Heteroresistance to Fluconazole and Voriconazole in Cryptococcus neoformans

Mondon, P.; Petter, R.; Amalfitano, G.; Luzzati, R.; Concia, E.; Polacheck, I.; Kwon-Chung, K. J.

doi:10.1128/aac.43.8.1856

Cited by 139Fungal Infections and StudiesAntifungal resistance and susceptibilityFungal Plant Pathogen Control

Heteroresistance to Fluconazole and Voriconazole in Cryptococcus neoformans

Open access

Mondon, P., Petter, R., Amalfitano, G., Luzzati, R., Concia, E., Polacheck, I., Kwon-Chung, K. J.·1999·Antimicrobial Agents and Chemotherapy

DOI 10.1128/aac.43.8.1856PMC PMC89380

Open this paper in CoChat — free account

Abstract

Cryptococcus neoformans isolates that exhibited unusual patterns of resistance to fluconazole and voriconazole were isolated from seven isolates from two different geographical regions: one isolate from an Israeli non-AIDS patient and six serial isolates from an Italian AIDS patient who had suffered six recurrent episodes of cryptococcal meningitis. Each isolate produced cultures with heterogeneous compositions in which most of the cells were susceptible, but cells highly resistant to fluconazole (MICs, ≥64 μg/ml) were recovered at a variable frequency (7 × 10 −3 to 4.6 × 10 −2 ). Evidence showed that this type of resistance is innate and is unrelated to drug exposure since the Israeli patient had never been treated with azoles or any other antimycotic agents. Analysis of clonal subpopulations of these two strains showed that they exhibited heterogeneous patterns of resistance. The number of subpopulations which grew on fluconazole or voriconazole agar declined progressively with increasing azole concentration without a sharp cutoff point. For the Italian serial isolates, the number of clonal populations resistant to fluconazole (64 μg/ml) and voriconazole (1 μg/ml) increased steadily, yielding the highest number for the isolate from the last episode. Attempts to purify a sensitive subpopulation failed, but clones highly resistant to fluconazole (100 μg/ml) and moderately resistant to voriconazole (1 μg/ml) always produced a homogeneous population of resistant cells. Upon maintenance on drug-free medium, however, the majority of the homogeneously resistant cells of these subclones lost their resistance and returned to the stable initial heteroresistant phenotype. The pattern of heteroresistance was not affected by the pH or osmolarity of the medium but was influenced by temperature. The resistance appeared to be suppressed at 35°C and was completely abolished at 40°C. Although heterogeneity in azole resistance among subpopulations of single isolates has been reported for Candida species, the transient changes in expression of resistance under different growth conditions reported here have not been observed in fungal pathogens.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

Integrity signals

Registry

Crossref · 10.1128/aac.43.8.1856

Cites

36 of 36 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Heteroresistance was first described in 1999, when researchers observed that a subset of Cryptococcus cells were able to grow at azole concentrations well above the inhibitory concentration in vitro.
“This phenomenon was first described in 1999, when researchers observed that a subset of Cryptococcus cells were able to grow at azole concentrations well above the inhibitory concentration in vitro21.”
From Treatment strategies for cryptococcal infection: challenges, advances and future outlook (2021) · cites this paper as [21]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

