ArticleBMC infectious diseases2015
Development of fluconazole resistance in a series of Candida parapsilosis isolates from a persistent candidemia patient with prolonged antifungal therapy.
Article in BMC infectious diseases, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers.
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38 citing papers in PubMed, 63 citations in OpenAlex.
- Combination antifungal therapy against resistant C. albicans: efficacy and immune response in mice.AMB Express · 2026Article
- The rise ofEuro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2025Article
- Threats from theMicrobiology and molecular biology reviews : MMBR · 2024Review
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- Paradigm Shift:Journal of fungi (Basel, Switzerland) · 2023Article
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- The antifungal effect induced by itraconazole in Candida parapsilosis largely depends on the oxidative stress generated at the mitochondria.Current genetics · 2023Article
- Determinants of fluconazole resistance and echinocandin tolerance inEmerging microbes & infections · 2022Article
- Evolution of Fluconazole Resistance Mechanisms and Clonal Types ofAntimicrobial agents and chemotherapy · 2022Article
- Candida parapsilosis Mdr1B and Cdr1B Are Drivers of Mrr1-Mediated Clinical Fluconazole Resistance.Antimicrobial agents and chemotherapy · 2022Article
- A Soil-IsolatedAntibiotics (Basel, Switzerland) · 2022Article
- Iodine induces toxicity againstIranian journal of microbiology · 2022Article
- Experimental and in-host evolution of triazole resistance in human pathogenic fungi.Frontiers in fungal biology · 2022Review
- Determinants of fluconazole resistance and the efficacy of fluconazole and milbemycin oxim combination againstFrontiers in fungal biology · 2022Article
- Epidemiology of Candidemia in Children over 7 Years in a Medical Center in Turkey.Microbiology spectrum · 2021Article
- Balancing Positive and Negative Selection:mBio · 2021Article
- Article
- Prevalence and Antifungal Susceptibility ofFrontiers in microbiology · 2021Article
- Efficacy of LAMB against Emerging Azole- and Multidrug-ResistantJournal of fungi (Basel, Switzerland) · 2020Article
- First Report of Candidemia Clonal Outbreak Caused by Emerging Fluconazole-Resistant Candida parapsilosis Isolates Harboring Y132F and/or Y132F+K143R in Turkey.Antimicrobial agents and chemotherapy · 2020Article
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCandida parapsilosis was the most common species causing candidemia in the 2010 China Hospital Invasive Fungal Surveillance Net (CHIF-NET) database. Compared to Candida albicans, the description of azole resistance and mechanisms in C. parapsilosis is very limited. We report a patient with C. parapsilosis candidemia over several months, due to a probable intravascular source, who developed fluconazole resistance after prolonged treatment. CASE PRESENTATION: An 82 year-old male had a hospital admission of approximately 1.5 years duration. He was initially admitted with acute pancreatitis. Prior to succumbing to the illness, he developed candidemia and treated with three antifungal drugs for nearly 5 months, at suboptimal doses and without source control. Following treatment, 6 blood cultures were still positive for C. parapsilosis. The last 2 strains were resistant to fluconazole (MICs 32 μg/mL) and intermediate to voriconazole (MICs 0.5 μg/mL). Microsatellite multilocus analysis indicated that the 6 isolates from the patient belonged to a single genotype. The first 4 isolates were susceptible to fluconazole (MICs 2 μg/mL) and voriconazole (MICs 0.015-0.03 μg/mL), which were slightly higher than susceptible control strains from other patients. Overexpression of MDR1 genes were detected in the two resistant isolates, and this was associated with a homozygous mutation in MRR1 genes (T2957C /T2957C), with the amino acid exchange L986P.
conclusionsThis case corroborates that the resistant C. parapsilosis isolates can emerge in the setting of complicated infections and the extensive use of antifungal agents, emphasizing the need for standardizing and improving the antifungal treatment as well as source control in the treatment of infection diseases.
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