Resistance of Candida species to antifungal agents: molecular mechanisms and clinical consequences

D. Sanglard, Frank Christopher Odds

    Research output: Contribution to journalArticle

    572 Citations (Scopus)

    Abstract

    Candida albicans and related species pathogenic for man become resistant to antifungal agents, in particular triazole compounds, by expression of efflux pumps that reduce drug accumulation, alteration of the structure or concentration of antifungal target proteins, and alteration of membrane sterol composition. The clinical consequences of antifungal resistance can be seen in treatment failures in patients and in changes in the prevalences of Candida species causing disease. These effects were seen unequivocally in HIV-infected patients with oropharyngeal candida. infections, but their incidence has decreased dramatically with the introduction of highly active antiretroviral therapy. The evidence for similar emergence of antifungal-resistant yeast strains and species in other types of candida infections is confounded by non-standardised susceptibility testing methods and definitions of a resistant fungal isolate. Recent large-scale surveys of yeasts isolated from blood cultures, based on standardised methodology and resistance definitions, do not support the view that antifungal resistance in pathogenic yeasts constitutes a significant or growing therapeutic problem.

    Original languageEnglish
    Pages (from-to)73-85
    Number of pages12
    JournalLancet Infectious Diseases
    Volume2
    Issue number2
    DOIs
    Publication statusPublished - 2002

    Keywords

    • HUMAN-IMMUNODEFICIENCY-VIRUS
    • HIV-INFECTED PATIENTS
    • BLOOD-STREAM INFECTIONS
    • VULVO-VAGINAL CANDIDIASIS
    • NON-ALBICANS CANDIDA
    • FLUCONAZOLE RESISTANCE
    • OROPHARYNGEAL CANDIDIASIS
    • DRUG-RESISTANCE
    • IN-VITRO
    • AIDS PATIENTS

    Cite this

    Resistance of Candida species to antifungal agents: molecular mechanisms and clinical consequences. / Sanglard, D.; Odds, Frank Christopher.

    In: Lancet Infectious Diseases, Vol. 2, No. 2, 2002, p. 73-85.

    Research output: Contribution to journalArticle

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    abstract = "Candida albicans and related species pathogenic for man become resistant to antifungal agents, in particular triazole compounds, by expression of efflux pumps that reduce drug accumulation, alteration of the structure or concentration of antifungal target proteins, and alteration of membrane sterol composition. The clinical consequences of antifungal resistance can be seen in treatment failures in patients and in changes in the prevalences of Candida species causing disease. These effects were seen unequivocally in HIV-infected patients with oropharyngeal candida. infections, but their incidence has decreased dramatically with the introduction of highly active antiretroviral therapy. The evidence for similar emergence of antifungal-resistant yeast strains and species in other types of candida infections is confounded by non-standardised susceptibility testing methods and definitions of a resistant fungal isolate. Recent large-scale surveys of yeasts isolated from blood cultures, based on standardised methodology and resistance definitions, do not support the view that antifungal resistance in pathogenic yeasts constitutes a significant or growing therapeutic problem.",
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