National Committee for Clinical Laboratory Standards
Bruck, E. (1980) · PEDIATRICS · doi:10.1542/peds.65.1.187 · Cited by 14,736 · see citing works
Clinical, Cellular, and Molecular Factors That Contribute to Antifungal Drug Resistance
White, T. C., Marr, K. A., & Bowden, R. A. (1998) · Clinical Microbiology Reviews · doi:10.1128/cmr.11.2.382 · Cited by 1,353 · see citing works
Methicillin resistance in staphylococci: molecular and biochemical basis and clinical implications
Chambers, H. F. “. (1997) · Clinical Microbiology Reviews · doi:10.1128/cmr.10.4.781 · Cited by 1,128 · see citing works
Expression of methicillin resistance in heterogeneous strains of Staphylococcus aureus
Hartman, B. J., & Tomasz, A. (1986) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.29.1.85 · Cited by 265 · see citing works
Sigma-B, a putative operon encoding alternate sigma factor of Staphylococcus aureus RNA polymerase: molecular cloning and DNA sequencing
Wu, S., de LENCASTRE, H., & Tomasz, A. (1996) · Journal of Bacteriology · doi:10.1128/jb.178.20.6036-6042.1996 · Cited by 241 · see citing works
A new triazole, voriconazole (UK-109,496), blocks sterol biosynthesis in Candida albicans and Candida krusei
Sanati, H., Belanger, P. H., Fratti, R. A., & Ghannoum, M. A. (1997) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.41.11.2492 · Cited by 221 · see citing works
Rapid, Transient Fluconazole Resistance in Candida albicans Is Associated with Increased mRNA Levels of CDR
Marr, K. A., Lyons, C. N., Rustad, T., Bowden, R. A., & White, T. C. (1998) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.42.10.2584 · Cited by 166 · see citing works
Persistence of initial infection in recurrent Cryptococcus neoformans meningitis
Spitzer, E. D., Spitzer, S. G., Freundlich, L. F., & Casadevall, A. (1993) · The Lancet · doi:10.1016/0140-6736(93)90354-j · Cited by 165 · see citing works
Susceptibility testing of Cryptococcus neoformans: a microdilution technique
Ghannoum, M. A., Ibrahim, A. S., Fu, Y., Shafiq, M. C., Edwards, J. E., & Criddle, R. S. (1992) · Journal of Clinical Microbiology · doi:10.1128/jcm.30.11.2881-2886.1992 · Cited by 145 · see citing works
Mechanisms of heteroresistance in methicillin-resistant Staphylococcus aureus
Ryffel, C., Strässle, A., Kayser, F. H., & Berger‐Bächi, B. (1994) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.38.4.724 · Cited by 140 · see citing works
IN MEDICAL MYCOLOGY
Taxonomic, R. (1980) · Cited by 137 · see citing works
Identification of Patients with Acute AIDS-Associated Cryptococcal Meningitis Who Can Be Effectively Treated with Fluconazole: The Role of Antifungal Susceptibility Testing
Witt, M. D., Lewis, R. J., Larsen, R. A., Milefchik, E. N., Leal, M. A. E., Haubrich, R., Richie, J., Edwards, J. E., & Ghannoum, M. A. (1996) · Clinical Infectious Diseases · doi:10.1093/clinids/22.2.322 · Cited by 136 · see citing works
Increased Fluconazole Resistance of Cryptococcus neoformans Isolated from a Patient with AIDS and Recurrent Meningitis
Paugam, A., Dupouy‐Camet, J., Blanche, P., Gangneux, J., Tourte-Schaefer, C., & Sicard, D. (1994) · Clinical Infectious Diseases · doi:10.1093/clinids/19.5.975-a · Cited by 117 · see citing works
In Vitro Activities of Voriconazole, Fluconazole, and Itraconazole against 566 Clinical Isolates of Cryptococcus neoformans from the United States and Africa
Pfaller, M. A., Zhang, J., Messer, S. A., Brandt, M. E., Hajjeh, R. A., Jessup, C. J., Tumberland, M., Mbidde, E. K., & Ghannoum, M. A. (1999) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.43.1.169 · Cited by 114 · see citing works
Susceptibilities of serial Cryptococcus neoformans isolates from patients with recurrent cryptococcal meningitis to amphotericin B and fluconazole
Casadevall, A., Spitzer, E. D., Webb, D., & Rinaldi, M. G. (1993) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.37.6.1383 · Cited by 104 · see citing works
Cloning and characterization of a gene affecting the methicillin resistance level and the autolysis rate in Staphylococcus aureus
Maki, H., Yamaguchi, T., & Murakami, K. (1994) · Journal of Bacteriology · doi:10.1128/jb.176.16.4993-5000.1994 · Cited by 91 · see citing works
Fluconazole tolerance in clinical isolates of Cryptococcus neoformans
Venkateswarlu, K., Taylor, M., Manning, N. J., Rinaldi, M. G., & Kelly, S. L. (1997) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.41.4.748 · Cited by 74 · see citing works
In Vitro Comparative Efficacy of Voriconazole and Itraconazole against Fluconazole-Susceptible and -Resistant Cryptococcus neoformans Isolates
Nguyen, M. H., & Yu, C. Y. (1998) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.42.2.471 · Cited by 72 · see citing works
Molecular Subtypes and Antifungal Susceptibilities of Serial Cryptococcus neoformans Isolates in Human Immunodeficiency Virus-Associated Cryptococcosis
Brandt, M. E., Pfaller, M. A., Hajjeh, R. A., Graviss, E. A., Rees, J., Spitzer, E. D., Pinner, R. W., & Mayer, L. W. (1996) · The Journal of Infectious Diseases · doi:10.1093/infdis/174.4.812 · Cited by 72 · see citing works
The Hidden Danger of Primary Fluconazole Prophylaxis for Patients with AIDS
Berg, J., Clancy, C. J., & Nguyen, M. H. (1998) · Clinical Infectious Diseases · doi:10.1086/517056 · Cited by 69 · see citing works
Correlation of In Vitro Azole Susceptibility with In Vivo Response in a Murine Model of Cryptococcal Meningitis
Vélez, J. D., Allendoerfer, R., Luther, M., Rinaldi, M. G., & Graybill, J. R. (1993) · The Journal of Infectious Diseases · doi:10.1093/infdis/168.2.508 · Cited by 69 · see citing works
Reversible fluconazole resistance in Candida albicans: a potential in vitro model
Calvet, H. M., Yeaman, M. R., & Filler, S. G. (1997) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.41.3.535 · Cited by 68 · see citing works
Possible Development of Resistance to Fluconazole During Suppressive Therapy for AIDS-Associated Cryptococcal Meningitis
Armengou, A., Porcar, C., Mascaró, J. M., & Garcia-Bragado, F. (1996) · Clinical Infectious Diseases · doi:10.1093/clinids/23.6.1337-a · Cited by 68 · see citing works
Persistence, replacement, and microevolution of Cryptococcus neoformans strains in recurrent meningitis in AIDS patients
Sullivan, D. J., Haynes, K., Moran, G. P., Shanley, D. B., & Coleman, D. C. (1996) · Journal of Clinical Microbiology · doi:10.1128/jcm.34.7.1739-1744.1996 · Cited by 65 · see citing works
Resistance heterogeneity in methicillin-resistantStaphylococcus aureus
Matthews, P., & Stewart, P. R. (1984) · FEMS Microbiology Letters · doi:10.1111/j.1574-6968.1984.tb00718.x · Cited by 63 · see citing works
Formation of potent hybrid promoters of the mutant llm gene by IS256 transposition in methicillin-resistant Staphylococcus aureus
Maki, H., & Murakami, K. (1997) · Journal of Bacteriology · doi:10.1128/jb.179.22.6944-6948.1997 · Cited by 62 · see citing works
Genetic control of population structure in heterogeneous strains of methicillin resistantStaphylococcus aureus
de LENCASTRE, H., Figueiredo, A. M. S., & Tomasz, A. (1993) · European Journal of Clinical Microbiology & Infectious Diseases · doi:10.1007/bf02389872 · Cited by 54 · see citing works
Impact ofsarandagron methicillin resistance inStaphylococcus aureus
DurÃ¡n, S. P., Kayser, F. H., & Berger‐Bächi, B. (1996) · FEMS Microbiology Letters · doi:10.1111/j.1574-6968.1996.tb08394.x · Cited by 52 · see citing works
Azole Drug Resistance as a Cause of Clinical Relapse in AIDS Patients with Cryptococcal Meningitis
Birley, H., Johnson, E. M., McDonald, P., Parry, C. M., Carey, P. B., & Warnock, D. W. (1995) · International Journal of STD & AIDS · doi:10.1177/095646249500600510 · Cited by 51 · see citing works
Methicillin-Resistant Staphylococci: Genetics of the Minority Population
Seligman, S. J. (1966) · Journal of General Microbiology · doi:10.1099/00221287-42-2-315 · Cited by 44 · see citing works
Gastrointestinal Visceral Motor Complications of Dermatomal Herpes Zoster: Report of Two Cases and Review
Tribble, D. R., Church, P., & Frame, J. N. (1993) · Clinical Infectious Diseases · doi:10.1093/clinids/17.3.431 · Cited by 44 · see citing works
Increase of methicillin resistance in Staphylococcus aureus caused by deletion of a gene whose product is homologous to lytic enzymes
Fujimura, T., & Murakami, K. (1997) · Journal of Bacteriology · doi:10.1128/jb.179.20.6294-6301.1997 · Cited by 37 · see citing works
Comparative Evaluation of National Committee for Clinical Laboratory Standards Broth Macrodilution and Agar Dilution Screening Methods for Testing Fluconazole Susceptibility of Cryptococcus neoformans
Kirkpatrick, W. R., McAtee, R. K., Revankar, S. G., Fothergill, A. W., McCarthy, D. I., Rinaldi, M. G., & Patterson, T. F. (1998) · Journal of Clinical Microbiology · doi:10.1128/jcm.36.5.1330-1332.1998 · Cited by 31 · see citing works
Fluconazole-Resistant Cryptococcus neoformans Isolated from an Immunocompetent Patient without Prior Exposure to Fluconazole
Orni‐Wasserlauf, R., Izkhakov, E., Siegman‐Igra, Y., Bash, E., Polacheck, I., & Giladi, M. (1999) · Clinical Infectious Diseases · doi:10.1086/313546 · Cited by 28 · see citing works
Self-citation
Isolation of Candida species on media with and without added fluconazole reveals high variability in relative growth susceptibility phenotypes
Schoofs, A., Odds, F. C., Colebunders, R., Ieven, M., Wouters, L., & Goossens, H. (1997) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.41.8.1625 · Cited by 26 · see citing works
Formation of a minichromosome in Cryptococcus neoformans as a result of electroporative transformation
Varma, A., & Kwon-Chung, K. J. (1994) · Current Genetics · doi:10.1007/bf00326305 · Cited by 20 · see citing works
Self-citation

