Abstract:Candidiasis is a highly pervasive infection posing major health risks, especially for immunocompromised populations. Pathogenic Candida species have evolved intrinsic and acquired resistance to a variety of antifungal medications. The primary goal of this literature review is to summarize the molecular mechanisms associated with antifungal resistance in Candida species. Resistance can be conferred via gain-of-function mutations in target pathway genes or their transcriptional regulators. Therefore, an overview of the known gene mutations is presented for the following antifungals: azoles (fluconazole, voriconazole, posaconazole and itraconazole), echinocandins (caspofungin, anidulafungin and micafungin), polyenes (amphotericin B and nystatin) and 5-fluorocytosine (5-FC). The following mutation hot spots were identified: (1) ergosterol biosynthesis pathway mutations (ERG11 and UPC2), resulting in azole resistance; (2) overexpression of the efflux pumps, promoting azole resistance (transcription factor genes: tac1 and mrr1; transporter genes: CDR1, CDR2, MDR1, PDR16 and SNQ2); (3) cell wall biosynthesis mutations (FKS1, FKS2 and PDR1), conferring resistance to echinocandins; (4) mutations of nucleic acid synthesis/repair genes (FCY1, FCY2 and FUR1), resulting in 5-FC resistance; and (5) biofilm production, promoting general antifungal resistance. This review also provides a summary of standardized inhibitory breakpoints obtained from international guidelines for prominent Candida species. Notably, N. glabrata, P. kudriavzevii and C. auris demonstrate fluconazole resistance.

Status: Published Type: Journal Article|Review PubMed ID: 37998390

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#1-10(ALS3-ERG11) #11-20(ERG11-FKS1) #21-30(FKS1-KRE1) #31-40(MDR1-PHR1) #41-50(PHR2-XOG1)

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Jump to Summary Chart for:

#1-10(ALS3-ERG11) #11-20(ERG11-FKS1) #21-30(FKS1-KRE1) #31-40(MDR1-PHR1) #41-50(PHR2-XOG1)

• To find other papers on a gene and topic, click on the colored ball in the appropriate box.
  displays other papers with information about that topic for that gene.
  displays other papers in CGD that are associated with that topic.
  The topic is addressed in these papers but does not describe a specific gene or chromosomal feature.


• To go to the Locus page for a gene, click on the gene name.