Protocols for Measuring Tolerant and Heteroresistant Drug Responses of Pathogenic Yeasts
Abstract
The classic definition of antimicrobial susceptibility to antifungal drugs ignores the persistence of subpopulations that survive in the presence of a drug. Even in entirely clonal populations, small subpopulations of yeast can grow in the presence of a drug, sometimes up to extremely high drug concentrations, such that they may be clinically relevant. Identifying and quantifying the incidence with which these subpopulations arise is an essential step in understanding how pathogenic yeast, such as Candida species (i.e., C. albicans, C. glabrata, C. auris, C. tropicalis, C. parapsilosis, and others) as well as Cryptococcus species, behave in response to antifungal therapeutics. Here we describe simple in vitro protocols for the quantification of drug responses with subpopulation resolution.
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Clinically, heteroresistance refers to persistent infection, treatment failure, or relapse despite in vitro susceptibility results indicating sensitivity.
“Clinically, it refers to persistent infection, treatment failure, or relapse, despite in vitro susceptibility results indicating sensitivity [97,98].”
From Insight into the Mechanisms and Clinical Relevance of Antifungal Heteroresistance (2025) · cites this paper as [98]
For Cryptococcus spp., heteroresistance is a critical factor in treatment failure of cryptococcosis and involves a subpopulation that appears under antifungal exposure and retains the potential to grow under continuous drug stress.
“For Cryptococcus spp., heteroresistance is a critical factor in the treatment failure of cryptococcosis and involves a subpopulation that appears under antifungal exposure and retains the potential to grow under continuous drug stress [98].”
From Insight into the Mechanisms and Clinical Relevance of Antifungal Heteroresistance (2025) · cites this paper as [98]
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- Authors
- Lyons, N., & Berman, J.
- Affiliations
- Tel Aviv University (IL)
- Corresponding author
- Berman, Judith
- Venue
- Methods in Molecular Biology
- Publisher
- Springer US
- Published
- 2023
- Volume
- 2658
- Pages
- 67-79
- ISSN
- 1064-3745 (ISSN-L)
- 1940-6029
- OpenAlex
- W4362689720
- Cited by
- 8
- References
- 10
- Citations by year
- 2026: 5 · 2025: 2 · 2024: 1
- FWCI
- 14.45
- Type
- book chapter
- Language
- en
- Open access
- closed
- Licence
- Locations
- Methods in molecular biology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Fungal and yeast genetics research
- Life Sciences › Agricultural and Biological Sciences › Ecology, Evolution, Behavior and Systematics › Fungal Plant Pathogen Control
- Keywords
- drug tolerance, heteroresistance, pathogenic yeasts, Candida, Cryptococcus, antifungal susceptibility, subpopulations, Candida albicans, Candida auris, Candida tropicalis, Candida parapsilosis, Candida glabrata
- MeSH terms
- Antifungal Agents, Candida, Microbial Sensitivity Tests, Yeasts, Drug Resistance, Fungal
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