Flagged first, then by citations

Sorted by citations

Efflux-Mediated Antifungal Drug Resistance
Cannon, R. D., Lamping, E., Holmes, A. R., Niimi, K., Baret, P. V., Keniya, M. V., Tanabe, K., Niimi, M., Goffeau, A., & Monk, B. C. (2009) · Clinical Microbiology Reviews · doi:10.1128/cmr.00051-08 · Cited by 608 · see citing works
Regulatory circuitry governing fungal development, drug resistance, and disease.
Shapiro, R. S., Robbins, N., & Cowen, L. E. (2011) · Microbiology and Molecular Biology Reviews · doi:10.1128/mmbr.00045-10 · Cited by 576 · see citing works
Antifungal drug resistance of pathogenic fungi
Kontoyiannis, D. P., & Lewis, R. E. (2002) · The Lancet · doi:10.1016/s0140-6736(02)08162-x · Cited by 553 · see citing works
Microbial Cell Individuality and the Underlying Sources of Heterogeneity
Avery, S. V. (2006) · Nature Reviews Microbiology · doi:10.1038/nrmicro1460 · Cited by 521 · see citing works
Cryptococcus neoformans Overcomes Stress of Azole Drugs by Formation of Disomy in Specific Multiple Chromosomes
Sionov, E., Lee, H., Chang, Y. C., & Kwon-Chung, K. J. (2010) · PLoS Pathogens · doi:10.1371/journal.ppat.1000848 · Cited by 479 · see citing works
Self-citation
Untitled work
(2014) · doi:10.1128/cmr.00126-13 · Cited by 437 · see citing works
Treatment strategies for cryptococcal infection: challenges, advances and future outlook
Iyer, K. R., Revie, N. M., Fu, C., Robbins, N., & Cowen, L. E. (2021) · Nature Reviews Microbiology · doi:10.1038/s41579-021-00511-0 · Cited by 363 · see citing works
Drug-Resistant Fungi: An Emerging Challenge Threatening Our Limited Antifungal Armamentarium
Arastehfar, A. A., Gabaldón, T., Garcia‐Rubio, R., Jenks, J. D., Hoenigl, M., Salzer, H. J. F., İlkit, M., Lass‐Flörl, C., & Perlin, D. S. (2020) · Antibiotics · doi:10.3390/antibiotics9120877 · Cited by 294 · see citing works
Stress, drugs, and evolution: the role of cellular signaling in fungal drug resistance.
Cowen, L. E., & Steinbach, W. J. (2008) · Eukaryotic Cell · doi:10.1128/ec.00041-08 · Cited by 285 · see citing works
In vitro antifungal activities of voriconazole and reference agents as determined by NCCLS methods: Review of the literature
Espinel‐Ingroff, A., Boyle, K., & Sheehan, D. J. (2001) · Mycopathologia · doi:10.1023/a:1010954803886 · Cited by 251 · see citing works
Role of ATP-Binding-Cassette Transporter Genes in High-Frequency Acquisition of Resistance to Azole Antifungals in Candida glabrata
Sanglard, D., Ischer, F., & Bille, J. (2001) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.45.4.1174-1183.2001 · Cited by 247 · see citing works
Fungal cytochrome P450 sterol 14α-demethylase (CYP51) and azole resistance in plant and human pathogens
Becher, R., & Wirsel, S. G. R. (2012) · Applied Microbiology and Biotechnology · doi:10.1007/s00253-012-4195-9 · Cited by 247 · see citing works
Defining breakthrough invasive fungal infection–Position paper of the mycoses study group education and research consortium and the European Confederation of Medical Mycology
Cornely, O. A., Hoenigl, M., Lass‐Flörl, C., Chen, S. C. ‐., Kontoyiannis, D. P., Morrissey, C. O., & Thompson, G. R. (2019) · Mycoses · doi:10.1111/myc.12960 · Cited by 224 · see citing works
New Horizons in Antifungal Therapy
Pianalto, K. M., & Alspaugh, J. A. (2016) · Journal of Fungi · doi:10.3390/jof2040026 · Cited by 195 · see citing works
Breakthrough invasive fungal infections: Who is at risk?
Jenks, J. D., Cornely, O. A., Chen, S. C. ‐., Thompson, G. R., & Hoenigl, M. (2020) · Mycoses · doi:10.1111/myc.13148 · Cited by 191 · see citing works
Heteroresistance to Fluconazole in Cryptococcus neoformans Is Intrinsic and Associated with Virulence
Sionov, E., Chang, Y. C., Garraffo, H. M., & Kwon-Chung, K. J. (2009) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.00295-09 · Cited by 179 · see citing works
Self-citation
Dynamic ploidy changes drive fluconazole resistance in human cryptococcal meningitis
Stone, N. R. H., Rhodes, J., Fisher, M. C., Mfinanga, S., Kivuyo, S., Rugemalila, J., Segal, E. S., Needleman, L., Molloy, S. F., Kwon-Chung, J., et al. (2019) · Journal of Clinical Investigation · doi:10.1172/jci124516 · Cited by 167 · see citing works
Combatting the evolution of antifungal resistance in Cryptococcus neoformans
Bermas, A., & Geddes‐McAlister, J. (2020) · Molecular Microbiology · doi:10.1111/mmi.14565 · Cited by 138 · see citing works
Cryptococcosis: epidemiology, fungal resistance, and new alternatives for treatment
Gullo, F. P., Rossi, S. A., Sardi, J. D. C. O., Teodoro, V. L. I., Mendes‐Giannini, M. J. S., & Fusco‐Almeida, A. M. (2013) · European Journal of Clinical Microbiology & Infectious Diseases · doi:10.1007/s10096-013-1915-8 · Cited by 122 · see citing works
Identification of a Cryptococcus neoformans Cytochrome P450 Lanosterol 14α-Demethylase (Erg11) Residue Critical for Differential Susceptibility between Fluconazole/Voriconazole and Itraconazole/Posaconazole
Sionov, E., Chang, Y. C., Garraffo, H. M., Dolan, M. A., Ghannoum, M. A., & Kwon-Chung, K. J. (2011) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.05502-11 · Cited by 120 · see citing works
Self-citation
Rapid Mechanisms for Generating Genome Diversity: Whole Ploidy Shifts, Aneuploidy, and Loss of Heterozygosity
Bennett, R. J., Forche, A., & Berman, J. (2014) · Cold Spring Harbor Perspectives in Medicine · doi:10.1101/cshperspect.a019604 · Cited by 118 · see citing works
Azole heteroresistance in Cryptococcus neoformans: Emergence of resistant clones with chromosomal disomy in the mouse brain during fluconazole treatment
Sionov, E., Chang, Y. C., & Kwon-Chung, K. J. (2013) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.00694-13 · Cited by 112 · see citing works
Self-citation
Review of the safety and efficacy of voriconazole
Rathbun, R. C., & Hoffman, H. L. (2002) · Expert Opinion on Investigational Drugs · doi:10.1517/13543784.11.3.409 · Cited by 110 · see citing works
Drug resistance in Cryptococcus neoformans
Perfect, J. R., & Cox, G. M. (1999) · Drug Resistance Updates · doi:10.1054/drup.1999.0090 · Cited by 106 · see citing works
Inducible Azole Resistance Associated with a Heterogeneous Phenotype in Candida albicans
Marr, K. A., Lyons, C. N., Ha, K. C., Rustad, T. R., & White, T. C. (2001) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.45.1.52-59.2001 · Cited by 106 · see citing works
Mechanisms of Cryptococcal Virulence and Persistence
Olszewski, M. A., Zhang, Y., & Huffnagle, G. B. (2010) · Future Microbiology · doi:10.2217/fmb.10.93 · Cited by 94 · see citing works
Heteroresistance to Fluconazole Is a Continuously Distributed Phenotype among Candida glabrata Clinical Strains Associated with In Vivo Persistence
Ben-Ami, R., Zimmerman, O., Finn, T., Amit, S., Novikov, A., Wertheimer, N., Lurie-Weinberger, M., & Berman, J. (2016) · mBio · doi:10.1128/mbio.00655-16 · Cited by 88 · see citing works
Molecular mechanisms of acquired antifungal drug resistance in principal fungal pathogens and EUCAST guidance for their laboratory detection and clinical implications
