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Many strains of this yeast are intrinsically resistant to azole antifungal agents, and treatment is problematic, leading to high morbidity and mortality rates in immunosuppressed individuals. The primary goal of this study was to investigate the genes involved in the drug resistance of clinical isolates of <jats:italic>C. glabrata.<\/jats:italic>\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>The clinical isolates of <jats:italic>C. glabrata<\/jats:italic> were collected in an epidemiological survey of candidal infection in immunocompromised patients and consisted of four fluconazole and itraconazole resistant isolates, two fluconazole and itraconazole sensitive isolates, and <jats:italic>C. glabrata<\/jats:italic> CBS 138 as reference strain. Antifungal susceptibility patterns of the organisms were determined beforehand by the Clinical and Laboratory Standards Institute (CLSI). The potential gene(s) implicated in antifungal resistance were investigated using complementary DNA- Amplified Fragment Length Polymorphism (cDNA-AFLP). Semi-quantitative RT-PCR was carried out to evaluate the expression of gene(s) in resistant isolates as compared to sensitive and reference strains.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results and conclusions<\/jats:title>\n            <jats:p>The aldo-keto-reductase superfamily (<jats:italic>AKR<\/jats:italic> gene) was upregulated in the resistant clinical isolates as assessed by cDNA-AFLP. Semi-quantitative RT-PCR revealed AKR mRNA expression approximately twice that seen in the sensitive isolates. Overexpression of the <jats:italic>AKR<\/jats:italic> gene was associated with increased fluconazole and itraconazole resistance in <jats:italic>C. glabrata<\/jats:italic>. The data suggest that upregulation of the <jats:italic>AKR<\/jats:italic> gene might give a new insight into the mechanism of azole resistance.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/2008-2231-21-1","type":"journal-article","created":{"date-parts":[[2013,1,2]],"date-time":"2013-01-02T07:14:28Z","timestamp":1357110868000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Overexpression of aldo-keto-reductase in azole-resistant clinical isolates of Candida glabrata determined by cDNA-AFLP"],"prefix":"10.1186","volume":"21","author":[{"given":"Shirin","family":"Farahyar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farideh","family":"Zaini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parivash","family":"Kordbacheh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sassan","family":"Rezaie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahin","family":"Safara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reza","family":"Raoofian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mansour","family":"Heidari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2013,1,2]]},"reference":[{"key":"91_CR1","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1128\/CMR.00029-06","volume":"20","author":"M Pfaller","year":"2007","unstructured":"Pfaller M, Diekema D: Epidemiology of invasive candidiasis: a persistent public health problem. 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