Antifungal Resistance Among <i>Candida</i> Species

Klepser, Michael E.

doi:10.1592/phco.21.12.124s.34511

Cited by 50 publications

(28 citation statements)

References 88 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The most common treatment is the use of antifungal agents, such as azoles (fluconazole, itraconazole, miconazole and ketoconazole) and polyenes (amphotericin B or nystatin). The control of the infections caused by Candida faces several problems, including the limited number of effective antifungal agents, their high toxicity and costs, the recurrence of the infection and, mainly, the increasing resistance to them [6,7].…”

Section: Introductionmentioning

confidence: 99%

Susceptibilities of Candida albicans Mouth Isolates to Antifungal Agents, Essentials Oils and Mouth Rinses

et al. 2012

View full text Add to dashboard Cite

Forty Candida albicans strains isolated from patient's mouth with fixed orthodontic appliances were analyzed to their susceptibilities to antifungal agents, mouth rinses and essential oils. Susceptibility to fluconazole, econazole, miconazole and ketoconazole, amphotericin B and nystatin was assessed by the disk diffusion (DD) method based on the Clinical and Laboratory Standards Institute M44-A protocol, and by Etest (fluconazole and amphotericin B). The susceptibilities to mouth rinses and essential oils were also determined by the DD technique. All isolates tested were susceptible (S) to amphotericin B, nystatin and fluconazole. The overall concordance between the DD and the Etest was 100% for amphotericin and fluconazole. One isolate was resistant to econazole (2.5%) and the other to ketoconazole (2.5%). Econazole and ketoconazole had the highest percentages of susceptible dose dependent (SDD), 55 and 95%, respectively. Regarding to the susceptibility isolates profile, seven phenotypes were detected, and the 3 more represented (90% of the isolates) of them were SDD to one, two or three azoles. The study of mouth rinses showed a high variability of efficacy against C. albicans. The results showed that the isolates susceptibility to essential oils differed (P \ 0.05). The profile activity was: cinnamon [ laurel [ mint [ eucalyptus [ rosemary [ lemon [ myrrh [ tangerine. The main finding was that the susceptibility to cinnamon and laurel varied among the three more representative antifungal phenotypes (P \ 0.05). The susceptibility of econazole-SDD isolates to cinnamon and lemon was higher than those of the econazole-S yeasts (P \ 0.05). In contrast, econazole-SDD isolates were less affected by laurel than econazole-S counterparts (P \ 0.05).

show abstract

Section: Introductionmentioning

confidence: 99%

Susceptibilities of Candida albicans Mouth Isolates to Antifungal Agents, Essentials Oils and Mouth Rinses

et al. 2012

View full text Add to dashboard Cite

show abstract

“…Immunocompromised individuals, such as AIDS and cancer patients, neonates, organ transplant recipients, and patients with indwelling catheters, can develop disseminated candidiasis, a systemic form of the disease with an approximately 40% mortality rate (2,4,5). Candida infections have become more difficult to treat due to a limited number of antifungal therapies and increased frequency of drug-resistant isolates (6,7).…”

mentioning

confidence: 99%

Ppg1, a PP2A-Type Protein Phosphatase, Controls Filament Extension and Virulence in Candida albicans