Rogers, T. R., Verweij, P. E., Castanheira, M., Dannaoui, E., White, P. L., Arendrup, M. C., Subcommittee on Antifungal Susceptibility Testing (AFST) of the ESCMID European Committee for Antimicrobial Susceptibility Testing (EUCAST), Arendrup, M. C., Arikan-Akdagli, S., Barchiesi, F., et al. (2022) · Journal of Antimicrobial Chemotherapy · doi:10.1093/jac/dkac161 · Cited by 82 · see citing works
Aneuploidy and Drug Resistance in Pathogenic Fungi
Kwon-Chung, K. J., & Chang, Y. C. (2012) · PLoS Pathogens · doi:10.1371/journal.ppat.1003022 · Cited by 76 · see citing works
Self-citation
Fluconazole resistance in cryptococcal disease: emerging or intrinsic?
Cheong, J. W. S., & McCormack, J. (2012) · Medical Mycology · doi:10.3109/13693786.2012.715763 · Cited by 75 · see citing works
CPS1 , a Homolog of the Streptococcus pneumoniae Type 3 Polysaccharide Synthase Gene, Is Important for the Pathobiology of Cryptococcus neoformans
Chang, Y. C., Jong, A., Huang, S. H., Zerfas, P. M., & Kwon-Chung, K. J. (2006) · Infection and Immunity · doi:10.1128/iai.00089-06 · Cited by 74 · see citing works
Self-citation
New Approaches for Cryptococcosis Treatment
Spadari, C. D. C., Wirth, F., Lopes, L. B., & Ishida, K. (2020) · Microorganisms · doi:10.3390/microorganisms8040613 · Cited by 73 · see citing works
Ploidy variation as an adaptive mechanism in human pathogenic fungi
Morrow, C. A., & Fraser, J. A. (2013) · Seminars in Cell and Developmental Biology · doi:10.1016/j.semcdb.2013.01.008 · Cited by 72 · see citing works
Increasing trend of fluconazole-non-susceptible Cryptococcus neoformans in patients with invasive cryptococcosis: a 12-year longitudinal study
Chen, Y., Chang, T.-Y., Liu, J.-W., Chen, F., Chien, C., Lee, C., & Lu, C. (2015) · BMC Infectious Diseases · doi:10.1186/s12879-015-1023-8 · Cited by 71 · see citing works
The Exciting Future of Antifungal Therapy
Neely, M. N., & Ghannoum, M. A. (2000) · European Journal of Clinical Microbiology & Infectious Diseases · doi:10.1007/s100960000395 · Cited by 71 · see citing works
Fluconazole Monotherapy Is a Suboptimal Option for Initial Treatment of Cryptococcal Meningitis Because of Emergence of Resistance
Hope, W., Stone, N. R. H., Johnson, A., McEntee, L., Farrington, N., Santoro-Castelazo, A., Liu, X., Lucaci, A., Hughes, M., Oliver, J. D., et al. (2019) · mBio · doi:10.1128/mbio.02575-19 · Cited by 70 · see citing works
Roles of Three Cryptococcus neoformans and Cryptococcus gattii Efflux Pump-Coding Genes in Response to Drug Treatment
Chang, M., Sionov, E., Lamichhane, A. K., Kwon-Chung, K. J., & Chang, Y. C. (2018) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.01751-17 · Cited by 63 · see citing works
Self-citation
Antifungal heteroresistance causes prophylaxis failure and facilitates breakthrough Candida parapsilosis infections
Zhai, B., Liao, C., Jaggavarapu, S., Tang, Y., Rolling, T., Ning, Y., Sun, T., Bergin, S. A., Gjonbalaj, M., Miranda, E., et al. (2024) · Nature Medicine · doi:10.1038/s41591-024-03183-4 · Cited by 62 · see citing works
Characterization of Heteroresistance to Fluconazole among Clinical Isolates of Cryptococcus neoformans
Yamazumi, T., Pfaller, M. A., Messer, S. A., Houston, A. K., Boyken, L., Hollis, R. J., Furuta, I., & Jones, R. N. (2003) · Journal of Clinical Microbiology · doi:10.1128/jcm.41.1.267-272.2003 · Cited by 62 · see citing works
Essential Gene Discovery in the Basidiomycete Cryptococcus neoformans for Antifungal Drug Target Prioritization
Ianiri, G., & Idnurm, A. (2015) · mBio · doi:10.1128/mbio.02334-14 · Cited by 62 · see citing works
Deletion of Cryptococcus neoformans AIF Ortholog Promotes Chromosome Aneuploidy and Fluconazole-Resistance in a Metacaspase-Independent Manner
Semighini, C. P., Averette, A. F., Perfect, J. R., & Heitman, J. (2011) · PLoS Pathogens · doi:10.1371/journal.ppat.1002364 · Cited by 61 · see citing works
Characterization of the chromosome 4 genes that affect fluconazole-induced disomy formation in Cryptococcus neoformans
Ngamskulrungroj, P., Chang, Y., Hansen, B., Bugge, C., Fischer, E., & Kwon-Chung, K. J. (2012) · PLoS ONE · doi:10.1371/journal.pone.0033022 · Cited by 56 · see citing works
Self-citation
Fungemia in a cancer patient caused by fluconazole-resistant Cryptococcus laurentii
Averbuch, D., Boekhout, T., Falk, R. J., Engelhard, D., Shapiro, M., Block, C., & Polacheck, I. (2002) · Medical Mycology · doi:10.1080/714031137 · Cited by 56 · see citing works
Self-citation
Mycobacterium tuberculosis Subculture Results in Loss of Potentially Clinically Relevant Heteroresistance
Metcalfe, J. Z., Streicher, E. M., Theron, G., Colman, R. E., Asteria-Peñaloza, R., Allender, C., Lemmer, D., Warren, R. M., & Engelthaler, D. M. (2017) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.00888-17 · Cited by 54 · see citing works
Gaining Insights from Candida Biofilm Heterogeneity: One Size Does Not Fit All
Kean, R., Delaney, C., Rajendran, R., Sherry, L., Metcalfe, R., Thomas, R., McLean, W., Williams, C., & Ramage, G. (2018) · Journal of Fungi · doi:10.3390/jof4010012 · Cited by 53 · see citing works
Genome-wide expression profiling of the response to short-term exposure to fluconazole in Cryptococcus neoformans serotype A
Florio, A. R., Ferrari, S., Carolis, E. D., Torelli, R., Fadda, G., Sanguinetti, M., Sanglard, D., & Posteraro, B. (2011) · BMC Microbiology · doi:10.1186/1471-2180-11-97 · Cited by 48 · see citing works
Involvement of PDK1, PKC and TOR signalling pathways in basal fluconazole tolerance in Cryptococcus neoformans
Lee, H., Lamichhane, A. K., Garraffo, H. M., Kwon-Chung, K. J., & Chang, Y. C. (2012) · Molecular Microbiology · doi:10.1111/j.1365-2958.2012.08016.x · Cited by 47 · see citing works
Self-citation
Moderate levels of 5-fluorocytosine cause the emergence of high frequency resistance in cryptococci
Chang, Y. C., Lamichhane, A. K., Cai, H., Walter, P. J., Bennett, J. E., & Kwon-Chung, K. J. (2021) · Nature Communications · doi:10.1038/s41467-021-23745-1 · Cited by 45 · see citing works
Self-citation
Antifungal use in HIV infection
Mylonakis, E. E., & Marty, F. M. (2002) · Expert Opinion on Pharmacotherapy · doi:10.1517/14656566.3.2.91 · Cited by 45 · see citing works
Molecular typing and antifungal susceptibility of clinical sequential isolates of Cryptococcus neoformans from Sao Paulo State, Brazil
Fusco‐Almeida, A. M., Matsumoto, M. T., Baeza, L. C., Silva, R. B. D. O. E., Kleiner, A. A. P., Melhem, M. D. S. C., & Mendes‐Giannini, M. J. S. (2006) · FEMS Yeast Research · doi:10.1111/j.1567-1364.2006.00128.x · Cited by 44 · see citing works
Emerging Issues in Antifungal Resistance
Perfect, J. R., & Ghannoum, M. A. (2020) · Infectious Disease Clinics of North America · doi:10.1016/j.idc.2020.05.003 · Cited by 44 · see citing works
Cell cycle‐ and age‐dependent activation of Sod1p drives the formation of stress resistant cell subpopulations within clonal yeast cultures
Sumner, E. R., Avery, A. M., Houghton, J. E., Robins, R. A., & Avery, S. V. (2003) · Molecular Microbiology · doi:10.1046/j.1365-2958.2003.03715.x · Cited by 44 · see citing works
