Novel non hot spot modification in Fks1 of Candida auris confers echinocandin resistance
We determined echinocandin susceptibility and FKS1 genotypes of thirteen clinical isolates of Candida auris recovered from four patients at a tertiary care center in Salvador, Brazil. Three isolates were categorized as echinocandin-resistant and harbored a novel FKS1 mutation leading to an amino acid change W691L located downstream from hot-spot 1. When introduced to echinocandin-susceptible C. auris strains by CRISPR/Cas9, Fks1 W691L induced elevated MIC values to all echinocandins (ANF 16-32x; CAS >64x; MCF >64x).