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Cited by 474Antifungal resistance and susceptibilityFungal and yeast genetics researchFungal Plant Pathogen Control

Candidiasis and Mechanisms of Antifungal Resistance

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Bhattacharya, Somanon, Sae-Tia, Sutthichai, Fries, Bettina C.·2020·Antibiotics
DOI 10.3390/antibiotics9060312PMC PMC7345657
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Abstract

Candidiasis can be present as a cutaneous, mucosal or deep-seated organ infection, which is caused by more than 20 types of Candida sp., with C. albicans being the most common. These are pathogenic yeast and are usually present in the normal microbiome. High-risk individuals are patients of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), organ transplant, and diabetes. During infection, pathogens can adhere to complement receptors and various extracellular matrix proteins in the oral and vaginal cavity. Oral and vaginal Candidiasis results from the overgrowth of Candida sp. in the hosts, causing penetration of the oral and vaginal tissues. Symptoms include white patches in the mouth, tongue, throat, and itchiness or burning of genitalia. Diagnosis involves visual examination, microscopic analysis, or culturing. These infections are treated with a variety of antifungals that target different biosynthetic pathways of the pathogen. For example, echinochandins target cell wall biosynthesis, while allylamines, azoles, and morpholines target ergosterol biosynthesis, and 5-Flucytosine (5FC) targets nucleic acid biosynthesis. Azoles are commonly used in therapeutics, however, because of its fungistatic nature, Candida sp. evolve azole resistance. Besides azoles, Candida sp. also acquire resistance to polyenes, echinochandins, and 5FC. This review discusses, in detail, the drug resistance mechanisms adapted by Candida sp.

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  • The obtained results are consistent with recent studies, which noticed that due to the wide usage of azole drugs and prolonged antifungal therapy, the number of azole-resistant Candida isolates is still increasing.

    “The obtained results are consistent with recent studies, which noticed that due to the wide usage of azole drugs and prolonged antifungal therapy, the number of azole-resistant Candida isolates is still increasing (Bhattacharya et al. 2020; Zhang et al. 2020; Tan et al. 2021).”

    From In vitro study on the potential fungicidal effects of atorvastatin in combination with some azole drugs against multidrug resistant Candida albicans (2021) · cites this paper as Bhattacharya et al. 2020

    Section 3, “Drug Efficacies and Therapeutic Failure” (page not provided), says prolonged azole use may cause Candida to develop resistance and describes resistance as an emerging problem. It does not establish that the number of azole-resistant Candida isolates is still increasing; its example of steadily increasing resistance concerns isolates from one patient, not a broader rise in isolate numbers. (LLM, conf=0.86)

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Cited by

Sorted by citations

Authors
Bhattacharya, S., Sae-Tia, S., & Fries, B. C.
Affiliations
  • Stony Brook University (US)
  • Northport VA Medical Center (US)
Corresponding author
Bhattacharya, Somanon
ORCID
Venue
Antibiotics
Publisher
MDPI AG
Published
2020-06-09
Volume
9
Issue
6
Pages
312
ISSN
2079-6382 (ISSN-L)
DOI
10.3390/antibiotics9060312
PMC
PMC7345657
OpenAlex
W3034483708
Cited by
474
References
25
Citations by year
2026: 39 · 2025: 81 · 2024: 104 · 2023: 77 · 2022: 101 · 2021: 64 · 2020: 8
FWCI
2.98
Type
journal article
Language
en
Open access
Licence
Locations
  • Antibiotics (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
National Institute of Health (NIH) (NIH 1R01AI127704)
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
candidiasis, antifungal resistance, Candida albicans, Candida, azole resistance, echinocandin resistance, polyene resistance, 5-fluorocytosine, ergosterol biosynthesis, cell wall biosynthesis, oral candidiasis, vaginal candidiasis, HIV/AIDS, immunosuppression, diabetes mellitus, antifungal therapy

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