Characterization of Cryptococcus neoformans isolated from urban environmental sources in Goiânia, Goiás State, Brazil
Kobayashi, C. C. B. A., Souza, L. K. H. E., Fernandes, O. D. F. L., de Brito, S. C. A., Silva, A. C., de Sousa, E. D., & Silva, M. D. R. R. (2005) · Revista do Instituto de Medicina Tropical de São Paulo · doi:10.1590/s0036-46652005000400005 · Cited by 41 · see citing works
Cryptococcus neoformans Yap1 is required for normal fluconazole and oxidative stress resistance
Paul, S. K., Doering, T. L., & Moye-Rowley, S. (2014) · Fungal Genetics and Biology · doi:10.1016/j.fgb.2014.10.015 · Cited by 39 · see citing works
Cloning and characterization of the lanosterol 14α-demethylase (ERG11) gene in Cryptococcus neoformans
Revankar, S. G., Fu, J., Rinaldi, M. G., Kelly, S. L., Kelly, D. E., Lamb, D. C., Keller, S. M., & Wickes, B. L. (2004) · Biochemical and Biophysical Research Communications · doi:10.1016/j.bbrc.2004.09.112 · Cited by 39 · see citing works
Transcription factor Znf2 coordinates with the chromatin remodeling SWI/SNF complex to regulate cryptococcal cellular differentiation
Lin, J., Zhao, Y., Ferraro, A. R., Yang, E., Lewis, Z., & Lin, X. (2019) · Communications Biology · doi:10.1038/s42003-019-0665-2 · Cited by 38 · see citing works
Antifungal susceptibilities of clinical and environmental isolates of Cryptococcus neoformans in goiânia city, Goiás, Brasil
Souza, L. K. H. E., Fernandes, O. D. F. L., Kobayashi, C. C. B. A., Passos, X. S., Costa, C. R., Lemos, J. A., Júnior, A. H. D. S., & Silva, M. D. R. R. (2005) · Revista do Instituto de Medicina Tropical de São Paulo · doi:10.1590/s0036-46652005000500003 · Cited by 38 · see citing works
Dynamic and Heterogeneous Mutations to Fluconazole Resistance in Cryptococcus neoformans
Xu, J., Onyewu, C., Yoell, H. J., Ali, R. Y., Vilgalys, R. J., & Mitchell, T. G. (2001) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.45.2.420-427.2001 · Cited by 34 · see citing works
Susceptibility profile of clinical and environmental isolates ofCryptococcus neoformansandCryptococcus gattiiin Uberaba, Minas Gerais, Brazil
Andrade-Silva, L. E., Paim, K. F., Mora, D. J., da Silva, P. R., Andrade, A. A., Araujo, N. E., Pedrosa, A. L., & Silva-Vergara, M. L. (2013) · Medical Mycology · doi:10.3109/13693786.2012.761737 · Cited by 33 · see citing works
Cryptococcus gattii:in vitrosusceptibility to the new antifungal albaconazole versus fluconazole and voriconazole
Morera, Y., Torres-Rodrı́guez, J. M., Jiménez-Cabello, T., & Baró, T. (2005) · Medical Mycology · doi:10.1080/13693780400029528 · Cited by 32 · see citing works
A novel episomal shuttle vector for transformation of Cryptococcus neoformans with the ccdB gene as a positive selection marker in bacteria
Mondon, P., Chang, Y. C., Varma, A., & Kwon-Chung, K. J. (2000) · FEMS Microbiology Letters · doi:10.1111/j.1574-6968.2000.tb09134.x · Cited by 31 · see citing works
Self-citation
Microsatellite typing and susceptibilities of serial Cryptococcus neoformansisolates from Cuban patients with recurrent cryptococcal meningitis
Zaragozí, M. T. I., Martínez-Machín, G., Andreu, C. F., Hagen, F., Boekhout, T., Klaassen, C. H. W., & Meis, J. F. G. M. (2010) · BMC Infectious Diseases · doi:10.1186/1471-2334-10-289 · Cited by 31 · see citing works
Large-Scale Chromosomal Changes and Associated Fitness Consequences in Pathogenic Fungi
Forche, A. (2014) · Current Fungal Infection Reports · doi:10.1007/s12281-014-0181-2 · Cited by 30 · see citing works
In vitro susceptibilities of cerebrospinal fluid isolates of Cryptococcus neoformans collected during a ten‐year period against fluconazole, voriconazole and posaconazole (SCH56592)
Yıldıran, Ş. T., Fothergill, A. W., Sutton, D. A., & Rinaldi, M. G. (2002) · Mycoses · doi:10.1046/j.1439-0507.2002.00765.x · Cited by 30 · see citing works
Coregulation of extracellular vesicle production and fluconazole susceptibility in Cryptococcus neoformans
Rizzo, J., Trottier, A., Moyrand, F., Coppée, J., Maufrais, C., Zimbres, A. C. G., Dang, T. T. V., Alanio, A., Desnos‐Ollivier, M., Mouyna, I., et al. (2023) · mBio · doi:10.1128/mbio.00870-23 · Cited by 29 · see citing works
Pheromone independent unisexual development in Cryptococcus neoformans
Gyawali, R., Zhao, Y., Lin, J., Fan, Y., Xu, X., Upadhyay, S., & Lin, X. (2017) · PLoS Genetics · doi:10.1371/journal.pgen.1006772 · Cited by 27 · see citing works
Heteroresistance and fungi
Ferreira, G. F., & Santos, D. A. (2017) · Mycoses · doi:10.1111/myc.12639 · Cited by 26 · see citing works
Aspergillus fumigatus Can Display Persistence to the Fungicidal Drug Voriconazole
Scott, J., Valero, C., Mato-López, Á., Donaldson, I. J., Roldán, A., Chown, H., Van Rhijn, N., Lobo-Vega, R., Gago, S., Furukawa, T., et al. (2023) · Microbiology Spectrum · doi:10.1128/spectrum.04770-22 · Cited by 24 · see citing works
Cryptococcus neoformans var. neoformans resistant to fluconazole in an HIV-negative patient with chronic lymphocytic leukemia
Assing, K., Birgens, H., & Arendrup, M. C. (2003) · Clinical Microbiology and Infection · doi:10.1046/j.1469-0691.2003.00571.x · Cited by 24 · see citing works
Approaches for identifying and measuring heteroresistance in azole-susceptible Candida isolates
Gautier, C., Maciel, E. I., & Ene, I. V. (2024) · Microbiology Spectrum · doi:10.1128/spectrum.04041-23 · Cited by 23 · see citing works
Novel ABC Transporter Associated with Fluconazole Resistance in Aging of Cryptococcus neoformans
Oliveira, N. K., Bhattacharya, S., Gambhir, R., Joshi, M., & Fries, B. C. (2022) · Journal of Fungi · doi:10.3390/jof8070677 · Cited by 23 · see citing works
In Vitro Activity of a Novel Antifungal Compound, MYC-053, against Clinically Significant Antifungal-Resistant Strains of Candida glabrata , Candida auris , Cryptococcus neoformans , and Pneumocystis spp
Tetz, G. V., Collins, M. S., Vikina, D., & Tetz, V. (2019) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.01975-18 · Cited by 23 · see citing works
Investigation of fluconazole heteroresistance in clinical and environmental isolates of Cryptococcus neoformans complex and Cryptococcus gattii complex in the state of Amazonas, Brazil
Moreira, I. D. M. B., Cortez, A. C. A., de Souza, É. S., Pinheiro, S. B., de Souza Oliveira, J. G., Sadahiro, A., Cruz, K. S., Matsuura, A. B. J., Melhem, M. D. S. C., Frickmann, H., et al. (2022) · Medical Mycology · doi:10.1093/mmy/myac005 · Cited by 22 · see citing works
Comparative Analysis of the Vitek 2 Antifungal Susceptibility System and E-test with the CLSI M27-A3 Broth Microdilution Method for Susceptibility Testing of Indian Clinical Isolates of Cryptococcus neoformans
Tewari, A., Behera, B., Mathur, P., & Xess, I. (2012) · Mycopathologia · doi:10.1007/s11046-012-9528-9 · Cited by 20 · see citing works
Colony and Single Cell Level Analysis of the Heterogeneous Response of Cryptococcus neoformans to Fluconazole
