Progressive loss of echinocandin activity following prolonged use for treatment of Candida albicans oesophagitis
| Autor: | David S. Perlin, Michel Laverdière, Steven Park, Richard G. Lalonde, Donald C. Sheppard, Jean Guy Baril |
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| Rok vydání: | 2006 |
| Předmět: |
Adult
Male Microbiology (medical) Antifungal Agents Saccharomyces cerevisiae Proteins Echinocandin Lipoproteins HIV Infections Microbial Sensitivity Tests Peptides Cyclic Microbiology Echinocandins Lipopeptides chemistry.chemical_compound Fatal Outcome Drug Resistance Fungal Candida albicans medicine Esophagitis Humans Pharmacology (medical) Pharmacology AIDS-Related Opportunistic Infections biology Candidiasis Micafungin Membrane Proteins bacterial infections and mycoses Caspofungin Acetate biology.organism_classification Corpus albicans Infectious Diseases chemistry Glucosyltransferases Multilocus sequence typing Anidulafungin Caspofungin medicine.drug |
| Zdroj: | Journal of Antimicrobial Chemotherapy. 57:705-708 |
| ISSN: | 1460-2091 0305-7453 |
| Popis: | Received 5 October 2005; returned 15 December 2005; revised 19 December 2005; accepted 17 January 2006 Objectives: To illustrate the progressive loss of cross-echinocandin activity on Candida albicans isolates with strong clonal homology from a patient with advanced HIV infection and chronic oesophagitis progressively resistant to uninterrupted micafungin treatment. Methods: Antifungal susceptibility profiles for different antifungal agents were determined against serial C. albicans isolates retrieved before and during therapy. Multilocus sequencing typing (MLST) was performed on each of the isolates. FKS1 mutations conferring reduced susceptibility to echinocandin drugs were determined by DNA sequence analysis. Results: Four C. albicans isolates showing identical allelic homology were retrieved from the patient at the initiation and during therapy with micafungin. The progressive lack of clinical response to micafungin therapy was associated with increased MICs of all three echinocandin drugs (caspofungin, micafungin and anidulafungin) in association with the acquisition of mutations in the FKS1 gene. Conclusions: This report documents for the first time a progressive loss of activity of all three echinocandin drugs against clonally related C. albicans isolates following long-term clinical exposure to this new class of antifungal agents. |
| Databáze: | OpenAIRE |
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