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Candida Species Biofilms' Antifungal Resistance
Sónia Silva1, Célia F Rodrigues2, Daniela Araújo3
1Centre of Biological Engineering (CEB), University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal. soniasilva@deb.uminho.pt.
Abstract:
Candida infections (candidiasis) are the most prevalent opportunistic fungal infection on humans and, as such, a major public health problem. In recent decades, candidiasis has been associated to Candida species other than Candida albicans. Moreover, biofilms have been considered the most prevalent growth form of Candida cells and a strong causative agent of the intensification of antifungal resistance. As yet, no specific resistance factor has been identified as the sole responsible for the increased recalcitrance to antifungal agents exhibited by biofilms. Instead, biofilm antifungal resistance is a complex multifactorial phenomenon, which still remains to be fully elucidated and understood. The different mechanisms, which may be responsible for the intrinsic resistance of Candida species biofilms, include the high density of cells within the biofilm, the growth and nutrient limitation, the effects of the biofilm matrix, the presence of persister cells, the antifungal resistance gene expression and the increase of sterols on the membrane of biofilm cells. Thus, this review intends to provide information on the recent advances about Candida species biofilm antifungal resistance and its implication on intensification of the candidiasis.
Insights
Candida biofilms, a prevalent form of fungal infection, exhibit increased antifungal resistance due to multiple factors. Understanding these mechanisms is crucial for treating candidiasis effectively.
Area of Science:
- Mycology
- Infectious Diseases
- Antimicrobial Resistance
Background:
- Candidiasis, caused by Candida species, is a common opportunistic infection and a significant public health concern.
- Non-albicans Candida species are increasingly implicated in candidiasis.
- Candida biofilms represent a major challenge due to their association with intensified antifungal resistance.
Purpose of the Study:
- To review recent advances in understanding antifungal resistance in Candida biofilms.
- To explore the multifactorial mechanisms contributing to biofilm recalcitrance.
- To discuss the implications of biofilm resistance on candidiasis treatment.
Main Methods:
- Literature review of recent studies on Candida biofilms and antifungal resistance.
- Analysis of proposed mechanisms contributing to biofilm-associated resistance.
- Synthesis of information on the clinical implications of these findings.
Main Results:
- Biofilm antifungal resistance is a complex phenomenon, not attributable to a single factor.
- Key contributing mechanisms include high cell density, nutrient limitation, biofilm matrix effects, persister cells, altered gene expression, and increased membrane sterols.
- These factors collectively enhance the recalcitrance of Candida biofilms to antifungal agents.
Conclusions:
- Candida biofilm resistance is multifactorial and requires comprehensive understanding.
- Further research is needed to fully elucidate these mechanisms.
- Targeting these mechanisms holds promise for improving candidiasis treatment strategies.