Altamirano, S., Simmons, C., & Kozubowski, L. (2018) · Frontiers in Cellular and Infection Microbiology · doi:10.3389/fcimb.2018.00203 · Cited by 19 · see citing works
Eugenol Induces Phenotypic Alterations and Increases the Oxidative Burst in Cryptococcus
Alves, J. C. O., Ferreira, G. F., dos Santos, J. R. A., da Silva, L. C. N., Rodrigues, J. F. S., Neto, W. R. N., Farah, E. I., Santos, Á. R. C., Mendes, B. S., Sousa, L. V. N. F., et al. (2017) · Frontiers in Microbiology · doi:10.3389/fmicb.2017.02419 · Cited by 19 · see citing works
Heterogeneity in the transcriptional response of the human pathogen Aspergillus fumigatus to the antifungal agent caspofungin
Colabardini, A. C., Wang, F., Dong, Z., Pardeshi, L. A., Rocha, M. C., Costa, J. H., dos Reis, T. F., Brown, A. C., Jaber, Q. Z., Fridman, M., et al. (2021) · Genetics · doi:10.1093/genetics/iyab183 · Cited by 19 · see citing works
Molecular Principles of Antifungal Drug Resistance
Sanglard, D., & White, T. C. (2014) · ASM Press eBooks · doi:10.1128/9781555815776.ch14 · Cited by 19 · see citing works
Early clinical and microbiological predictors of outcome in hospitalized patients with cryptococcal meningitis
de Oliveira, L., Melhem, M. D. S. C., Buccheri, R., Chagas, O. J., Vidal, J. E., & Díaz-Quijano, F. A. (2022) · BMC Infectious Diseases · doi:10.1186/s12879-022-07118-7 · Cited by 18 · see citing works
Clinical utility of antifungal susceptibility testing
McCarty, T. P., Luethy, P. M., Baddley, J. W., & Pappas, P. G. (2022) · JAC-Antimicrobial Resistance · doi:10.1093/jacamr/dlac067 · Cited by 17 · see citing works
Effects of environmental factors on sensitivity of Cryptococcus neoformans to fluconazole and amphotericin B
Carlson, T., Lupinacci, E., Moseley, K., & Chandrasekaran, S. (2021) · FEMS Microbiology Letters · doi:10.1093/femsle/fnab040 · Cited by 16 · see citing works
Infection Control - Updates
Sudhakar, C. (2012) · InTech eBooks · doi:10.5772/2251 · Cited by 16 · see citing works
Serotypes of Clinical Cerebrospinal Fluid Cryptococcus neoformans Isolates from Southern Taiwan and Their In Vitro Susceptibilities to Amphotericin B, Fluconazole, and Voriconazole
Chang, W., Huang, C.-R., Lei, C.-B., Lee, P.-Y., Chien, C., Chang, H., Chang, C.-S., & Lu, C.-H. (2004) · Japanese Journal of Infectious Diseases · doi:10.7883/yoken.jjid.2004.113 · Cited by 15 · see citing works
Editorial Commentary:Free Fluconazole for Cryptococcal Meningitis: Too Little of a Good Thing?
Hamill, R. J. (2006) · Clinical Infectious Diseases · doi:10.1086/507900 · Cited by 15 · see citing works
Experimental and in-host evolution of triazole resistance in human pathogenic fungi
Handelman, M., & Osherov, N. (2022) · Frontiers in Fungal Biology · doi:10.3389/ffunb.2022.957577 · Cited by 14 · see citing works
Synthetic Pesticides Used in Agricultural Production Promote Genetic Instability and Metabolic Variability in Candida spp.
Potocki, L., Baran, A., Oklejewicz, B., Szpyrka, E., Podbielska, M., & Schwarzbacherová, V. (2020) · Genes · doi:10.3390/genes11080848 · Cited by 14 · see citing works
In vivodevelopment of fluconazole resistance in serialCryptococcus gattiiisolates from a cat
Sykes, J. E., Hodge, G., Singapuri, A., Yang, M. L., Gelli, A., & Thompson, G. R. (2016) · Medical Mycology · doi:10.1093/mmy/myw104 · Cited by 13 · see citing works
Nitrogen concentration affects amphotericin B and fluconazole tolerance of pathogenic cryptococci
Bosch, C., Toplis, B., Vreulink, J.-M., Volschenk, H., & Botha, A. (2020) · FEMS Yeast Research · doi:10.1093/femsyr/foaa010 · Cited by 12 · see citing works
Mutants with heteroresistance to amphotericin B and fluconazole in Candida
Claudino, A. L. R., Peixoto Junior, R. F., Melhem, M. S. C., Szeszs, M. W., Lyon, J. P., Chavasco, J. K., & Franco, M. C. (2009) · Brazilian Journal of Microbiology · doi:10.1590/s1517-83822009000400028 · Cited by 12 · see citing works
Fluconazole Resistance and Heteroresistance in Cryptococcus spp.: Mechanisms and Implications
Moreira, I. D. M. B., de Sousa, N. S. O., de Almeida, J. D. R., Filho, R. L. L. R., Cruz, K. S., Matsuura, A. B. J., Melhem, M. D. S. C., de Souza, É. S., Frickmann, H., Lacerda, M., et al. (2025) · Revista da Sociedade Brasileira de Medicina Tropical · doi:10.1590/0037-8682-0328-2024 · Cited by 12 · see citing works
Cryptococcus neoformansYop1, an endoplasmic reticulum curvature-stabilizing protein, participates with Sey1 in influencing fluconazole-induced disomy formation
Ngamskulrungroj, P., Chang, Y. C., Hansen, B. T., Bugge, C., Fischer, E. R., & Kwon-Chung, K. J. (2012) · FEMS Yeast Research · doi:10.1111/j.1567-1364.2012.00824.x · Cited by 12 · see citing works
Self-citation
Combating increased antifungal drug resistance in Cryptococcus, what should we do in the future?
Deng, H., Song, J., Huang, Y., Yang, C., Zang, X., Zhou, Y., Li, H., Dai, B., & Xue, X. (2023) · Acta Biochimica et Biophysica Sinica · doi:10.3724/abbs.2023011 · Cited by 11 · see citing works
First Molecular Typing of Cryptococcemia-Causing Cryptococcus in Central-West Brazil
Tsujisaki, R. A. D. S., Paniago, A. M. M., Lima, M. S. D. C., de Alencar, D. D. S. O., Spositto, F. L. E., Nunes, M. D. O., Trilles, L., & Chang, M. R. (2013) · Mycopathologia · doi:10.1007/s11046-013-9676-6 · Cited by 11 · see citing works
Drug Resistance in Cryptococcus: Epidemiology and Molecular Mechanisms
Pfaller, M. A., Lodge, J. K., & Ghannoum, M. A. (2014) · ASM Press eBooks · doi:10.1128/9781555816858.ch16 · Cited by 9 · see citing works
Advancing Antimicrobial Resistance Research Through Quantitative Modeling and Synthetic Biology
Farquhar, K. S., Flohr, H., & Charlebois, D. A. (2020) · Frontiers in Bioengineering and Biotechnology · doi:10.3389/fbioe.2020.583415 · Cited by 9 · see citing works
Cryptococcus neoformans: a Sugar-Coated Killer
Perfect, J. R. (2014) · ASM Press eBooks · doi:10.1128/9781555815776.ch21 · Cited by 9 · see citing works
Novel ABC Transporter Associated with Fluconazole Resistance in Aging of Cryptococcus neoformans
Oliveira, N. K., Bhattacharya, S., Gambhir, R., Joshi, M., & Fries, B. C. (2022) · doi:10.20944/preprints202201.0263.v1 · Cited by 24 · see citing works
Population heterogeneity in Cryptococcus neoformans: Impact on pathogenesis
Agrawal, R., de Castro, R. J. A., Sturny-Leclère, A., & Alanio, A. (2024) · PLoS Pathogens · doi:10.1371/journal.ppat.1012332 · Cited by 8 · see citing works
DNA fingerprinting pattern and susceptibility to antifungal drugs in Cryptococcus neoformans variety grubii isolates from Barcelona city and rural environmental samples
Morera, Y., Torres-Rodrı́guez, J. M., Jiménez-Cabello, T., Baró, T., Alía, C., & Lazéra, M. (2005) · Mycopathologia · doi:10.1007/s11046-005-6332-9 · Cited by 8 · see citing works
In Vitro Antifungal Activity of Chimeric Peptides Derived from Bovine Lactoferricin and Buforin II against Cryptococcus neoformans var. grubii
Carvajal, S. K., Vargas‐Casanova, Y., Pineda‐Castañeda, H. M., García‐Castañeda, J. E., Monroy, Z. J. R., & Parra‐Giraldo, C. M. (2022) · Antibiotics · doi:10.3390/antibiotics11121819 · Cited by 7 · see citing works

