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Fluconazole resistance in Candida species: a current perspective

Authors Berkow EL, Lockhart SR

Received 26 April 2017

Accepted for publication 13 July 2017

Published 31 July 2017 Volume 2017:10 Pages 237—245

DOI https://doi.org/10.2147/IDR.S118892

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Akshita Wason

Peer reviewer comments 3

Editor who approved publication: Professor Suresh Antony

Elizabeth L Berkow, Shawn R Lockhart

Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA

Abstract: Candida albicans and the emerging non-albicans Candida spp. have significant clinical relevance among many patient populations. Current treatment guidelines include fluconazole as a primary therapeutic option for the treatment of these infections, but it is only fungistatic against Candida spp. and both inherent and acquired resistance to fluconazole have been reported. Such mechanisms of resistance include increased drug efflux, alteration or increase in the drug target, and development of compensatory pathways for producing the target sterol, ergosterol. While many mechanisms of resistance observed in C. albicans are also found in the non-albicans species, there are also important and unexpected differences between species. Furthermore, mechanisms of fluconazole resistance in emerging Candida spp., including the global health threat Candida auris, are largely unknown. In order to preserve the utility of one of our fundamental antifungal drugs, fluconazole, it is essential that we fully appreciate the manner by which Candida spp. manifest resistance to it.

Keywords: Candida, fluconazole resistance, ERG11, drug efflux, ergosterol

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