Evaluation of fluconazole resistance mechanisms in candida albicans clinical isolates from HIV-infected patients in Brazil

Goldman, Gustavo Henrique; Ferreira, Márcia Eliana da Silva; Marques, Everaldo dos Reis; Savoldi, Marcela; Perlin, David S.; Park, Steven; Martı́nez, Patricio; Goldman, Maria Helena S.; Colombo, Arnaldo Lopes

doi:10.1016/j.diagmicrobio.2004.04.009

Cited by 99 publications

(105 citation statements)

References 32 publications

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“…This can be explained by the similarity in azole compounds; these are substrates for multidrug efflux transporters that respond to ERG11 mutations (Andes et al, 2006;Song et al, 2004). Multiple resistance to azole antifungals was mainly associated with specific point mutations in the ERG11 gene (Marichal et al, 1999;Wang et al, 2009;Goldman et al, 2004), and was also associated with overexpression of the ERG11 gene and efflux pumps encoded by the CDR1, CDR2 and MDR1 genes (Hoot et al, 2008;Oliver et al, 2007).…”

Section: Discussionmentioning

confidence: 99%

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Overexpression and mutation as a genetic mechanism of fluconazole resistance in Candida albicans isolated from human immunodeficiency virus patients in Indonesia

Rosana

Yasmon

Lestari

2015

Journal of Medical Microbiology

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Section: Discussionmentioning

confidence: 99%

“…Overall, six amino acid changes (D116E, D153E, I261V, E266D, V437I, V488I; (Xu et al, 2008;Chau et al, 2004;Goldman et al, 2004).…”

Section: Molecular Characteristics Of Lanosterol 14a-demethylase (Cypmentioning

confidence: 99%

Overexpression and mutation as a genetic mechanism of fluconazole resistance in Candida albicans isolated from human immunodeficiency virus patients in Indonesia

Rosana

Yasmon

Lestari

2015

Journal of Medical Microbiology

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“…Stepwise acquisition of resistance involves multiple mechanisms. Molecular epidemiology of azole resistance in a large population of C. albicans suggests that CDR1/CDR2 up-regulation is more prevalent than ERG11 or MDR1 up-regulation, with combinations of CDR1/CDR2 up-regulation and ERG11 alterations as the most common (Goldman et al 2004;Park and Perlin 2005;Coste et al 2007;Siikala et al 2010;Flowers et al 2012). Although CDR1/CDR2 and MDR1 up-regulation can be explained by TAC1 and MRR1 GOF mutations, ERG11 up-regulation is not always associated with UPC2 GOF mutations, implicating additional regulators (Flowers et al 2012).…”

Section: Resistance Acquisition Through Multiple Mechanismsmentioning

confidence: 99%

Mechanisms of Antifungal Drug Resistance

Cowen

Sanglard

Howard

et al. 2014

Cold Spring Harb Perspect Med

492

399

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Antifungal therapy is a central component of patient management for acute and chronic mycoses. Yet, treatment choices are restricted because of the sparse number of antifungal drug classes. Clinical management of fungal diseases is further compromised by the emergence of antifungal drug resistance, which eliminates available drug classes as treatment options. Once considered a rare occurrence, antifungal drug resistance is on the rise in many high-risk medical centers. Most concerning is the evolution of multidrug-resistant organisms refractory to several different classes of antifungal agents, especially among common Candida species. The mechanisms responsible are mostly shared by both resistant strains displaying inherently reduced susceptibility and those acquiring resistance during therapy. The molecular mechanisms include altered drug affinity and target abundance, reduced intracellular drug levels caused by efflux pumps, and formation of biofilms. New insights into genetic factors regulating these mechanisms, as well as cellular factors important for stress adaptation, provide a foundation to better understand the emergence of antifungal drug resistance.

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“…Several fluconazole-resistant strains had multiple mechanisms of resistance. A total of 4 mutations previously described, Y132F, K143R, E266D, and V437I, were identified among the strains, while some isolates contained more than one mutation (Goldman et al 2004). …”

Section: Molecular Mechanisms Of Antifungal Resistancementioning

confidence: 99%

Surveillance programs for detection and characterization of emergent pathogens and antimicrobial resistance: results from the Division of Infectious Diseases, UNIFESP

Colombo

Janini

Salomão

et al. 2009

An. Acad. Bras. Ciênc.

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Several epidemiological changes have occurred in the pattern of nosocomial and community acquired infectious diseases during the past 25 years. Social and demographic changes possibly related to this phenomenon include a rapid population growth, the increase in urban migration and movement across international borders by tourists and immigrants, alterations in the habitats of animals and arthropods that transmit disease, as well as the raise of patients with impaired host defense abilities. Continuous surveillance programs of emergent pathogens and antimicrobial resistance are warranted for detecting in real time new pathogens, as well as to characterize molecular mechanisms of resistance. In order to become more effective, surveillance programs of emergent pathogens should be organized as a multicenter laboratory network connected to the main public and private infection control centers. Microbiological data should be integrated to guide therapy, adapting therapy to local ecology and resistance patterns. This paper presents an overview of data generated by the Division of Infectious Diseases, Federal University of São Paulo, along with its participation in different surveillance programs of nosocomial and community acquired infectious diseases.

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Evaluation of fluconazole resistance mechanisms in candida albicans clinical isolates from HIV-infected patients in Brazil

Cited by 99 publications

References 32 publications

Overexpression and mutation as a genetic mechanism of fluconazole resistance in Candida albicans isolated from human immunodeficiency virus patients in Indonesia

Overexpression and mutation as a genetic mechanism of fluconazole resistance in Candida albicans isolated from human immunodeficiency virus patients in Indonesia

Mechanisms of Antifungal Drug Resistance

Surveillance programs for detection and characterization of emergent pathogens and antimicrobial resistance: results from the Division of Infectious Diseases, UNIFESP

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