Novel non hot spot modification in Fks1 ofCandida aurisconfers echinocandin resistance

Abstract

We determined echinocandin susceptibility andFKS1genotypes of thirteen clinical isolates ofCandida aurisrecovered from four patients at a tertiary care center in Salvador, Brazil. Three isolates were categorized as echinocandin-resistant and harbored a novelFKS1mutation leading to an amino acid change W691L located downstream from hot-spot 1. When introduced to an echinocandin-susceptibleC. aurisstrains by CRISPR/Cas9, Fks1 W691L induced elevated MIC values to all echinocandins (ANF 16-32x; CAS >64x; MCF >64x).