The incidence of life-threatening fungal infections has increased steadily over the most recent decade
[1,
2]. In the most recent years, there has been increased interest in the opportunistic pathogen,
Candida, which is responsible for the majority of fungal infections. Indeed, the increase in
Candida blood infections among hospitalized patients and the rising incidence of infections caused by non-
albicans Candida species, including
C glabrata,
C tropicalis, and
C parapsilosis, have been noted
[3]. In particular,
C glabrata has emerged as a major cause of mucosal and invasive fungal infection in the United States, second only to
C albicans
[4]. The rise in the number of
C glabrata systemic infections deserves a great deal of attention due to the high mortality rate associated with
C glabrata fungemia
[5]. Because the frequency of fungal infections is increasing, the need for antifungal agents has correspondingly increased, but antifungal agents are restricted to a few compounds. In particular, fluconazole is a highly effective widespectrum antifungal agent that is widely prescribed for the treatment of superficial and systemic candidiasis because it can be orally administered. However, the widespread and prolonged use of azoles in recent years has led to the rapid development of drug resistance in
Candida species
[6,
7].
C glabrata infections are difficult to treat and are often resistant to many azole antifungal agents, especially fluconazole
[8,
9]. Fluconazole has limited activity against
C glabrata because
C glabrata has an intrinsically low susceptibility to azole antifungal agents. Furthermore, acquired azole resistance has recently been reported in oral isolates of
C glabrata from hematopoietic stem cell transplant recipients and patients who have received radiation for the treatment of head and neck cancer
[9,
10]. The mechanisms underlying
C albicans resistance to azole antifungal agents have been well elucidated. Nonetheless, the molecular basis for the intrinsically low susceptibility of
C glabrata remains unclear. Several mechanisms of acquired resistance to azole antifungal agents have been proposed, including the upregulation of the genes that encode the ATPbinding cassette (ABC) transporters (
CDR1 and
CDR2)
[11] and the target of azole antifungal agents, lanosterol 14-α-demethylase (
ERG11)
[12]. Recently, a proteomic analysis of multiple matched sets of azolesusceptible and azole-resistant
Candida isolates was undertaken in order to understand the mechanisms underlying azole antifungal resistance. In this study, we investigated changes in the expression levels of cellular and membrane proteins between fluconazole-resistant and -susceptible
C glabrata strains. Here, we report several proteins that were found to be associated with fluconazole resistance.