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

The DOI matches its Crossref record; 36 of the 36 references it cites were found in a registry or an index.

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?

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
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
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
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
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
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
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
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
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
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

Flagged first, then by citations

Show all 36 references

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
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
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
Microbial Cell Individuality and the Underlying Sources of Heterogeneity
Avery, S. V. (2006) · Nature Reviews Microbiology · doi:10.1038/nrmicro1460 · Cited by 521
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
Self-citation
Untitled work
(2014) · doi:10.1128/cmr.00126-13 · Cited by 437
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
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 302
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
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
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
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 253
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 229
New Horizons in Antifungal Therapy
Pianalto, K. M., & Alspaugh, J. A. (2016) · Journal of Fungi · doi:10.3390/jof2040026 · Cited by 197
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
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
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
Combatting the evolution of antifungal resistance in Cryptococcus neoformans
Bermas, A., & Geddes‐McAlister, J. (2020) · Molecular Microbiology · doi:10.1111/mmi.14565 · Cited by 143
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 127
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 123
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
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
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
Drug resistance in Cryptococcus neoformans
Perfect, J. R., & Cox, G. M. (1999) · Drug Resistance Updates · doi:10.1054/drup.1999.0090 · Cited by 106
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
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 96
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
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
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
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
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 76
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 79
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 74
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 72
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
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
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 66
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
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
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 63
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
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
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
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
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 56
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 49
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 50
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 46
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
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
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
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
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
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 41
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 40
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
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
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
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
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
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
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
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 33
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
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 31
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
Heteroresistance and fungi
Ferreira, G. F., & Santos, D. A. (2017) · Mycoses · doi:10.1111/myc.12639 · Cited by 26
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
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
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
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
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
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
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
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
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
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
Molecular Principles of Antifungal Drug Resistance
Sanglard, D., & White, T. C. (2014) · ASM Press eBooks · doi:10.1128/9781555815776.ch14 · Cited by 19
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
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
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 17
Infection Control - Updates
Sudhakar, C. (2012) · InTech eBooks · doi:10.5772/2251 · Cited by 16
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
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
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 15
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
In vivo development of fluconazole resistance in serial Cryptococcus gattii isolates 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
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
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
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 13
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 13
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 12
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
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
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
Cryptococcus neoformans: a Sugar-Coated Killer
Perfect, J. R. (2014) · ASM Press eBooks · doi:10.1128/9781555815776.ch21 · Cited by 9
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
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
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
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

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 › Infectious Diseases › Fungal Infections and Studies
Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
Life Sciences › Agricultural and Biological Sciences › Plant Science › 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

Overview

Integrity signals

Verification

Claims the paper makes

Claims other papers make about this one

Self-check

Citations

Cites

Cited by

Related

Metadata

Record

About these checks