Fluconazole-resistant candida glabrata bloodstream isolates, South Korea, 2008-2018

Eun Jeong Won, Min Ji Choi, Mi Na Kim, Dongeun Yong, Wee Gyo Lee, Young Uh, Taek Soo Kim, Seung Ah Byeon, Seung Yeob Lee, Soo Hyun Kim, Jong Hee Shin

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

We investigated the clinical outcomes and molecular mechanisms of fluconazole-resistant (FR) Candida glabrata bloodstream infections. Among 1,158 isolates collected during multicenter studies in South Korea during 2008-2018, 5.7% were FR. For 64 patients with FR bloodstream infection isolates, the 30-day mortality rate was 60.9% and the 90-day mortality rate 78.2%; these rates were significantly higher than in patients with fluconazole-susceptible dose-dependent isolates (30-day mortality rate 36.4%, 90-day mortality rate 43.8%; p<0.05). For patients with FR isolates, appropriate antifungal therapy was the only independent protective factor associated with 30-day (hazard ratio 0.304) and 90-day (hazard ratio 0.310) mortality. Sequencing of pleiotropic drug-resistance transcription factor revealed that 1-2 additional Pdr1p amino acid substitutions (except genotype-specific Pdr1p amino acid substitutions) occurred in 98.5% of FR isolates but in only 0.9% of fluconazole-susceptible dose-dependent isolates. These results highlight the high mortality rate of patients infected with FR C. glabrata BSI isolates harboring Pdr1p mutations.

Original languageEnglish
Pages (from-to)31-40
Number of pages10
JournalEmerging infectious diseases
Volume27
Issue number3
DOIs
Publication statusPublished - 2021 Mar

Bibliographical note

Funding Information:
This research was supported by the Basic Science Research Program through the National Research Foundation of South Korea funded by the Ministry of Education (grant no. NRF-2019R1A2C1004644).

Publisher Copyright:
© 2021 Centers for Disease Control and Prevention (CDC). All rights reserved.

All Science Journal Classification (ASJC) codes

  • Epidemiology
  • Microbiology (medical)
  • Infectious Diseases

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