Fluconazole resistance in Candida species: a current perspective
- PMID: 28814889
- PMCID: PMC5546770
- DOI: 10.2147/IDR.S118892
Fluconazole resistance in Candida species: a current perspective
Abstract
Candida albicans and the emerging non-albicans Candida spp. have significant clinical relevance among many patient populations. Current treatment guidelines include fluconazole as a primary therapeutic option for the treatment of these infections, but it is only fungistatic against Candida spp. and both inherent and acquired resistance to fluconazole have been reported. Such mechanisms of resistance include increased drug efflux, alteration or increase in the drug target, and development of compensatory pathways for producing the target sterol, ergosterol. While many mechanisms of resistance observed in C. albicans are also found in the non-albicans species, there are also important and unexpected differences between species. Furthermore, mechanisms of fluconazole resistance in emerging Candida spp., including the global health threat Candida auris, are largely unknown. In order to preserve the utility of one of our fundamental antifungal drugs, fluconazole, it is essential that we fully appreciate the manner by which Candida spp. manifest resistance to it.
Keywords: Candida; ERG11; drug efflux; ergosterol; fluconazole resistance.
Conflict of interest statement
Disclosure The authors report no conflicts of interest in this work.
References
-
- Calderone RA, Clancy CJ. Candida and Candidiasis. 2nd ed. Washington, DC: American Society of Microbiology; 2012.
-
- Rees JR, Pinner RW, Hajjeh RA, Brandt ME, Reingold AL. The epidemiological features of invasive mycotic infections in the San Francisco Bay area, 1992–1993: results of population-based laboratory active surveillance. Clin Infect Dis. 1998;27(5):1138–1147. - PubMed
-
- Jarvis WR. Epidemiology of nosocomial fungal infections, with emphasis on Candida species. Clin Infect Dis. 1995;20(6):1526–1530. - PubMed
-
- Horn DL, Neofytos D, Anaissie EJ, et al. Epidemiology and outcomes of candidemia in 2019 patients: data from the prospective antifungal therapy alliance registry. Clin Infect Dis. 2009;48(12):1695–1703. - PubMed
-
- Wilson LS, Reyes CM, Stolpman M, Speckman J, Allen K, Beney J. The direct cost and incidence of systemic fungal infections. Value Health. 2002;5(1):26–34. - PubMed
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