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Antimicrobial resistance: resistance to antifungal agents: mechanisms and clinical impact

Zeina A Kanafani1, John R Perfect

  • 1American University of Beirut Medical Center, Beirut, Lebanon. zk10@aub.edu.lb

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|January 4, 2008
PubMed

Insights

Antifungal resistance in invasive fungal infections is a growing concern for immunocompromised patients. Understanding resistance mechanisms is key to improving treatment outcomes and patient survival.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Pharmacology

Background:

  • Invasive fungal infections pose significant risks, especially for immunocompromised individuals.
  • Antifungal resistance is an increasing challenge, complicating treatment and affecting patient outcomes.
  • Current antifungal susceptibility testing has limitations in predicting clinical response.

Purpose of the Study:

  • To review the molecular mechanisms of antifungal resistance.
  • To discuss the clinical impact of antifungal resistance.
  • To highlight the importance of understanding clinical resistance in treatment failure.

Main Methods:

  • Literature review of molecular mechanisms of antifungal resistance.
  • Analysis of current guidelines for antifungal susceptibility testing.
  • Discussion of clinical resistance concepts.

Main Results:

  • Four primary mechanisms of azole resistance, involving altered gene expression, have been identified.
  • Mechanisms of resistance to polyenes and echinocandins require further investigation.
  • The correlation between in vitro antifungal susceptibility and clinical treatment response remains incomplete.

Conclusions:

  • A comprehensive understanding of both molecular and clinical resistance is crucial for managing invasive fungal infections.
  • Improved diagnostic and therapeutic strategies are needed to combat antifungal resistance.
  • Further research into resistance mechanisms is essential for developing effective treatments.

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