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    Objectives: This study aimed to elucidate the relative involvement of drug resistance gene copy number and overexpression in fluconazole resistance in clinical C. glabrata isolates using a population-based approach. Methods: Fluconazole resistance levels were quantified using the minimal inhibitory concentration (MIC) via Etest method. doi: 10.1128/JCM.00381-07 Pubmed Abstract | Pubmed Full Text | Cross Ref Full Text Torelli, R., Posteraro, B., Ferrari, S., La Sorda, M., Fadda, G., Sanglard, D., et al. The ATP-binding cassette transporter-encoding gene Cg SNQ2 is contributing to the Cg PDR1-dependent azole resistance of Candida glabrata. Both gene expression levels and gene copy number of Cg CDR1, Cg PDH1, Cg ERG11, and Cg SNQ2 were assessed via quantitative real-time PCR. The influence of the main effects and first-level interactions of both the expression level and copy number of these genes on fluconazole resistance levels were analyzed using a multivariate statistical model. glabrata isolates were collected from 30 patients during in a hospital survey. glabrata fluconazole MICs were independently increased by Cg SNQ2 overexpression (p ) and the interaction between Cg PDH1 gene copy number and Cg PDH1 expression level (p = 0.038). In contrast, both Cg PDH1 overexpression (p = 0.049) and the interaction between Cg SNQ2 and Cg ERG11 expression (p = 0.003) led to a significant decrease in fluconazole MICs. glabrata involves complex interactions between drug resistance gene expression and/or copy number. Changes in karyotype and azole susceptibility of sequential bloodstream isolates from patients with Candida glabrata candidemia. The population-based multivariate analysis highlighted the involvement of the Cg SNQ2 gene in fluconazole resistance and the complex effect of the other genes such as PDH1 for which overexpression was associated with reduced fluconazole resistance levels, while the interaction between PDH1 overexpression and copy number was associated with increased resistance levels. Candida glabrata is responsible for the increase in cases of systemic and superficial candidiasis in many countries (Diekema et al., 2002; Li et al., 2007; Pfaller and Diekema, 2007). Fluconazole resistance in Candida glabrata is associated with. Antimicogramma per Candida Guida pratica - Amcli Activities of fluconazole and voriconazole against bloodstream.
     
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