ArticleClinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases2022
In vivo emergence of high-level resistance during treatment reveals the first identified mechanism of amphotericin B resistance in Candida auris.
Article in Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 85 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
85 citing papers in PubMed, 1 synthesis or guideline pooled it, 117 citations in OpenAlex.
- Antifungal resistance and poor clinical outcome rates ofFrontiers in microbiology · 2026Pooled it
- Pathogenicity and virulence ofVirulence · 2026Review
- Multidrug Resistance and Host Adaptation in Candida Auris: From Molecular Mechanisms to Emerging Therapeutic Frontiers.Mycopathologia · 2026Review
- Antimicrobial Peptides as Eco-Innovative Therapeutics to Overcome Antifungal Pressure-Induced Resistance in Candida Infections.Current microbiology · 2026Review
- Beyond intrinsic resistance: novel insights into the emergence and management of resistance acquired in Candida auris upon antifungal exposure.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Review
- Evaluation of Sensititre YeastOne for antifungal susceptibility testing ofJournal of clinical microbiology · 2026Article
- Emerging evidence for a multitude of mechanisms and factors that determine amphotericin B resistance in pathogenic fungi.Cell surface (Amsterdam, Netherlands) · 2026Review
- Deciphering the multidrug resistance paradigm inAntimicrobial agents and chemotherapy · 2026Review
- Article
- Review
- Candida auris skin tropism and antifungal resistance are mediated by carbonic anhydrase Nce103.Nature microbiology · 2026Article
- Comprehensive Insights into Sugar Transporters ofJournal of fungi (Basel, Switzerland) · 2026Article
- Fluorescent Probes Derived from the Polyene Class of Antifungal Drugs Reveal Distinct Localization Patterns and Resistance-Associated Vacuolar Sequestration in Candida Species.Angewandte Chemie (International ed. in English) · 2026Article
- Article
- Resistance gene mutations and phylogenetic relationships inFrontiers in cellular and infection microbiology · 2026Article
- Repurposing Agents as Anti-Infective Therapeutics to Aid in the Treatment ofInfectious disease reports · 2025Article
- In Vivo Evolution of Candida auris Multidrug Resistance in a Patient Receiving Antifungal Treatment.The Journal of infectious diseases · 2025Article
- Genomic epidemiology of Colombian resistantAntimicrobial agents and chemotherapy · 2025Article
- Acquired amphotericin B resistance attributed to a mutatedAntimicrobial agents and chemotherapy · 2025Article
- Article
25 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 6 institutions in 3 countries.
Funding
Abstract
objectiveCandida auris has emerged as a health-care-associated and multidrug-resistant fungal pathogen of great clinical concern. As many as 50% of C. auris clinical isolates are reported to be resistant to amphotericin B, but no mechanisms contributing to this resistance have been identified. Here we describe a clinical case in which high-level amphotericin B resistance was acquired in vivo during therapy and undertake molecular and genetic studies to identify and characterize the genetic determinant of resistance.
methodsWhole-genome sequencing was performed on four C. auris isolates obtained from a single patient case. Cas9-mediated genetic manipulations were then used to generate mutant strains harbouring mutations of interest, and these strains were subsequently subjected to amphotericin B susceptibility testing and comprehensive sterol profiling.
resultsA novel mutation in the C. auris sterol-methyltransferase gene ERG6 was found to be associated with amphotericin B resistance, and this mutation alone conferred a >32-fold increase in amphotericin B resistance. Comprehensive sterol profiling revealed an abrogation of ergosterol biosynthesis and a corresponding accumulation of cholesta-type sterols in isolates and strains harbouring the clinically derived ERG6 mutation.
conclusionsTogether these findings definitively demonstrate mutations in C. auris ERG6 as the first identified mechanism of clinical amphotericin B resistance in C. auris and represent a significant step forward in the understanding of antifungal resistance in this emerging public health threat.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.