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bioRxiv · 10.1101/2025.05.13.653818

In vivo evolution of Candida auris multi-drug resistance in a patient receiving antifungal treatment

Wang, T. W.·Putnam, N.·Johnson, J. K.·Jabra-Rizk, M. A.
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Abstract

Candida auris is associated with life-threatening invasive disease due to high level of drug resistance. We present a clinical case of C. auris multi-drug resistance development in a single patient acquired during antifungal treatment. Five isolates were prospectively recovered from a transplant patient receiving antifungal therapy over a one-year period. While isolates were initially only resistant to fluconazole, the terminal isolate became resistant to caspofungin and amphotericin B with significant increase in micafungin MIC. Sequencing of ERG11 and FKS1 genes identified mutations associated with fluconazole and echinocandin resistance in the multi-drug-resistant isolate, underscoring the threat of therapy-induced development of resistance.

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Wang, T. W., Putnam, N., Johnson, J. K., Jabra-Rizk, M. A.. 2025-05-14. In vivo evolution of Candida auris multi-drug resistance in a patient receiving antifungal treatment. https://doi.org/10.1101/2025.05.13.653818

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