Acquired amphotericin B resistance attributed to a mutated in .

Antimicrobial agents and chemotherapy
Authors
Keywords
Abstract

First identified in 2009, (formerly ) is an emerging multidrug-resistant fungus that can cause invasive infections with a crude mortality rate ranging from 30 to 60%. Currently, 30-50% of isolates are intrinsically resistant to amphotericin B. In this study, we characterized a clinical case of acquired amphotericin B resistance using whole-genome sequencing, a large-scale phenotypic screen, comprehensive sterol profiling, and genotypic reversion using CRISPR. Data obtained in this study provide evidence that a deletion resulting in a frameshift in significantly contributes to the observed resistant phenotype, and a nonsense mutation in may more modestly contribute to resistance. Characterization of this isolate also revealed that a fitness cost is associated with the abrogation of ergosterol production and its replacement with other late-stage sterols. This article presents a clinical case description of amphotericin B resistance from a frameshift mutation in in and marks an advancement in the understanding of antifungal resistance in this fungal pathogen.

Year of Publication
2025
Journal
Antimicrobial agents and chemotherapy
Pages
e0060125
Date Published
09/2025
ISSN
1098-6596
DOI
10.1128/aac.00601-25
PubMed ID
40980913
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