HOMEPRODUCTSCOMPANYCONTACTFAQResearchDictionaryPharmaSign Up FREE or Login

FKS mutant Candida glabrata: risk factors and outcomes in patients with candidemia.

AbstractBACKGROUND:
Echinocandins are recommended for Candia glabrata candidemia. Mutations in the FKS1 and FKS2 genes are associated with echinocandin resistance. Few studies have assessed risk factors for FKS mutant isolates and outcomes in patients receiving micafungin treatment.
METHODS:
Patients with C. glabrata bloodstream infection admitted to a large, tertiary care hospital between 2009 and 2012 were included in this study. For each isolate, FKS1 and FKS2 genes were sequenced to identify mutations. Risk factors for FKS mutations and treatment outcomes in patients receiving an echinocandin were assessed using multivariate logistic regression.
RESULTS:
Seventy-two patients were included in the study of which 13 (18%) had an FKS mutant isolate. The only significant predictor for FKS mutations was prior echinocandin exposure (odds ratio [OR], 19.9; 95% confidence interval [CI], 4.7-84.7; P ≤ .01). Treatment failure occurred in 17 (30%) of 57 patients who received an echinocandin and was more common in patients with FKS mutants (6 of 10; 60%) compared with non-FKS mutants (11 of 47; 23%). Underlying gastrointestinal disorder (OR, 4.7; 95% CI, 1.1-20.9; P = .04) and prior echinocandin exposure (OR, 8.3; 95% CI, 1.7-40.4; P ≤ .01) were independent predictors of echinocandin treatment failure. Treatment response and echinocandin minimum inhibitory concentrations varied among specific FKS mutations.
CONCLUSIONS:
FKS mutations were identified in 18% of 72 patients with C. glabrata candidemia. Common risk factors for FKS mutant isolates included previous echinocandin exposure, which also influenced response rates.
AuthorsNicholas D Beyda, Julie John, Abdullah Kilic, Mohammad J Alam, Todd M Lasco, Kevin W Garey
JournalClinical infectious diseases : an official publication of the Infectious Diseases Society of America (Clin Infect Dis) Vol. 59 Issue 6 Pg. 819-25 (Sep 15 2014) ISSN: 1537-6591 [Electronic] United States
PMID24879785 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Copyright© The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: [email protected].
Chemical References
  • Antifungal Agents
  • Echinocandins
  • Fungal Proteins
  • Lipopeptides
  • Caspofungin
  • Micafungin
Topics
  • Adult
  • Aged
  • Aged, 80 and over
  • Antifungal Agents (pharmacology, therapeutic use)
  • Candida glabrata (drug effects, genetics)
  • Candidemia
  • Candidiasis (diagnosis, drug therapy, microbiology)
  • Caspofungin
  • Drug Resistance, Fungal (genetics)
  • Echinocandins (pharmacology, therapeutic use)
  • Female
  • Fungal Proteins (genetics)
  • Humans
  • Lipopeptides (pharmacology, therapeutic use)
  • Male
  • Micafungin
  • Microbial Sensitivity Tests
  • Middle Aged
  • Mutation
  • Patient Outcome Assessment
  • Prognosis
  • Risk Factors
  • Treatment Failure
  • Treatment Outcome
  • Young Adult

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!


Choose Username:
Email:
Password:
Verify Password:
Enter Code Shown: