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this overt inverse relationship has not been reported before now, C. albicans with targeted deletion of ERG3 or ERG11 showed increased susceptibility to amphotericin B and resistance to azoles. 11 The altered azole MICs for these sequential azole-naive isolates suggest that azole resistance in this clone may be associated with amphotericin B resistance mechanisms. This may be attributed to the predisposition of C. glabrata to multidrug resistance involving unexposed antifungals. The unexpected rapid loss and fluctuation of amphotericin B and fluconazole resistance in isolates 4 – 10 requires an explanation other than de novo emergence and recovery of resistance. Subpopulations with different resistance profiles are likely to have persisted in the gut and alternately invaded the bloodstream under the selective pressure. Alternatively, various subpopulations coexisted in the bloodstream, but only one of them was identified from blood cultures. This report highlights the adaptability of C. glabrata to long-term treatment with various antifungal agents. Considering its ability to acquire and retain multidrug resistance, combination therapy would be beneficial for prolonged C. glabrata fungaemia. In addition, Candida isolates from blood and normally sterile body fluids should be identified at the species level and susceptibility tests are recommended for all C. glabrata isolates recovered during prolonged antifungal treatment. References 1 Pfaller MA, Messer SA, Woosley LN et al. Echinocandin and triazole anti-fungal susceptibility profiles for clinical opportunistic yeast and mold isolates collected from 2010 to 2011: application of new CLSI clinical breakpoints and epidemiological cutoff values for characterization of geographic and temporal trends of antifungal resistance. CD et al. Increasing echinocandin resistance in Candida glabrata: clinical failure correlates with presence of FKS mutations and elevated minimum inhibitory concentrations. 5 Shin JH, Chae MJ, Song JW et al. Changes in karyotype and azole susceptibility of sequential bloodstream isolates from patients with Candida glab-rata candidemia. 6 Chapeland-Leclerc F, Hennequin C, Papon N et al. Acquisition of flucytosine, azole, and caspofungin resistance in Candida glabrata bloodstream isolates serially obtained from a hematopoietic stem cell transplant recipient. 9 Pfaller MA, Castanheira M, Lockhart SR et al. Frequency of decreased susceptibility and resistance to echinocandins among fluconazole-resistant bloodstream isolates of Candida glabrata. 10 Shin JH, Kim MN, Jang SJ et al. Detection of amphotericin B resistance in Candida haemulonii and closely related species by use of the Etest, Vitek-2 yeast susceptibility system, and CLSI and EUCAST broth microdilu-tion methods. Sir, We have read with special interest the paper …