Antifungal drug resistance in Candida: a special emphasis on amphotericin B

Abstract

Invasive fungal infections in humans caused by several Candida species, increased considerably in immunocompromised or critically ill patients, resulting in substantial morbidity and mortality. Candida albicans is the most prevalent species, although the frequency of these organisms varies greatly according to geographic region. Infections with C. albicans and non‐albicans Candida species have become more common, especially in the past 20 years, as a result of aging, immunosuppressive medication use, endocrine disorders, malnourishment, extended use of medical equipment, and an increase in immunogenic diseases. Despite C. albicans being the species most frequently associated with human infections, C. glabrata, C. parapsilosis, C. tropicalis, and C. krusei also have been identified. Several antifungal drugs with different modes of action are approved for use in clinical settings to treat fungal infections. However, due to the common eukaryotic structure of humans and fungi, only a limited number of antifungal drugs are available for therapeutic use. Furthermore, drug resistance in Candida species has emerged as a result of the growing use of currently available antifungal drugs against fungal infections. Amphotericin B (AmB), a polyene class of antifungal drugs, is mainly used for the treatment of serious systemic fungal infections. AmB interacts with fungal plasma membrane ergosterol, triggering cellular ion leakage via pore formation, or extracting the ergosterol from the plasma membrane inducing cellular death. AmB resistance is primarily caused by changes in the content or structure of ergosterol. This review summarizes the antifungal drug resistance exhibited by Candida species, with a special focus on AmB.

Candida auris Outbreaks: Current Status and Future Perspectives

“…Amphotericin B is a polyene that binds to ergosterol and creates pores at the membrane level. Resistance to this drug is primarily caused by modifications in the sterol composition of the membrane [95]. The mechanism of C. auris has not been extensively studied, but it is believed to be associated with modifications in the genes ERG2, ERG3, or ERG6, similar to other Candida species.…”

Pfaffia paniculata Extract, a Potential Antimicrobial Agent against Candida spp., Pseudomonas aeruginosa, and Streptococcus mutans Biofilms

“…For several decades now, the bacteria or fungi responsible for common or serious infections have developed resistance to all the new antimicrobials on the market [ 3 ]. Enterobacteria , Staphylococcus , Enterococcus, and fungi of the genus Candida are responsible for human infections without pharmacological options for therapy [ 3 , 4 , 5 , 6 , 7 ]. Faced with this situation, the World Health Organization published a list of bacterial species in 2017 [ 2 ], followed by a list of fungi in 2022 [ 8 ], including Candida albicans and Candida glabrata , for which the development of new therapeutic options was considered a priority to control morbidity and mortality rates worldwide.…”