Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Mar 24;64(4):e01651-19.
doi: 10.1128/AAC.01651-19. Print 2020 Mar 24.

Mechanisms of Acquired In Vivo and In Vitro Resistance to Voriconazole by Candida krusei following Exposure to Suboptimal Drug Concentration

Elisabete Ricardo  1   2 , Fréderic Grenouillet  3   4 , Isabel M Miranda  5   6 , Raquel M Silva  7 , Guilluame Eglin  3 , Nadège Devillard  8 , Acácio Gonçalves Rodrigues  5   2   9 , Cidália Pina-Vaz  5   2
Affiliations

Mechanisms of Acquired In Vivo and In Vitro Resistance to Voriconazole by Candida krusei following Exposure to Suboptimal Drug Concentration

Elisabete Ricardo et al. Antimicrob Agents Chemother. .

Abstract

Five Candida krusei isolates (susceptible and resistant) recovered from the urine of a kidney transplant patient treated with voriconazole (VRC) 200 mg twice daily for 20 days were studied. Eight unrelated clinical isolates of C. krusei were exposed in vitro to VRC 0.001 μg/ml for 30 days. Development of VRC transient resistance occurred in vivo, and induction of permanent resistance occurred in vitro Mostly, ABC1 and ERG11 genes were overexpressed, and a homozygous T418C mutation in the ERG11 gene was found.

Keywords: ABC1 ABC2 efflux pump genes; Candida krusei; ERG11 gene mutations; candidiasis; candiduria; mechanisms of antifungal resistance; underexposure to antifungal drugs; voriconazole.

PubMed Disclaimer

Figures

FIG 1
FIG 1
In vivo induction of resistance to voriconazole. (a) Timeline of the renal transplant procedure and antifungal therapy; identity of the C. krusei clinical isolates recovered from the kidney-transplant recipient and their respective susceptibility profiles. (b) Genotyping of C. krusei clinical isolates. M, molecular weight marker. (c) Relative gene expression profile of ABC1, ABC2, and ERG11 genes for the C. krusei clinical isolates. *, P ≤ 0.05.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Fisher JF. 2011. Candida urinary tract infections—epidemiology, pathogenesis, diagnosis, and treatment: executive summary. Clin Infect Dis 52:S429–432. doi:10.1093/cid/cir108. - DOI - PubMed
    1. Kauffman CA. 2014. Diagnosis and management of fungal urinary tract infection. Infect Dis Clin North Am 28:61–74. doi:10.1016/j.idc.2013.09.004. - DOI - PubMed
    1. Bougnoux M-E, Kac G, Aegerter P, d'Enfert C, Fagon J-Y, CandiRea Study Group . 2008. Candidemia and candiduria in critically ill patients admitted to intensive care units in France: incidence, molecular diversity, management and outcome. Intensive Care Med 34:292–299. doi:10.1007/s00134-007-0865-y. - DOI - PubMed
    1. Brammer KW, Coakley AJ, Jezequel SG, Tarbit MH. 1991. The disposition and metabolism of [14C]fluconazole in humans. Drug Metab Dispos 19:764–767. - PubMed
    1. Thomas L, Tracy CR. 2015. Treatment of fungal urinary tract infection. Urol Clin North Am 42:473–483. doi:10.1016/j.ucl.2015.05.010. - DOI - PubMed

Publication types

MeSH terms

Supplementary concepts