ArticleMycoses2020
Low level of antifungal resistance of Candida glabrata blood isolates in Turkey: Fluconazole minimum inhibitory concentration and FKS mutations can predict therapeutic failure.
Article in Mycoses, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 1 of them a synthesis that pooled it.
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Who cites it
32 citing papers in PubMed, 1 synthesis or guideline pooled it, 43 citations in OpenAlex.
- Candida glabrata (Nakaseomyces glabrata): A systematic review of clinical and microbiological data from 2011 to 2021 to inform the World Health Organization Fungal Priority Pathogens List.Medical mycology · 2024Pooled it
- Multidimensional assessment of in-host fitness costs of echinocandin resistance in the opportunistic fungal pathogenAntimicrobial agents and chemotherapy · 2026Article
- Candiduria in catheterized ICU patients: epidemiology, molecular identification, and antifungal susceptibility.Iranian journal of microbiology · 2026Article
- Genome analysis and machine learning-based feature selection strategy reveal potential drug-resistance determinants inEmerging microbes & infections · 2025Article
- Expression of 1,3-β-glucan synthase subunits inAntimicrobial agents and chemotherapy · 2025Article
- The Influence of the Seasonal Variability ofAntibiotics (Basel, Switzerland) · 2025Article
- Emergence of invasive candidiasis with multipleFrontiers in microbiology · 2025Article
- Implication of genotypes for prognosis of Candida glabrata bloodstream infections.The Journal of antimicrobial chemotherapy · 2024Article
- Novel antifungals and treatment approaches to tackle resistance and improve outcomes of invasive fungal disease.Clinical microbiology reviews · 2024Review
- Article
- Genomic description of acquired fluconazole- and echinocandin-resistance in patients with serialJournal of clinical microbiology · 2024Article
- A multidimensional assessment of in-host fitness costs of drug resistance in the opportunistic fungal pathogen Candida glabrata.FEMS yeast research · 2024Article
- Population genomic analyses reveal high diversity, recombination and nosocomial transmission amongMicrobial genomics · 2024Article
- OverlookedbioRxiv : the preprint server for biology · 2023Article
- Molecular fingerprinting by multi-locus sequence typing identifies microevolution and nosocomial transmission ofFrontiers in public health · 2023Article
- Invasive candidiasis: investigational drugs in the clinical development pipeline and mechanisms of action.Expert opinion on investigational drugs · 2022Article
- Candidemia among Hospitalized Pediatric Patients Caused by Several Clonal Lineages ofJournal of fungi (Basel, Switzerland) · 2022Article
- Antifungal Resistance in Clinical Isolates ofJournal of fungi (Basel, Switzerland) · 2021Review
- The Antifungal Pipeline: Fosmanogepix, Ibrexafungerp, Olorofim, Opelconazole, and Rezafungin.Drugs · 2021Review
- Emergence of resistantJAC-antimicrobial resistance · 2021Article
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Authors and funding
13 authors at 10 institutions in 7 countries.
Funding
Abstract
backgroundCandida glabrata is the third leading cause of candidaemia in Turkey; however, the data regarding antifungal resistance mechanisms and genotypic diversity in association with their clinical implication are limited.
objectivesTo assess genotypic diversity, antifungal susceptibility and mechanisms of drug resistance of C glabrata blood isolates and their association with patients' outcome in a retrospective multicentre study. PATIENTS/
methodsIsolates from 107 patients were identified by ITS sequencing and analysed by multilocus microsatellite typing, antifungal susceptibility testing, and sequencing of PDR1 and FKS1/2 hotspots (HSs).
resultsCandida glabrata prevalence in Ege University Hospital was twofold higher in 2014-2019 than in 2005-2014. Six of the analysed isolates had fluconazole MICs ≥ 32 µg/mL; of them, five harboured unique PDR1 mutations. Although echinocandin resistance was not detected, three isolates had mutations in HS1-Fks1 (S629T, n = 1) and HS1-Fks2 (S663P, n = 2); one of the latter was also fluconazole-resistant. All patients infected with isolates carrying HS-FKS mutations and/or demonstrating fluconazole MIC ≥ 32 µg/mL (except one without clinical data) showed therapeutic failure (TF) with echinocandin and fluconazole; seven such isolates were collected in Ege (n = 4) and Gulhane (n = 3) hospitals and six detected recently. Among 34 identified genotypes, none were associated with mortality or enriched for fluconazole-resistant isolates.
conclusionAntifungal susceptibility testing should be supplemented with HS-FKS sequencing to predict TF for echinocandins, whereas fluconazole MIC ≥ 32 µg/mL may predict TF. Recent emergence of C glabrata isolates associated with antifungal TF warrants future comprehensive prospective studies in Turkey.
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