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Cited by 229Antifungal resistance and susceptibilityFungal and yeast genetics researchYeasts and Rust Fungi Studies

Candida albicans Antifungal Resistance and Tolerance in Bloodstream Infections: The Triad Yeast-Host-Antifungal

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Costa-de-Oliveira, Sofia, Rodrigues, Acácio G.·2020·Microorganisms
DOI 10.3390/microorganisms8020154PMC PMC7074842
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Abstract

Candida albicans represents the most frequent isolated yeast from bloodstream infections. Despite the remarkable progress in diagnostic and therapeutic approaches, these infections continue to be a critical challenge in intensive care units worldwide. The economic cost of bloodstream fungal infections and its associated mortality, especially in debilitated patients, remains unacceptably high. Candida albicans is a highly adaptable microorganism, being able to develop resistance following prolonged exposure to antifungals. Formation of biofilms, which diminish the accessibility of the antifungal, selection of spontaneous mutations that increase expression or decreased susceptibility of the target, altered chromosome abnormalities, overexpression of multidrug efflux pumps and the ability to escape host immune defenses are some of the factors that can contribute to antifungal tolerance and resistance. The knowledge of the antifungal resistance mechanisms can allow the design of alternative therapeutically options in order to modulate or revert the resistance. We have focused this review on the main factors that are involved in antifungal resistance and tolerance in patients with C. albicans bloodstream infections.

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  • At present, clinical isolates of Candida spp. are considered to be one of the highly resistant fungi to most traditional antifungal drugs.

    “At present, clinical isolates of Candida spp. are considered to be one of the highly resistant fungi to most traditional antifungal drugs(Costa-de-oliveira and Rodrigues 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 Costa-de-oliveira and Rodrigues 2020

    The Conclusions (section 5; page unavailable) say that C. albicans has low in vitro resistance to antifungal drugs, contrary to describing Candida clinical isolates as highly resistant to most traditional antifungals. The review discusses how resistance can develop, but does not characterize it as generally high. (LLM, conf=0.86)

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Cited by

Sorted by citations

Authors
Costa-de-Oliveira, S., & Rodrigues, A. G.
Affiliations
  • Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Al. Hernâni Monteiro, 4200-319 Porto, Portugal
  • Universidade do Porto (PT)
ORCID
Venue
Microorganisms
Publisher
MDPI AG
Published
2020-01-22
Volume
8
Issue
2
Pages
154
ISSN
2076-2607 (ISSN-L)
DOI
10.3390/microorganisms8020154
PMC
PMC7074842
OpenAlex
W3002296030
Cited by
229
References
26
Citations by year
2026: 34 · 2025: 41 · 2024: 41 · 2023: 43 · 2022: 28 · 2021: 30 · 2020: 12
FWCI
1.33
Type
journal article
Language
en
Open access
Licence
Locations
  • Microorganisms (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
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 › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Yeasts and Rust Fungi Studies
Keywords
Candida albicans, bloodstream infection, antifungal resistance, antifungal tolerance, biofilm, multidrug efflux pumps, host immune evasion, antifungal susceptibility, intensive care unit patients

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