Abstract
We report a case of fluconazole-resistant oropharyngeal colonization caused by a strain of Candida glabrata that rapidly regained susceptibility once prophylaxis with this agent was discontinued and echinocandin therapy was initiated. Isolates collected before and after discontinuation of fluconazole were confirmed to be isogenic by RAPD analysis. Transcription analysis demonstrated constitutive expression of genes encoding efflux pumps in the isolate recovered on fluconazole prophylaxis and transient expression in those isolates collected after fluconazole was discontinued.
Acknowledgements
This work was supported in part by Public Health Service Grant DE-18096 from the National Institute of Dental and Craniofacial Research. The authors gratefully acknowledge Jon Maust and Marcos Olivo for their technical assistance with yeast identification and isolation.
Conflict of interest: SDW, ACV, SK, SB, SAL, WRK, JJT, COF: None to declare.N.PW. has received research support from Pfizer, Schering-Plough, and CyDex Pharmaceuticals. T.F.P. has received research support from Merck, Pfizer, Schering-Plough, and Nektar Therapeutics, has served on the speakers bureau for Merck and Pfizer, and as a consultant for Basilea, Merck, Nektar, Pfizer, and Toyama. S.W.R. has received research support from Pflzer, Schering-Plough, and Astellas.