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Whole Genome Sequencing of Candida glabrata for Detection of Markers of Antifungal Drug Resistance
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Resistance to antifungal agents in the critical care setting: problems and perspectives

M D Martins1, J H Rex

  • 1Center for Infectious Diseases, University of Texas Medical School-Houston 77030, USA.

New Horizons (Baltimore, Md.)
|August 1, 1996
PubMed

Insights

Antifungal resistance in Candida species, particularly to fluconazole, is a growing concern, especially in ICUs. This resistance can lead to shifts in species prevalence, impacting treatment strategies for invasive fungal infections.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Clinical Microbiology

Background:

  • Increasing use of antifungal agents drives antifungal resistance, mirroring trends seen with antibacterials.
  • Candida species resistance to fluconazole is clinically significant, impacting intensive care unit (ICU) patient management.
  • Epidemiologic shifts towards more resistant Candida species (e.g., C. glabrata, C. krusei) are a key concern.

Purpose of the Study:

  • To review the implications of antifungal resistance in invasive Candida infections within the ICU setting.
  • To discuss treatment strategies considering species prevalence and resistance patterns.
  • To evaluate the current and future role of antifungal susceptibility testing.

Main Methods:

  • Review of current literature on antifungal resistance in Candida species.
  • Analysis of clinical significance of resistance in ICU populations.
  • Discussion of therapeutic approaches for invasive fungal infections.

Main Results:

  • High-level fluconazole resistance in Candida is possible, but epidemiologic shifts to resistant species pose a greater clinical challenge.
  • Resistance to amphotericin B in Candida is less common.
  • Invasive mold infections in ICUs often involve intrinsically resistant agents, with therapy focusing on predisposing factors.

Conclusions:

  • Treatment strategies for invasive Candida infections must account for non-albicans Candida prevalence and antifungal resistance.
  • Antifungal susceptibility testing, particularly for fluconazole resistance, is evolving and may soon be clinically applicable.
  • Management of invasive mold infections in ICUs is complex and often requires addressing underlying conditions.

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