Candida albicans Transcriptional Profiling Within Biliary Fluid From a Patient With Cholangitis, Before and After Antifungal Treatment and Surgical Drainage

We used ribonucleic acid sequencing to profile transcription within biliary fluid from a patient with cholangitis; samples were collected before and after treatment with fluconazole and drainage. transcriptomes at the infection site distinguished treated from untreated cholangitis. After treatment, 1131 genes were differentially expressed in biliary fluid. Up-regulated genes were enriched in hyphal growth, cell wall organization, adhesion, oxidation reduction, biofilm, and fatty acid and ergosterol biosynthesis. This is the first study to define global gene expression during deep-seated human infection. Successful treatment of cholangitis induced genes involved in fluconazole responses and pathogenesis.