ABSTRACTCandida glabratainfections are increasing worldwide and exhibit greater rates of antifungal resistance than those with other species. DNA mismatch repair (MMR) gene deletions, such asmsh2Δ, inC. glabrataresulting in a mutator phenotype have recently been reported to facilitate rapid acquisition of antifungal resistance. This study determined the antifungal susceptibility profiles of 210C. glabrataisolates in 10 hospitals in India and investigated the impact of novelMSH2polymorphisms on mutation potential. No echinocandin- or azole-resistant strains and no mutations inFKShot spot regions were detected among theC. glabrataisolates, supporting ourin vitrosusceptibility testing results. CLSI antifungal susceptibility data showed that the MICs of anidulafungin (geometric mean [GM], 0.12 μg/ml) and micafungin (GM, 0.01 μg/ml) were lower and below the susceptibility breakpoint compared to that of caspofungin (CAS) (GM, 1.31 μg/ml). Interestingly, 69% of theC. glabratastrains sequenced contained six nonsynonymous mutations inMSH2, i.e., V239L and the novel mutations E459K, R847C, Q386K, T772S, and V239/D946E. Functional analysis ofMSH2mutations revealed that 49% of the tested strains (40/81) contained a partial loss-of-functionMSH2mutation. The novelMSH2substitution Q386K produced higher frequencies of CAS-resistant colonies upon expression in themsh2Δmutant. However, expression of two other novelMSH2alleles, i.e., E459K or R847C, did not confer selection of resistant colonies, confirming that not all mutations in theMSH2MMR pathway affect its function or generate a phenotype of resistance to antifungal drugs. The lack of drug resistance prevented any correlations from being drawn with respect toMSH2genotype.