Pan-Echinocandin Resistant <i>C. parapsilosis</i> Harboring an F652S Fks1 Alteration in a Patient with Prolonged Echinocandin Therapy

• Published in: Journal of Fungi
• Main Authors: Maria Siopi, Antonios Papadopoulos, Anastasia Spiliopoulou, Fotini Paliogianni, Nissrine Abou-Chakra, Maiken Cavling Arendrup, Christina Damoulari, Georgios Tsioulos, Efthymia Giannitsioti, Frantzeska Frantzeskaki, Iraklis Tsangaris, Spyros Pournaras, Joseph Meletiadis
• Format: Article
• Language: English
• Published: MDPI AG 2022-09-01
• Subjects: <i>Candida parapsilosis</i>; echinocandin; acquired resistance; <i>FKS1</i> mutation
• Online Access: https://www.mdpi.com/2309-608X/8/9/931
• ISSN: 2309-608X

The isolation of a pan-echinocandin-resistant <i>Candida parapsilosis</i> strain (anidulafungin, caspofungin, micafungin and rezafungin EUCAST MICs > 8 mg/L) from urine of a patient following prolonged exposure to echinocandins (38 days of micafungin followed by 16 days of anidulafungin) is described. The isolate harbored the novel alteration F652S in the hotspot 1 region of fks1. Isogenic <i>C. parapsilosis</i> bloodstream isolates collected up to 1.5 months earlier from the same patient were susceptible to echinocandins (anidulafungin, caspofungin and micafungin EUCAST MICs 1–2, 1 and 1 mg/L, respectively) and contained wild-type <i>FKS1</i> sequences. This is the first report of pan-echinocandin resistance in <i>C. parapsilosis</i> associated with an aminoacid change in hotspot 1 region of fks1.