Current and future approaches to antimycotic treatment in the era of resistant fungi and immunocompromised hosts

Bastert, J.; Schaller, Martin; Korting, H.C.; Evans, E. G. V.

doi:10.1016/s0924-8579(00)00323-x

Cited by 47 publications

(35 citation statements)

References 92 publications

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“…In some cases, especially for Candida, there is a tendency of pathogen shift from C. albicans to less sensitive species such as C. glabrata and C. krusei, thus reducing the number of available, effective antifungal agents (Bastert et al, 2001). The high cost of antifungal agents also renders them unaffordable by the majority of the population in developing countries including Tanzania, where resources are limited (Moshi et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

Screening of traditionally used Tanzanian medicinal plants for antifungal activity

Kisangau

Hosea

Lyaruu

et al. 2009

Pharmaceutical Biology

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Section: Introductionmentioning

confidence: 99%

Screening of traditionally used Tanzanian medicinal plants for antifungal activity

Kisangau

Hosea

Lyaruu

et al. 2009

Pharmaceutical Biology

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“…Among problems that hamper effective management of Candida infections in these countries include; limited number of effective antifungal agents, toxicity of the available antifungal agents, resistance of Candida to commonly used antifungals, relapse of candida infections and the high cost of antifungal agents (Debruyne, 1997;Sangeorzan et al, 1994). Reports of resistance to commonly used antifungal agents like fluconazole abound (Ruhnke et al, 1994;Redding et al, 1994), including shifts from Candida albicans to less sensitive species such as Candida glabrata and Candida krusei (Bastert et al, 2001;Powderly, 1992). When relapses occur, the infections tend to be increasingly refractory to treatment.…”

Section: Introductionmentioning

confidence: 99%

Brine Shrimp Toxicity Evaluation Of Some Tanzanian Plants Used Traditionally For The Treatment Of Fungal Infections

Moshi¹,

Beukel²,

Hamza³

et al. 2008

Afr. J. Trad. Compl. Alt. Med.

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“…Candida albicans, a dimorphic opportunistic human pathogen, is the most prominent cause of oropharyngeal, vaginal, and invasive candidiasis in humans (3). In particular, oropharyngeal infections are very common in human immunodeficiency virus (HIV)-infected individuals and patients with AIDS, while deep-seated infections are frequent in neutropenic patients (27,31).…”

mentioning

confidence: 99%

Increase of Virulence and Its Phenotypic Traits in Drug-Resistant Strains of Candida albicans

Angiolella

Stringaro²,

Bernardis

et al. 2008

Antimicrob Agents Chemother

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There is concern about the rise of antifungal drug resistance, but little is known about comparative biological properties and pathogenicity of drug-resistant strains. We generated fluconazole (FLC; CO23 RFLC )-or micafungin (FK; CO23 RFK )-resistant strains of Candida albicans by treating a FLC-and FK-susceptible strain of this fungus (CO23 S ) with stepwise-increasing concentrations of either drug. Molecular analyses showed that CO23 RFLC had acquired markedly increased expression of the drug-resistance efflux pump encoded by the MDR1 gene, whereas CO23 RFK had a homozygous mutation in the FSK1 gene. These genetic modifications did not alter to any extent the growth capacity of the drug-resistant strains in vitro, either at 28°C or at 37°C, but markedly increased their experimental pathogenicity in a systemic mouse infection model, as assessed by the overall mortality and target organ invasion. Interestingly, no apparent increase in the vaginopathic potential of the strains was observed with an estrogen-dependent rat vaginal infection. The increased pathogenicity of drug-resistant strains for systemic infection was associated with a number of biochemical and physiological changes, including (i) marked cellular alterations associated with a different expression and content of major cell wall polysaccharides, (ii) more rapid and extensive hypha formation in both liquid and solid media, and (iii) increased adherence to plastic and a propensity for biofilm formation. Overall, our data demonstrate that experimentally induced resistance to antifungal drugs, irrespective of drug family, can substantially divert C. albicans biology, affecting in particular biological properties of potential relevance for deep-seated candidiasis.

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Current and future approaches to antimycotic treatment in the era of resistant fungi and immunocompromised hosts

Cited by 47 publications

References 92 publications

Screening of traditionally used Tanzanian medicinal plants for antifungal activity

Screening of traditionally used Tanzanian medicinal plants for antifungal activity

Brine Shrimp Toxicity Evaluation Of Some Tanzanian Plants Used Traditionally For The Treatment Of Fungal Infections

Increase of Virulence and Its Phenotypic Traits in Drug-Resistant Strains of Candida albicans

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