{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"bioRxiv"}],"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T23:44:21Z","timestamp":1768520661205,"version":"3.49.0"},"posted":{"date-parts":[[2025,5,14]]},"group-title":"Microbiology","reference-count":23,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:00:00Z","timestamp":1747180800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","award":["R01AI130170"],"award-info":[{"award-number":["R01AI130170"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2025,5,14]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                <jats:p>\n                  <jats:italic>Candida auris<\/jats:italic>\n                  is associated with life-threatening invasive disease due to high level of drug resistance. We present a clinical case of\n                  <jats:italic>C. auris<\/jats:italic>\n                  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\n                  <jats:italic>ERG11<\/jats:italic>\n                  and\n                  <jats:italic>FKS1<\/jats:italic>\n                  genes identified mutations associated with fluconazole and echinocandin resistance in the multi-drug-resistant isolate, underscoring the threat of therapy-induced development of resistance.\n                <\/jats:p>","DOI":"10.1101\/2025.05.13.653818","type":"posted-content","created":{"date-parts":[[2025,5,17]],"date-time":"2025-05-17T02:00:17Z","timestamp":1747447217000},"source":"Crossref","is-referenced-by-count":0,"title":["<i>In vivo<\/i>\n                  evolution of\n                  <i>Candida auris<\/i>\n                  multi-drug resistance in a patient receiving antifungal treatment"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6889-2453","authenticated-orcid":false,"given":"Tristan W.","family":"Wang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"Putnam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. Kristie","family":"Johnson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4425-3873","authenticated-orcid":false,"given":"Mary Ann","family":"Jabra-Rizk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"54368","reference":[{"key":"2025060122105058000_2025.05.13.653818v1.1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-micro-032521-015858"},{"key":"2025060122105058000_2025.05.13.653818v1.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fgb.2019.103243"},{"key":"2025060122105058000_2025.05.13.653818v1.3","doi-asserted-by":"publisher","DOI":"10.1128\/aac.00911-24"},{"key":"2025060122105058000_2025.05.13.653818v1.4","doi-asserted-by":"publisher","DOI":"10.1038\/s41579-023-00861-x"},{"key":"2025060122105058000_2025.05.13.653818v1.5","doi-asserted-by":"publisher","DOI":"10.1007\/s40588-024-00233-w"},{"key":"2025060122105058000_2025.05.13.653818v1.6","doi-asserted-by":"publisher","DOI":"10.1111\/myc.13655"},{"issue":"3","key":"2025060122105058000_2025.05.13.653818v1.7","first-page":"e00371","volume":"5","year":"2020","journal-title":"Candida auris phenotypic heterogeneity determines pathogenicity in vitro mSphere"},{"key":"2025060122105058000_2025.05.13.653818v1.8","first-page":"e00760","article-title":"Comparative evaluations of the pathogenesis of Candida auris phenotypes and Candida albicans using clinically relevant murine models of infections","volume":"5","year":"2020","journal-title":"mSphere"},{"key":"2025060122105058000_2025.05.13.653818v1.9","unstructured":"CLSI Performance standards for antifungal susceptibility testing of yeasts. CLSI supplement M60, 2017."},{"key":"2025060122105058000_2025.05.13.653818v1.10","unstructured":"CDC Candida auris. https:\/\/www.cdc.gov\/fungal\/candida-auris\/index.html, 2021."},{"key":"2025060122105058000_2025.05.13.653818v1.11","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-024-53588-5"},{"key":"2025060122105058000_2025.05.13.653818v1.12","doi-asserted-by":"publisher","DOI":"10.3390\/jof7090754"},{"key":"2025060122105058000_2025.05.13.653818v1.13","doi-asserted-by":"publisher","DOI":"10.1038\/s41564-024-01854-z"},{"key":"2025060122105058000_2025.05.13.653818v1.14","doi-asserted-by":"publisher","DOI":"10.1128\/aac.00053-22"},{"issue":"3","key":"2025060122105058000_2025.05.13.653818v1.15","doi-asserted-by":"crossref","first-page":"e0158521","DOI":"10.1128\/Spectrum.01585-21","article-title":"Delineation of the direct contribution of Candida auris ERG11 mutations to clinical triazole resistance","volume":"9","year":"2021","journal-title":"Microbiol Spectr"},{"key":"2025060122105058000_2025.05.13.653818v1.16","doi-asserted-by":"publisher","DOI":"10.1080\/22221751.2024.2377584"},{"key":"2025060122105058000_2025.05.13.653818v1.17","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01652-21"},{"key":"2025060122105058000_2025.05.13.653818v1.18","doi-asserted-by":"publisher","DOI":"10.1128\/mBio.03333-20"},{"key":"2025060122105058000_2025.05.13.653818v1.19","doi-asserted-by":"publisher","DOI":"10.1128\/aac.02276-21"},{"key":"2025060122105058000_2025.05.13.653818v1.20","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2021.11.024"},{"key":"2025060122105058000_2025.05.13.653818v1.21","doi-asserted-by":"publisher","DOI":"10.1128\/mBio.03364-19"},{"key":"2025060122105058000_2025.05.13.653818v1.22","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01757-18"},{"key":"2025060122105058000_2025.05.13.653818v1.23","doi-asserted-by":"publisher","DOI":"10.1128\/mSphere.00506-18"}],"container-title":[],"original-title":[],"link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1101\/2025.05.13.653818","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T08:41:53Z","timestamp":1768466513000},"score":1,"resource":{"primary":{"URL":"http:\/\/biorxiv.org\/lookup\/doi\/10.1101\/2025.05.13.653818"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,14]]},"references-count":23,"URL":"https:\/\/doi.org\/10.1101\/2025.05.13.653818","relation":{"is-preprint-of":[{"id-type":"doi","id":"10.1093\/infdis\/jiaf394","asserted-by":"subject"}]},"subject":[],"published":{"date-parts":[[2025,5,14]]},"subtype":"preprint"}}