Resistance to amphotericin B: emerging clinical and microbiological patterns

Area of Science:

• Mycology
• Infectious Diseases
• Clinical Microbiology

Background:

• Increasing reports of clinical amphotericin B (AmB) resistance in fungal pathogens, notably Candida albicans.
• Advances in antifungal susceptibility testing (AST) improve the correlation between laboratory results and clinical outcomes.
• AmB resistance poses a significant challenge in managing invasive fungal infections.

Purpose of the Study:

• To review current knowledge on amphotericin B resistance in fungal pathogens.
• To discuss the correlation between in vitro and in vivo results of AmB susceptibility testing.
• To provide recommendations for the appropriate use of AmB susceptibility testing in clinical settings.

Main Methods:

• Literature review of published reports on amphotericin B resistance.
• Analysis of studies correlating in vitro antifungal susceptibility data with clinical outcomes.
• Examination of documented mechanisms of amphotericin B resistance.
• Review of evidence regarding the transmission of resistant fungal isolates.

Main Results:

• Clinically significant amphotericin B resistance is an emerging concern in various fungal species.
• Improved in vitro/in vivo correlations in antifungal susceptibility testing enhance its clinical utility.
• Understanding resistance mechanisms and transmission is vital for infection control.

Conclusions:

• Amphotericin B resistance necessitates careful monitoring and appropriate use of susceptibility testing.
• Antifungal susceptibility testing should be considered in specific clinical scenarios to guide therapy.
• Further research into resistance mechanisms and effective treatment strategies is warranted.