Relative Contribution of the ABC Transporters Cdr1, Pdh1, and Snq2 to Azole Resistance in Candida glabrata
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The utility of the azole antifungals for the treatment of invasive candidiasis is severely hampered by azole resistance in Candida glabrata . This resistance is mediated almost exclusively by activating mutations in the zinc cluster transcription factor Pdr1, which controls the genes encoding the multidrug resistance transporters Cdr1, Pdh1, and Snq2.
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In Candida glabrata, nearly all clinical triazole resistance is attributable to overexpression of CgCDR1, CgPDH1, and CgSNQ2.
“in which nearly all of the clinical triazole resistance is attributable to overexpression of the ATP-binding cassette (ABC)-type efflux pump-encoding genes C. glabrata CDR1 (CgCDR1), CgPDH1, and CgSNQ2 (16).”
From Mutations in <i>TAC1B</i> : a Novel Genetic Determinant of Clinical Fluconazole Resistance in Candida auris (2020) · cites this paper as [16]
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“A common mechanism of altering azole resistance in C. glabrata involves the upregulation of drug efflux pumps, such as CDR1 , PDH1 , and SNQ2 , facilitated by the zinc cluster transcription factor Pdr1 (28, 29, 31, 54, 55).”
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“A well-characterized example is found in Candida glabrata , where overexpression of multidrug efflux pumps serves as a core mechanism of azole resistance, primarily regulated by the zinc-cluster transcription factor CgPdr1 (Whaley et al. 2018).”
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“Their significance was assessed by Whaley et al. (2018), who found that over-expression of CDR1 was the primary factor for azole resistance, even though all three transporters are involved in this phenomenon.”
Zap1 is required for Candida glabrata response to fluconazole
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“A common mechanism of altering azole resistance in C. glabrata involves the upregulation of drug efflux pumps such as CDR1 , PDH1 , and SNQ2 , facilitated by the zinc cluster transcription factor Pdr1 (28, 29, 31, 56, 57).”
BackgroundPromising Role of Fruitless Wolfberry Bud Tea in Combating Nakaseomyces glabratus Resistance
Zhang, L., Ma, Z., Zhou, X., Zhang, Z., & Wu, T. (2025) · Pathogens · doi:10.3390/pathogens14040351
“According to Whaley et al. [49], CDR1 is the main transporter linked to PDR1 that causes multidrug resistance to azoles in the clinical isolate of N. glabratus being studied.”
Barker, K. S., Patterson, H. P., Morschhäuser, J., Cuomo, C. A., Wiederhold, N. P., & Rogers, P. D. (2025) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2025.05.07.652603
Self-citationWilliams, C. C., & Usher, J. (2025) · Microbiology Spectrum · doi:10.1128/spectrum.02522-24
“By increasing the expression of these efflux pump genes, CgPDR1 + enhances the efflux of antifungal agents from the fungal cell, thereby reducing intracellular drug concentrations and rendering the fungus less susceptible to the effects of the drug (36, 40, 42, 43).”
Pawar, K., & Singh, A. K. (2025) · Journal of Medical Microbiology · doi:10.1099/jmm.0.002083
“Testing was performed according to the manufacturer’s instructions (bioMérieux, Chicago, IL, USA), with modifications as recommended by the CLSI guidelines (M60, second ed., 2020) [40].”
Gil, F., Laiolo, J., Bayona-Pacheco, B. L., Cannon, R. D., Ferreira‐Pereira, A., & Carpinella, M. C. (2022) · Figshare · doi:10.6084/m9.figshare.21321440
Pinheiro, M. J. F., Parker, J. E., Ferreira, M. T., Fernandes, F., & Mira, N. P. (2026) · Microbiology Spectrum · doi:10.1128/spectrum.03344-25
“As a result of CDR1 overexpression, strains encoding Pdr1 GOF mutants avoid internal accumulation of azoles, reducing their toxic effects (2, 6, 15, 16).”
Diploidy alters the path of fluconazole adaptation in Candida glabrataPreprint
Galeota-Sprung, B., Fernandez, A., Wright, C., Tejada, R. S., & Sniegowski, P. (2026) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.64898/2026.05.22.727327
“We observed some evidence that aneuploidies may provide a transient adaptive state: in one diploid replicate population adapting at 100 µg/mL FLC, we detected a PDR1 V329F/+ ERG11 K152E/+ diploid carrying chrC, chrF, and chrI trisomies at transfer 10.”
Patiño, L. H., Muñoz, M. A. M., Ramírez, A. L., Jiménez-A, M. J., Ceballos-Garzón, A., Parra‐Giraldo, C. M., & Ramírez, J. D. (2026) · Acta Tropica · doi:10.1016/j.actatropica.2026.108235
Non-albicans Candida Species: Epidemiology and Antifungal Resistance
Bosan, M. A., Durrani, A. D., Faiz, A., Farooqi, J. Q., & Jabeen, K. (2026) · Current Fungal Infection Reports · doi:10.1007/s12281-026-00542-1
“In N. glabratus , the major efflux pump genes are CgCDR1 , CgPDH1 , and CgSNQ2 , which encode ATP-binding cassette-type transporters and substantially contribute to azole resistance [ 68].”
- Authors
- Whaley, S. G., Zhang, Q., Caudle, K. E., & Rogers, P. D.
- Affiliations
- University of Tennessee Health Science Center (US)
- Venue
- Antimicrobial Agents and Chemotherapy
- Publisher
- American Society for Microbiology
- Published
- 2018-10
- Volume
- 62
- Issue
- 10
- ISSN
- 0066-4804 (ISSN-L)
- 1098-6596
- PMC
- PMC6153852
- OpenAlex
- W2884775618
- Cited by
- 59
- References
- 31
- Citations by year
- 2026: 7 · 2025: 12 · 2024: 6 · 2023: 8 · 2022: 11 · 2021: 5 · 2020: 4 · 2019: 5 · 2018: 1
- FWCI
- 2.84
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Antimicrobial Agents and Chemotherapy (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- HHS | NIH | National Institute of Allergy and Infectious Diseases (R01AI058145, R01AI131620)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Health Sciences › Medicine › Oncology › Drug Transport and Resistance Mechanisms
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Fungal and yeast genetics research
- Keywords
- Candida glabrata, azole resistance, ABC transporters, CDR1, PDR1, multidrug resistance, antifungal resistance, clinical isolates
- MeSH terms
- Antifungal Agents, Azoles, Fungal Proteins, Membrane Proteins, Microbial Sensitivity Tests, ATP-Binding Cassette Transporters, Drug Resistance, Fungal, Membrane Transport Proteins, Candida glabrata
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