Molecular basis of antifungal drug resistance in yeasts

Int J Antimicrob Agents. 2017 Nov;50(5):599-606. doi: 10.1016/j.ijantimicag.2017.05.012. Epub 2017 Jun 29.

Abstract

Besides inherent differences in in vitro susceptibilities, clinically-relevant yeast species may acquire resistance upon exposure to most antifungal drugs used in the clinic. In recent years, major fundamental research studies have been conducted to improve our understanding of the molecular basis of antifungal resistance. This topic is of major interest as antifungal resistance in yeast is clearly evolving and is correlated with clinical failure. This minireview is an overview of the most recent findings about key molecular mechanisms evolving in human pathogenic yeasts, particularly Candida spp., in the context of antifungal drug resistance. Also included are the methods currently available for in vitro antifungal susceptibility testing and for molecular detection of mutations associated with resistance. Finally, the genetic drivers of antifungal resistance are discussed in light of the spectra of multidrug resistance as observed in Candida glabrata.

Keywords: Antifungal resistance; Clinical failure; Molecular mechanisms; Multidrug resistance; Review; Yeast.

Publication types

  • Review

MeSH terms

  • Antifungal Agents / pharmacology
  • Candida / drug effects*
  • Candida / genetics*
  • Drug Resistance, Fungal*
  • Genes, Fungal*
  • Humans
  • Microbial Sensitivity Tests / methods
  • Mutation

Substances

  • Antifungal Agents