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Updated: Mar 11, 2026
Whole Genome Sequencing of Candida glabrata for Detection of Markers of Antifungal Drug Resistance
Published on: December 28, 2017
Antifungal drug resistance in Candida species
Giulia Morace1, Federica Perdoni1, Elisa Borghi1
1Department of Health Sciences, Università degli Studi di Milano, Blocco C, via A. di Rudinì 8, 20142 Milan, Italy.
Abstract:
Invasive Candida infections are well established infectious entities of immunocompromised or critically ill patients and are characterised by high morbidity and mortality. Owing to the common eukaryotic structure of fungi and humans, a limited number of antifungal drugs is available for therapeutic purposes. In this unsatisfactory scenario, the emergence of drug resistance represents an important health problem. Failure of antifungal treatment can be related to host factors, to the pharmacokinetic and pharmacodynamic parameters of the drug, or to morphological, reproductive modalities and biofilm production of the fungus itself. Innate or acquired antifungal resistance derives from the presence or onset of molecular mechanisms related to the toxic activity of the drug itself. The resulting resistance can thus be extended to different molecules of the same class according to a greater or lesser affinity of the molecules for the target. In addition, non-specific cellular mechanisms of extrusion of toxic substances, such as overexpression of efflux pumps, can play a role involving different antifungal classes. Here we briefly review the current antifungal susceptibility testing methods and their usefulness as predictors of antifungal resistance in Candida spp., focusing on assessment of the involved molecular mechanisms.
Insights
Invasive Candida infections pose significant risks, especially for immunocompromised patients. Understanding antifungal drug resistance mechanisms is crucial for effective treatment strategies against Candida species.
Area of Science:
- Mycology and Infectious Diseases
- Antimicrobial Resistance Research
Background:
- Invasive Candida infections are a major cause of morbidity and mortality in immunocompromised and critically ill patients.
- Limited antifungal drug options exist due to shared eukaryotic structures between fungi and humans.
- Emergence of antifungal drug resistance in Candida species is a significant global health challenge.
Approach:
- Review of current antifungal susceptibility testing (AST) methods.
- Focus on the predictive value of AST in identifying antifungal resistance.
- Assessment of underlying molecular mechanisms contributing to Candida antifungal resistance.
Key Points:
- Treatment failure in invasive candidiasis can stem from host factors, drug pharmacokinetics/pharmacodynamics, or fungal characteristics like biofilm production.
- Antifungal resistance arises from molecular mechanisms targeting drug activity, potentially conferring cross-resistance within drug classes.
- Non-specific mechanisms like efflux pump overexpression can contribute to resistance across different antifungal classes.
Conclusions:
- Current AST methods are essential for predicting antifungal resistance in Candida species.
- Understanding molecular mechanisms of resistance is key to overcoming treatment failures.
- Further research into resistance mechanisms will guide the development of novel therapeutic strategies.
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