The first rare case of infection reported in China and its genomic evolution in a human host environment.

INTRODUCTION

is a rare human pathogenic fungus, which has been poorly characterized at the genome level. In this study, we reported the first fatal case of infection in China and investigate the microevolution of in the human host environment.

METHODS

A series of stains were collected from the patient at different time points for routine microbial and drug sensitivity testing. The first isolate 07202534 was identified by whole genome sequencing. The and genetic evolutionary characteristics of were discussed based on the analysis of bioinformatics data.

RESULTS

The six isolates displayed dose-dependent sensitivity to fluconazole. The genome contained homologous genes such as and which were recognized to be related to azole resistance. In addition, amino acid variation was detected at F105L and other important sites of . In addition, the mean divergence time between and CBS 6054 was 406.04 million years, indicating that originated earlier than its closest relative. In addition, the six strains of isolated form the patient had higher homology and fewer mutation sites, which indicated the stability in genome. We also found that had a wide natural niche and may evolve slowly.

DISCUSSION

We believe that this study will contribute to improve our understanding of the genetic evolution, pathogenicity, and drug resistance of and will aid in the prevention and control of its spread.