Evidence map›Paper›PMID 39856577›Full record

ArticleBMC infectious diseases2025

Comparative evaluation of antifungal susceptibility testing methods of invasive Candida species and detection of FKS genes mutations in caspofungin intermediate and resistant isolates.

Dalia Saad ElFeky, Doaa Mahdy El-Wakil, Mai M Mwafy, Mohamed M A Atia, Noha Mahmoud Gohar

Abstract readComparative Study
PubMed Full text at PMC Publisher
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Article in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Dalia Saad ElFekyDepartment of Medical Microbiology and Immunology, Faculty of Medicine, Cairo University, Al-Saray Street, Al-Manial, Cairo, 11562, Egypt.
Doaa Mahdy El-WakilDepartment of Medical Microbiology and Immunology, Faculty of Medicine, Cairo University, Al-Saray Street, Al-Manial, Cairo, 11562, Egypt. do3aamahdy@cu.edu.eg.
Mai M MwafyDepartment of Medical Microbiology and Immunology, Faculty of Medicine, Tanta University, Tanta, Egypt.
Mohamed M A AtiaGenome Mapping Department, Agricultural Genetic Engineering Research Institute (AGERI), Agricultural Research Center (ARC), Giza, Egypt. matia@matia.org.
Noha Mahmoud GoharDepartment of Medical Microbiology and Immunology, Faculty of Medicine, Cairo University, Al-Saray Street, Al-Manial, Cairo, 11562, Egypt.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFungal invasive infections caused by Candida species pose a substantial public health risk with limited therapeutic options. Antifungal susceptibility testing (AFST) is necessary to optimize the therapy. The study aimed to compare different AFST methods of Candida spp. and detect FKS gene mutations among caspofungin-intermediate and resistant isolates.

methodsA total of 60 non-replicative invasive Candida isolates recovered from various clinical samples were included. In-vitro AFST was carried out using the ATB FUNGUS 3, Vitek-2 AST-YS08, and E-test. Hotspot (HS) regions of FKS genes were sequenced for caspofungin-intermediate and resistant isolates.

resultsCandida albicans (58.3%) was the most predominant spp., followed by C. glabrata (28.3%). Based on the clinical breakpoints (CBPs), fluconazole resistance was found in C. albicans (45.7%), C. tropicalis (25%), and the C. parapsilosis isolate, while 35.3% of C. glabrata were susceptible dose-dependent (SDD). None of C. albicans, C. tropicalis, or C. parapsilosis isolates were resistant to voriconazole. Using the epidemiological cut-off values (ECVs) for amphotericin B, 6.7% of isolates were non-wild type (non-WT), including C. guilliermondii (50%), C. tropicalis (25%), and C. glabrata (11.8%), while all C. albicans, C. parapsilosis, and C. kefyr isolates were classified as wild-type (WT). ATB FUNGUS 3 and Vitek-2 had the highest categorical agreement (CA) (83.1%) for amphotericin B, while a lower concordance was detected with voriconazole (23.2%) and fluconazole (52.2%). For caspofungin, Vitek-2 and E-test had a CA of 89.8%. Eleven isolates (10 C. glabrata and one C. parapsilosis) exhibited resistance or intermediate susceptibility to caspofungin (MICs: 0.25‒>32 µg/ml). Molecular characterization of the FKS gene demonstrated that FKS1 mutations V47I, V52K, V56T, D57S, L62F, I71Y, I71Q in the HS1 region, and G7S, P11H mutations in the HS2 region were associated with increased caspofungin MIC values (16 µg/ml). Mutations at the HS1 of the FKS2 gene; K33V, W35K, and W35V; were associated with the highest caspofungin MICs of > 32 µg/ml.

conclusionsATB FUNGUS 3 demonstrated acceptable performance for AFST, however, azole activity against Candida spp. should be interpreted carefully. Novel mutations within HS regions of FKS genes elucidated different levels of caspofungin resistance in C. glabrata and C. parapsilosis isolates.

Indexed as

Antifungal AgentsCandidaCaspofunginDrug Resistance, FungalFungal ProteinsGlucosyltransferasesHumansMicrobial Sensitivity TestsMutationAntifungal AgentsCaspofunginFungal ProteinsGlucosyltransferasesAcquired resistanceATB FUNGUS 3Candida speciesCaspofunginFKS mutationsVitek-2 AST-YS08

Identifiers

PMID39856577
PMCPMC11760087

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.