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Microbiology 148 (2002), 1061-1072
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Microbiology (2002), 148, 1061-1072.
© 2002 Society for General Microbiology


Research Paper

Homozygosity at the Candida albicans MTL locus associated with azole resistance

Tige R. Rustad1,2, David A. Stevens3,4, Michael A. Pfaller5 and Theodore C. White1,2

Department of Pathobiology, School of Public Health and Community Medicine, University of Washington, Seattle, WA 98195, USA1
Seattle Biomedical Research Institute, 4 Nickerson St Suite 200, Seattle, WA 98109-1651, USA2
Department of Medicine, Santa Clara Valley Medical Center and California Institute for Medical Research, San Jose, CA 95128, USA3
Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, CA 52242, USA4
Department of Pathology, University of Iowa, Iowa City, IA 52242, USA5

Author for correspondence: Theodore C. White. Tel: +1 206 284 8846 ext. 344. Fax: +1 206 284 0313. e-mail: tedwhite{at}u.washington.edu

Antifungal drug resistance in the pathogenic fungus Candida albicans is a serious threat to the growing population of immunocompromised patients. This study describes a significant correlation between loss of heterozygosity at the C. albicans mating-type-like (MTL) locus and resistance to azole antifungals. A pool of 96 clinical isolates consisting of 50 azole-resistant or susceptible dose-dependent isolates and 46 azole-susceptible isolates was screened by PCR for the presence of MTLa1 and MTL{alpha}1. These genes were used as markers for the MTLa and MTL{alpha} loci. Both loci were present in 84 of the isolates. Six isolates failed to amplify MTLa1 and six failed to amplify MTL{alpha}1. Further PCR analysis demonstrated that loss of the MTLa1 and MTL{alpha}1 genes corresponded to loss of all of the loci-specific genes, resulting in homozygosity at the MTL locus. Southern analysis and single nucleotide polymorphism (SNP) analysis were used to determine that this loss of heterogeneity was due to replacement of one of the MTL loci with a duplicate of the other locus resulting in two homozygous copies of the MTL locus. Of the 12 homozygous isolates, one isolate was sensitive to azole drugs. Statistical analysis of the data demonstrates a strong correlation between homozygosity at the MTL locus and azole resistance (P<0·003). In a set of serial isolates, an increase in azole resistance correlated with the loss of heterozygosity at the MTL locus, lending further strength to the correlation. Gene disruptions of the MTL loci were found to have no effect on azole susceptibility.

Keywords: pathogenic fungi, mating locus, drug resistance

Abbreviations: CHEF, contour-clamped homogeneous electric field; chr, chromosome; EtBr, ethidium bromide; SNP, single nucleotide polymorphism




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