{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T19:39:36Z","timestamp":1792611576387,"version":"4.5.0"},"reference-count":49,"publisher":"American Society for Microbiology","issue":"6","license":[{"start":{"date-parts":[[2018,6,1]],"date-time":"2018-06-01T00:00:00Z","timestamp":1527811200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/100000002","name":"HHS | National Institutes of Health","doi-asserted-by":"publisher","award":["AI109025"],"award-info":[{"award-number":["AI109025"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004324","name":"Astellas Pharma US","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004324","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            <jats:named-content content-type=\"genus-species\">Candida auris<\/jats:named-content>\n            has simultaneously emerged on five continents as a fungal pathogen causing nosocomial outbreaks. The challenges in the treatment of\n            <jats:named-content content-type=\"genus-species\">C. auris<\/jats:named-content>\n            infections are the variable antifungal susceptibility profiles among clinical isolates and the development of resistance to single or multiple classes of available antifungal drugs. Here, the\n            <jats:italic>in vitro<\/jats:italic>\n            susceptibility to echinocandin antifungal drugs was determined and\n            <jats:italic>FKS1<\/jats:italic>\n            sequencing was performed on 106\n            <jats:named-content content-type=\"genus-species\">C. auris<\/jats:named-content>\n            clinical isolates. Four isolates were identified to be resistant to all tested echinocandins (MIC \u2265 4 mg\/liter) and harbored an S639F mutation in\n            <jats:italic>FKS1<\/jats:italic>\n            hot spot region 1. All remaining isolates were\n            <jats:italic>FKS1<\/jats:italic>\n            wild type (WT) and echinocandin susceptible, with micafungin being the most potent echinocandin (MIC\n            <jats:sub>50<\/jats:sub>\n            = 0.125 mg\/liter). Antifungal susceptibility testing with caspofungin was challenging due to the fact that all\n            <jats:italic>FKS1<\/jats:italic>\n            WT isolates exhibited an Eagle effect (also known as the paradoxical growth effect), which occurred at various intensities. To assess whether the Eagle effect resulted in pharmacodynamic resistance, 8 representative isolates were evaluated for their\n            <jats:italic>in vivo<\/jats:italic>\n            drug response in a murine model of invasive candidiasis. All isolates were susceptible to caspofungin at a human therapeutic dose, except for those harboring the S639F mutation. The data suggest that only isolates carrying mutations in\n            <jats:italic>FKS1<\/jats:italic>\n            are echinocandin resistant and that routine\n            <jats:italic>in vitro<\/jats:italic>\n            testing of\n            <jats:named-content content-type=\"genus-species\">C. auris<\/jats:named-content>\n            isolates for susceptibility to caspofungin by the broth microdilution method should be viewed cautiously or avoided.\n          <\/jats:p>","DOI":"10.1128\/aac.00238-18","type":"journal-article","created":{"date-parts":[[2018,4,6]],"date-time":"2018-04-06T09:44:50Z","timestamp":1523007890000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":237,"title":["Understanding Echinocandin Resistance in the Emerging Pathogen Candida auris"],"prefix":"10.1128","volume":"62","author":[{"given":"Milena","family":"Kordalewska","sequence":"first","affiliation":[{"name":"Public Health Research Institute, Rutgers Biomedical and Health Sciences, Newark, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annie","family":"Lee","sequence":"additional","affiliation":[{"name":"Public Health Research Institute, Rutgers Biomedical and Health Sciences, Newark, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Park","sequence":"additional","affiliation":[{"name":"Public Health Research Institute, Rutgers Biomedical and Health Sciences, Newark, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Indira","family":"Berrio","sequence":"additional","affiliation":[{"name":"Medical and Experimental Mycology Group, Corporaci\u00f3n para Investigaciones Biol\u00f3gicas (CIB), Medell\u00edn, Colombia"},{"name":"Hospital General de Medellin Luz Castro de Guti\u00e9rrez ESE, Medell\u00edn, 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