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Fluconazole-Resistant Candida glabrata Bloodstream Isolates, South Korea, 2008-2018

Authors
 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 
Citation
 EMERGING INFECTIOUS DISEASES, Vol.27(3) : 779-788, 2021-03 
Journal Title
 EMERGING INFECTIOUS DISEASES 
ISSN
 1080-6040 
Issue Date
2021-03
Keywords
Candida glabrata ; PDR1 ; South Korea ; antimicrobial resistance ; candidemia ; fluconazole resistance ; fungal infections ; fungi ; mortality
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.
Files in This Item:
T202100725.pdf Download
DOI
10.3201/eid2703.203482
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
Yonsei Authors
Yong, Dong Eun(용동은) ORCID logo https://orcid.org/0000-0002-1225-8477
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/182219
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