Journal of Clinical and Diagnostic Research (Sep 2018)
Molecular Mechanisms of Antifungal Drug Resistance in Candida Species
Abstract
Invasive Candidal infections have emerged as one of the major threats to the world. Although, many new antifungal drugs have been developed in the recent years, the emergence of drug resistance has become a major deterrent in the antifungal therapy. Candida develops several molecular mechanisms to resist the exposure to antifungal drugs. Prolonged treatment in patients may trigger development of resistance to the prescribed drugs. Most of the antifungal therapeutic agents being fungistatic rather than fungicidal are the key reason for selection of resistant Candida strains. Overexpression or mutation of the target enzymes as well as transcriptional activation of genes encoding the drug efflux pumps of ATP Binding Cassette (ABC) and Major Facilitator Superfamilies (MFS) are some of the factors implicated in the development of drug resistance. Basic understanding of the underlying molecular mechanisms of antifungal drug resistance and their clinical impact is vital in planning of the effective management of Candidal infections. There is an interesting possibility of antifungal resistance in Candida becoming a marker in the assessment of the outcome of antifungal therapy in the future. This review describe and summarises the molecular mechanisms of drug resistance in candida species.
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