Characterization of Heteroresistance to Fluconazole among Clinical Isolates of Cryptococcus neoformans
Yamazumi, T., Pfaller, M. A., Messer, S. A., Houston, A. K., Boyken, L., Hollis, R. J., Furuta, I., & Jones, R. N. (2003) · Journal of Clinical Microbiology · doi:10.1128/jcm.41.1.267-272.2003 · Cited by 62 · see citing works
Avaliacao do fenomeno de heteroresistencia em isolados clinicos de Cryptococcus neoformans
Ruiz, M. D. S., & da Silva, M. (2010)
Heteroresistance to Fluconazole in Cryptococcus neoformans Is Intrinsic and Associated with Virulence
Sionov, E., Chang, Y. C., Garraffo, H. M., & Kwon-Chung, K. J. (2009) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.00295-09 · Cited by 179 · see citing works
Self-citation
Heterorresistência ao fluconazol em agentes de criptococose
Feliciano, L. M., & Melhem, M. D. S. C. (2018) · BEPA Boletim Epidemiológico Paulista
S8.5d Cryptococcus neoformans and Cryptococcus gattii clinical isolates from Colombia develop heteroresistance to fluconazole at high concentrations
Melendres, J., Carvajal, S. K., Escandón, P., & Firacative, C. (2022) · Medical Mycology · doi:10.1093/mmy/myac072.s8.5d · Cited by 2 · see citing works

