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Antimicrob Agents Chemother. 2017 Jun 27;61(7). pii: e02496-16. doi: 10.1128/AAC.02496-16. Print 2017 Jul.

ERG11 Gene Mutations and MDR1 Upregulation Confer Pan-Azole Resistance in Candida tropicalis Causing Disseminated Candidiasis in an Acute Lymphoblastic Leukemia Patient on Posaconazole Prophylaxis.

Author information

1
Department of Hematology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China.
2
State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China.
3
Department of Hematology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China menghait2004@163.com.

Abstract

In this study, we present a rare case of fatal breakthrough Candida tropicalis infection in a patient with acute lymphoblastic leukemia (ALL) while on posaconazole prophylaxis. Then, we explore the mechanisms underlying azole resistance by focusing on enhanced efflux pumps and changes in the azole target enzyme Erg11p, which was encoded by the ERG11 gene. Our study demonstrates that Y132C substitution of Erg11p combined with MDR1 overexpression may be the pan-azole resistance mechanisms in Candida tropicalis.

KEYWORDS:

Candida tropicalis; ERG11 mutation; MDR1; acute leukemia; azole resistance; candidiasis; posaconazole

PMID:
28507109
PMCID:
PMC5487663
DOI:
10.1128/AAC.02496-16
[Indexed for MEDLINE]
Free PMC Article

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