{"doi":"10.1111/myc.13104","title":"Low level of antifungal resistance of <i>Candida glabrata</i> blood isolates in Turkey: Fluconazole minimum inhibitory concentration and <i>FKS</i> mutations can predict therapeutic failure","abstract":"BACKGROUND: Candida glabrata is the third leading cause of candidaemia in Turkey; however, the data regarding antifungal resistance mechanisms and genotypic diversity in association with their clinical implication are limited. OBJECTIVES: To assess genotypic diversity, antifungal susceptibility and mechanisms of drug resistance of C glabrata blood isolates and their association with patients' outcome in a retrospective multicentre study. PATIENTS/METHODS: Isolates from 107 patients were identified by ITS sequencing and analysed by multilocus microsatellite typing, antifungal susceptibility testing, and sequencing of PDR1 and FKS1/2 hotspots (HSs). RESULTS: Candida glabrata prevalence in Ege University Hospital was twofold higher in 2014-2019 than in 2005-2014. Six of the analysed isolates had fluconazole MICs ≥ 32 µg/mL; of them, five harboured unique PDR1 mutations. Although echinocandin resistance was not detected, three isolates had mutations in HS1-Fks1 (S629T, n = 1) and HS1-Fks2 (S663P, n = 2); one of the latter was also fluconazole-resistant. All patients infected with isolates carrying HS-FKS mutations and/or demonstrating fluconazole MIC ≥ 32 µg/mL (except one without clinical data) showed therapeutic failure (TF) with echinocandin and fluconazole; seven such isolates were collected in Ege (n = 4) and Gulhane (n = 3) hospitals and six detected recently. Among 34 identified genotypes, none were associated with mortality or enriched for fluconazole-resistant isolates. CONCLUSION: Antifungal susceptibility testing should be supplemented with HS-FKS sequencing to predict TF for echinocandins, whereas fluconazole MIC ≥ 32 µg/mL may predict TF. Recent emergence of C glabrata isolates associated with antifungal TF warrants future comprehensive prospective studies in Turkey.","journal":"Mycoses","year":2020,"id":92091,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":43,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.963,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":260363,"name":"Farnaz Daneshnia","orcid":"0000-0002-8782-2036","position":1,"is_corresponding":false},{"id":226005,"name":"Mohammadreza Salehi","orcid":"0000-0002-5538-7586","position":2,"is_corresponding":false},{"id":460954,"name":"Melike Yaşar","orcid":"0000-0001-8913-2314","position":3,"is_corresponding":false},{"id":462393,"name":"Tuğrul Hoşbul","orcid":null,"position":4,"is_corresponding":false},{"id":235821,"name":"Macit İlkit","orcid":"0000-0002-1174-4182","position":5,"is_corresponding":false},{"id":460955,"name":"Weihua Pan","orcid":"0000-0002-3528-204X","position":6,"is_corresponding":false},{"id":460956,"name":"Ferry Hagen","orcid":"0000-0002-5622-1916","position":7,"is_corresponding":false},{"id":460957,"name":"Nazlı Arslan","orcid":"0000-0002-3951-4418","position":8,"is_corresponding":false},{"id":92269,"name":"Hatice Türk Dağı","orcid":"0000-0002-0291-4987","position":9,"is_corresponding":false},{"id":460958,"name":"Süleyha Hilmioğlu Polat","orcid":"0000-0001-8850-2715","position":10,"is_corresponding":false},{"id":336885,"name":"David S. Perlin","orcid":"0000-0002-1268-5524","position":11,"is_corresponding":false},{"id":235822,"name":"Cornelia Lass‐Flörl","orcid":"0000-0002-2946-7785","position":12,"is_corresponding":false},{"id":235816,"name":"Amir Arastehfar","orcid":"0000-0002-4361-4841","position":0,"is_corresponding":true}],"reference_count":61,"raw_metadata":null,"created_at":"2026-07-18T22:29:54.256205Z","pmid":"32413170","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}