Implication of efflux pumps and ERG11 genes in resistance of clinical Trichosporon asahii isolates to fluconazole

has been recognized as an opportunistic agent having a limited sensitivity to antifungal treatment. Molecular mechanisms of azole resistance have been rarely reported for . Similar to other fungi, we hypothesized that both gene mutation and efflux pumps genes hyper-expression were implicated. The current work aimed to study the sensitivity of clinical isolates to different antifungal agents and to explore their resistance mechanisms by molecular methods including real-time PCR and gene sequencing. The sensitivity of isolates to fluconazole, amphotericin B and voriconazole was estimated by the Etest method. Real-time PCR was used to measure the relative expression of and genes via the housekeeping gene. Three pairs of primers were also chosen to sequence the gene. This exploration was followed by statistical study including the receiver operating characteristic (ROC) curve analysis to identify a relationship between gene mean expression and the sensitivity of isolates. In 31 clinical isolates, the resistance frequencies were 87, 16.1 and 3.2 %, respectively, for amphotericin B, fluconazole and voriconazole. Quantitative real-time PCR demonstrated that only over-expression was significantly associated with FCZ resistance confirmed by univariate statistical study and the ROC curve analysis (