Pan-Echinocandin-Resistant Candida glabrata Bloodstream Infection Complicating COVID-19: A Fatal Case Report
by
Brunella Posteraro 1,2,†, Riccardo Torelli 3,†, Antonietta Vella 3,†
, Paolo Maria Leone 2, Giulia De Angelis 1,3, Elena De Carolis 3, Giulio Ventura 3,4, Maurizio Sanguinetti 1,3,* and Massimo Fantoni 3,4
Brunella Posteraro 1,2,†, Riccardo Torelli 3,†, Antonietta Vella 3,†, Paolo Maria Leone 2, Giulia De Angelis 1,3, Elena De Carolis 3, Giulio Ventura 3,4, Maurizio Sanguinetti 1,3,* and Massimo Fantoni 3,4
1
Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
2
Dipartimento di Scienze Gastroenterologiche, Endocrino-Metaboliche e Nefro-Urologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
3
Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
4
Dipartimento di Sicurezza e Bioetica, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
*
Author to whom correspondence should be addressed.
â€
These authors contributed equally to this work.
J. Fungi 2020, 6(3), 163; https://doi.org/10.3390/jof6030163
Received: 6 August 2020 / Revised: 3 September 2020 / Accepted: 4 September 2020 / Published: 6 September 2020
(This article belongs to the Special Issue Fungal Infections Complicating COVID-19)
Coinfections with bacteria or fungi may be a frequent complication of COVID-19, but coinfections with Candida species in COVID-19 patients remain rare. We report the 53-day clinical course of a complicated type-2 diabetes patient diagnosed with COVID-19, who developed bloodstream infections initially due to methicillin-resistant Staphylococcus aureus, secondly due to multidrug-resistant Gram-negative bacteria, and lastly due to a possibly fatal Candida glabrata. The development of FKS-associated pan-echinocandin resistance in the C. glabrata isolated from the patient after 13 days of caspofungin treatment aggravated the situation. The patient died of septic shock shortly before the prospect of receiving potentially effective antifungal therapy. This case emphasizes the importance of early diagnosis and monitoring for antimicrobial drug-resistant coinfections to reduce their unfavorable outcomes in COVID-19 patients.
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Keywords:
SARS-CoV-2; coinfection; diabetes; bloodstream infection; Candida glabrata; echinocandin resistance; FKS mutation
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MDPI and ACS Style
Posteraro, B.; Torelli, R.; Vella, A.; Leone, P.M.; De Angelis, G.; De Carolis, E.; Ventura, G.; Sanguinetti, M.; Fantoni, M. Pan-Echinocandin-Resistant Candida glabrata Bloodstream Infection Complicating COVID-19: A Fatal Case Report. J. Fungi 2020, 6, 163.
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