[A case of micafungin-hyposensitive Candida glabrata due to FKS2 gene mutation]

Kansenshogaku Zasshi. 2011 Jan;85(1):49-53. doi: 10.11150/kansenshogakuzasshi.85.49.
[Article in Japanese]

Abstract

Candida glabrata was continuously isolated in cultured urine samples from a subject with thrombotic thrombocytopenic purpura. Yeast-like fungal phagocytosis found in gram staining led to agents being tested for antifungal susceptibility, revealing hyposensitivity to micafungin (MCFG) of MIC <2 mg/mL. MCFG administered for 10 days failed to cure C. glabrata infection. To clarify why hyposensitivity occurred, we analyzed the FKS gene sequence using the PCR, finding a deficit of 3 bases coding phenylalanine at FKS2 gene amino acid 659. MCFG hyposensitivity may thus occur in long-term candin-class anti-fungal agent treatment. Candin-class agents have potent anti-fungal activity with fewer adverse effects and are widely used clinically. Hyposensitivity due to resistant C. glabrata species showed thus be considered in fungal infection treatment.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antifungal Agents / pharmacology*
  • Candida glabrata / drug effects
  • Candida glabrata / genetics*
  • Drug Resistance, Fungal / genetics
  • Echinocandins / pharmacology*
  • Female
  • Fungal Proteins / genetics*
  • Humans
  • Lipopeptides / pharmacology*
  • Micafungin
  • Mutation*

Substances

  • Antifungal Agents
  • Echinocandins
  • Fungal Proteins
  • Lipopeptides
  • Micafungin