Abstract:
BACKGROUND:Candida parapsilosis was the most common species causing candidemia in the 2010 China Hospital Invasive Fungal Surveillance Net (CHIF-NET) database. Compared to Candida albicans, the description of azole resistance and mechanisms in C. parapsilosis is very limited. We report a patient with C. parapsilosis candidemia over several months, due to a probable intravascular source, who developed fluconazole resistance after prolonged treatment. CASE PRESENTATION:An 82 year-old male had a hospital admission of approximately 1.5 years duration. He was initially admitted with acute pancreatitis. Prior to succumbing to the illness, he developed candidemia and treated with three antifungal drugs for nearly 5 months, at suboptimal doses and without source control. Following treatment, 6 blood cultures were still positive for C. parapsilosis. The last 2 strains were resistant to fluconazole (MICs 32 μg/mL) and intermediate to voriconazole (MICs 0.5 μg/mL). Microsatellite multilocus analysis indicated that the 6 isolates from the patient belonged to a single genotype. The first 4 isolates were susceptible to fluconazole (MICs 2 μg/mL) and voriconazole (MICs 0.015-0.03 μg/mL), which were slightly higher than susceptible control strains from other patients. Overexpression of MDR1 genes were detected in the two resistant isolates, and this was associated with a homozygous mutation in MRR1 genes (T2957C /T2957C), with the amino acid exchange L986P. CONCLUSIONS:This case corroborates that the resistant C. parapsilosis isolates can emerge in the setting of complicated infections and the extensive use of antifungal agents, emphasizing the need for standardizing and improving the antifungal treatment as well as source control in the treatment of infection diseases.
journal_name
BMC Infect Disjournal_title
BMC infectious diseasesauthors
Zhang L,Xiao M,Watts MR,Wang H,Fan X,Kong F,Xu YCdoi
10.1186/s12879-015-1086-6subject
Has Abstractpub_date
2015-08-18 00:00:00pages
340issn
1471-2334pii
10.1186/s12879-015-1086-6journal_volume
15pub_type
杂志文章abstract:BACKGROUND:This study aims to investigate the clinical features of invasive community-acquired Staphylococcus aureus (CA-SA) infection in Chinese children and analyze its molecular features. METHODS:Clinical data and invasive CA-SA isolates were prospectively collected. Pediatric risk of mortality (PRISM) score was us...
journal_title:BMC infectious diseases
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journal_title:BMC infectious diseases
pub_type: 杂志文章,多中心研究,随机对照试验
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