........f4902934b9e1a860162444782c8b6f71 |
| قاعدة البيانات: | OpenAIRE |
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