Drug Resistance-Associated Mutations in of Multidrug-Resistant in a Tertiary Care Hospital of Eastern Saudi Arabia.

is an emerging multi-drug resistant pathogen with high mortality rate; nosocomial infections have been reported worldwide, causing a major challenge for clinicians and microbiological laboratories. The study aims to describe new cases of and detect drug resistance-associated mutations of by the sequencing of and genes. A total of six specimens were collected from blood, urine, ear swab, and groin screening samples. Isolates were incubated for 48 h on Sabouraud Dextrose agar (SDA) at 42 °C, then confirmed by MALDI-TOF MS. Furthermore, antifungal susceptibility testing was performed using the Vitek 2 system to detect Minimum Inhibitory Concentrations (MICs) of six antifungals. Sequences of gene and ITS regions from isolates and phylogenetic analysis were performed. Gene sequencing was analysed to detect drug resistance-associated mutations by and genes sequencing. All isolates were confirmed by MALDI-TOF MS, and evolutionary analyses using sequences of gene and ITS region. Antifungal susceptibility testing showed that all isolates were resistant to fluconazole. Sequencing of and genes from the isolates revealed the presence of two (F132Y and K143R) drug resistance-associated mutations in , however, gene was devoid of mutations. The study sheds light on a public health threat of an emerging pathogen, and the hospital implemented strict contact screening and infection control precautions to prevent infection. Finally, there is a critical need to monitor the antifungal resistance in different geographical areas and implementation of efficient guidelines for treatment.