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Whole Genome Sequencing of Candida glabrata for Detection of Markers of Antifungal Drug Resistance
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Antifungal drug resistance of oral fungi

Masakazu Niimi1, Norman A Firth, Richard D Cannon

  • 1Department of Oral Sciences, School of Dentistry, University of Otago, 310 Great King Street, Dunedin, 9016, New Zealand.

Odontology
|February 16, 2010
PubMed

Insights

Oral fungi cause disease, with candidiasis being common. Antifungal resistance in biofilms, often due to efflux pumps, complicates treatment, suggesting combined therapies are needed.

Area of Science:

  • Microbiology
  • Oral Health
  • Mycology

Background:

  • Fungi are a minor part of the oral microbiota but can cause significant oral disease.
  • Oral candidiasis is the most common oral fungal infection, presenting in various forms.
  • Current treatments for oral candidiasis include polyenes (e.g., nystatin) and azoles (e.g., fluconazole).

Purpose of the Study:

  • To review the mechanisms of antifungal resistance in oral fungi.
  • To explore the role of biofilms in antifungal resistance.
  • To discuss strategies for improving the treatment and prevention of oral fungal diseases.

Main Methods:

  • Review of existing literature on oral fungal microbiota, oral candidiasis, antifungal agents, and resistance mechanisms.
  • Analysis of factors contributing to antifungal resistance in fungal biofilms.
  • Discussion of therapeutic approaches combining antifungal drugs with biofilm disruption.

Main Results:

  • Resistance to polyenes is rare, but some Candida species exhibit innate azole resistance, and Candida albicans can acquire it.
  • Energy-dependent drug efflux is a primary mechanism for high-level azole resistance in fungi.
  • Oral fungal biofilms exhibit increased antifungal resistance due to efflux pumps, matrix permeability, and cellular stress responses.

Conclusions:

  • Multispecies oral biofilms significantly contribute to antifungal resistance.
  • Combined therapies targeting both fungal cells and biofilm structures are crucial for effective treatment and prevention of oral fungal diseases.
  • Further research into biofilm-disrupting agents and combination therapies is warranted.

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