et al. 2014

View full text Add to dashboard Cite

b Candida albicans, a major human fungal pathogen, is the primary cause of invasive candidiasis in a wide array of immunocompromised patients. C. albicans virulence requires the ability to undergo a reversible morphological transition from yeast to filaments in response to a variety of host environmental cues. These cues are sensed by the pathogen and activate multiple signal transduction pathways to induce filamentation. Reversible phosphorylation events are critical for regulation of many of these pathways. While a variety of protein kinases are known to function as components of C. albicans filamentous growth signal transduction pathways, considerably little is known about the role of phosphatases. Here we demonstrate that PPG1, encoding a putative type 2A-related protein phosphatase, is important for C. albicans filament extension, invasion, and virulence in a mouse model of systemic candidiasis. PPG1 is also important for downregulation of NRG1, a key transcriptional repressor of C. albicans filamentous growth, and is shown to affect the expression of several filament-specific target genes. An epistasis analysis suggests that PPG1 controls C. albicans filamentation via the cyclic AMP-protein kinase A (cAMP-PKA) signaling pathway. We demonstrate that Ppg1 possesses phosphatase activity and that a ppg1 catalytic mutant shows nearly equivalent filamentation, invasion, and virulence defects compared to those of a ppg1⌬/⌬ strain. Overall, our results suggest that phosphatases, such as Ppg1, play critical roles in controlling and fine-tuning C. albicans filament extension and virulence as well as signal transduction pathways, transcriptional regulators, and target genes associated with these processes.

show abstract

“…are more common in serious fungal infections our results showed exactly the opposite, i.e. C. albicans was the dominant cause (62.5%) of CBSI [15,16]. CBSI caused by C. lipolytica and C. lusitaniae were rarely reported and accounted for only 7% of all detected CBSI [17,18] [2,19,20].…”

Section: Discussionmentioning

confidence: 55%

“…This finding is in accordance with the up to now suggested emergence of resistance towards azole derivatives. Resistance occurrence is still not clear and it can be the consequence of several processes such as appearance of resistant variants from a common genotype, selection of strains from mixed population and reinfection with a resistant subtype [15].…”

Section: Discussionmentioning

confidence: 99%

Surveillance and characterization of Candida bloodstream infections in a Serbian tertiary care hospital

Stojanović

Stojanović-Radić

et al. 2016

J Infect Dev Ctries

View full text Add to dashboard Cite

Introduction: Candida spp. frequently cause hospital-acquired bloodstream infections (BSI) with a high mortality rate (up to 70%). We analyzed the frequency, infection characteristics, potential predisposing factors, susceptibility to antifungal drugs, biofilm production and other virulence characteristics of Candida spp. isolates obtained from a tertiary care hospital in Niš, Serbia, during a one year period. Methods: Medical histories, characteristics of isolated strains and drug susceptibility, as well as the effect on the function of isolated macrophages and other virulence features were evaluated. The obtained results were subjected to student's t-test and multivariate statistical analyzes. Results: Herein we report an annual incidence of 3.65 cases of C. albicans, C. lusitaniae and C. lipolytica infections per 10 5 population. Out of eight isolated strains, two (25%) were shown to be strong biofilm producers, one (12.5%) caused hemolysis on blood agar and in two (25%) cases macrophages were able to completely eliminate the yeast colonies. Chronic kidney disease, diabetes, malignant and other diseases were present in 37.5, 62.5, 50 and 75%, respectively, in the study group. All patients with Candida BSI received antifungal therapy (amphotericin B), however, hospital mortality was observed in 25% of patients. Conclusions: Evaluation of local Candida epidemiology, antifungal susceptibility and virulence factors, as well as personalized patient risk factors are important for the surveillance of Candida BSI, especially in intensive care unit patients and may contribute to the improved options and outcome for patients with Candida BSI.

show abstract

Antifungal Resistance Among Candida Species

Abstract: Isolation of Candida sp less susceptible to traditional therapies and recovery of increasingly resistant isolates during antifungal therapy are growing problems. It is important for clinicians to be aware of trends and mechanisms responsible for the expression of resistance.

Cited by 50 publications

References 88 publications

Susceptibilities of Candida albicans Mouth Isolates to Antifungal Agents, Essentials Oils and Mouth Rinses

Susceptibilities of Candida albicans Mouth Isolates to Antifungal Agents, Essentials Oils and Mouth Rinses

Ppg1, a PP2A-Type Protein Phosphatase, Controls Filament Extension and Virulence in Candida albicans

Surveillance and characterization of Candida bloodstream infections in a Serbian tertiary care hospital

Contact Info

Product

Resources

About