Running costs are estimated at no more than AUD 2 per assay compared to AUD 15 for DNA sequencing. The limitations of RCA in the primary identification of resistance are acknowledged (see above). However, the technique is well-suited as an epidemiological tool for high throughput screening for commonly-encountered ERG11 SNPs to assist in the detection of potentially-resistant check details strains and to track the movement of such strains.

Further, its utility in detecting SNPs in other genes that have been linked to azole resistance click here in C. albcians such as those encoding for the transcriptional activator of CDR1 (TAC1) and the transcriptional activator Upc2 (UPC2) [32, 33] warrant consideration. Conclusion In conclusion, the sensitive and specific RCA-based assay proved to be a simple robust method for the rapid detection of ERG11 mutations and showed excellent concordance with DNA sequencing.

It has good potential as a tool for tracking specific strains and identifying markers/co-markers of azole resistance. Broader implications include application of the method in the study of oher gene mutations linked to azole resistance in C. albicans and of azole resistance in other fungi such as Aspergillus fumigatus in which ERG11 mutations are a major mechanism of resistance [34, 35]. Methods C. albicans isolates Eight fluconazole-resistant “”reference”" isolates with previously-described mutations in ERG11 MM-102 mouse (strains C438, C440, C470, C480, C507, C527, C577 and C594 provided by A. Chau, Schering-Plough Research Institute, Kenilworth, New Jersey; Table 1) [15] were used to validate the RCA assay. Two fluconazole-susceptible Dichloromethane dehalogenase isolates (strains ATCC 10231 and ATCC 90028) were purchased from the American type culture collection (ATCC; Rockville, Md). Of 46 Australian clinical C.

albicans isolates, 25 (obtained from 19 patients) were resistant, or had reduced susceptibility to fluconazole (five patients – patient 3, 6, 8, 12 and 16 had >1 isolate recovered on separate occasions) and 21 were fluconazole-susceptible (Table 2). These isolates were from the culture collection of the Clinical Mycology laboratory, Westmead Hospital, Sydney and the Mycology Unit, Women’s and Children’s Hospital, Adelaide. The experimental work was approved as part of a Centre of Clinical Research Excellence Grant awarded by the National Health and Medical Research Council of Australia (grant #264625) and approved by the Scientific Advisory Committee, Sydney West Area Health Service and the Research and Development Committee, Centre for Infectious Diseases and Microbiology Laboratory Services, Westmead Hospital. Thus, 33 isolates with reduced fluconazole susceptibility and 23 fluconazole-susceptible isolates were studied. Isolates were identified as C. albicans by standard phenotypic methods [36] and maintained on Sabouraud’s dextrose agar at 4°C until required.