Authors: Mondon, P., Petter, R., Amalfitano, G., Luzzati, R., Concia, E., Polacheck, I., & Kwon-Chung, K. J.
Affiliations: National Institutes of Health (US)
University of Verona (IT)
Hadassah Medical Center (IL)
ORCID: Mondon, P.
Luzzati, R.
Polacheck, I.
Kwon-Chung, K. J.
Venue: Antimicrobial Agents and Chemotherapy
Publisher: American Society for Microbiology
Published: 1999-08
Volume: 43
Issue: 8
Pages: 1856-1861
ISSN: 0066-4804 (ISSN-L)
1098-6596
DOI: 10.1128/aac.43.8.1856
PMC: PMC89380
OpenAlex: W2000804360
Cited by: 139
References: 36
Citations by year: 2026: 5 · 2025: 6 · 2024: 3 · 2023: 6 · 2022: 11 · 2021: 5 · 2020: 9 · 2019: 7 · 2018: 3 · 2017: 5 · 2016: 3 · 2015: 2 · 2014: 10 · 2013: 7 · 2012: 12
FWCI: 3.27
Type: journal article
Language: en
Open access: green
europepmc.org
Licence: journals.asm.org/non-commercial-tdm-license (tdm)
Locations: Antimicrobial Agents and Chemotherapy (publishedVersion)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
ArTS Archivio della ricerca di Trieste (University of Trieste https://www.units.it/) (submittedVersion)
Funders: Pfizer
Topics: Health Sciences › Medicine › Epidemiology › Fungal Infections and Studies
Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
Life Sciences › Agricultural and Biological Sciences › Ecology, Evolution, Behavior and Systematics › Fungal Plant Pathogen Control
Keywords: Cryptococcus neoformans, azole resistance, fluconazole, voriconazole, heteroresistance, clonal subpopulations, cryptococcal meningitis, AIDS, temperature-dependent resistance, loss of resistance, serial isolates
MeSH terms: Acquired Immunodeficiency Syndrome, Adult, Amphotericin B, Antifungal Agents, Cryptococcus neoformans, Drug Resistance, Microbial, Humans, Hydrogen-Ion Concentration, Male, Microbial Sensitivity Tests, Osmolar Concentration, Phenotype, Pyrimidines, Staining and Labeling, Temperature, Triazoles, Fluconazole, Meningitis, Fungal, Itraconazole, Voriconazole

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

Heteroresistance to Fluconazole and Voriconazole in Cryptococcus neoformans

Abstract

Integrity signals

Claims the paper makes

Claims other papers make about this one

Self-check

Cites

Cited by

Related

Record

About these checks