ERG11 Gene Mutations and MDR1 Upregulation Confer Pan-Azole Resistance in Candida tropicalis Causing Disseminated Candidiasis in an Acute Lymphoblastic Leukemia Patient on Posaconazole Prophylaxis

Antimicrobial Agents and Chemotherapy
Liangshun YouHaitao Meng

Abstract

In this study, we present a rare case of fatal breakthrough Candida tropicalis infection in a patient with acute lymphoblastic leukemia (ALL) while on posaconazole prophylaxis. Then, we explore the mechanisms underlying azole resistance by focusing on enhanced efflux pumps and changes in the azole target enzyme Erg11p, which was encoded by the ERG11 gene. Our study demonstrates that Y132C substitution of Erg11p combined with MDR1 overexpression may be the pan-azole resistance mechanisms in Candida tropicalis.

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Citations

Apr 23, 2020·Canadian Journal of Microbiology·Jonathas Sales de OliveiraMarcos Fábio Gadelha Rocha
May 14, 2020·Medical Mycology·A T JamiuC H Pohl
Aug 26, 2020·Antimicrobial Agents and Chemotherapy·YanChun ZhuVishnu Chaturvedi

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Methods Mentioned

BETA
PCR

Software Mentioned

blast
MODEL
SWISS
Pymol

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