Overexpression and mutation as a genetic mechanism of fluconazole resistance in Candida albicans isolated from human immunodeficiency virus patients in Indonesia

Rosana, Yeva; Yasmon, Andi; Lestari, Delly Chipta

doi:10.1099/jmm.0.000123

Cited by 30 publications

(22 citation statements)

References 22 publications

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“…In fact, studies have demonstrated that Candida isolated from HIV‐positive patients is more likely to show fluconazole resistance. In Indonesia, Rosana, Yasmon and Lestari studied C. albicans oral isolates from HIV‐positive patients and observed fluconazole resistance in 13% of isolates as well as one isolated that was resistant to fluconazole and voriconazole. An Iranian study with C. albicans isolates from HIV‐positive patients with oropharyngeal candidiasis found that 25.97% were resistant to fluconazole .…”

Section: Discussioncontrasting

confidence: 53%

“…In C. tropicalis , azole resistance was already related to ERG11 gene mutations and overexpression and ERG3 gene mutations . HIV‐positive patients frequently use fluconazole for Candida infection treatment, which leads to increased tolerance and resistance to this antifungal and even cross resistance to other azoles . In fact, studies have demonstrated that Candida isolated from HIV‐positive patients is more likely to show fluconazole resistance.…”

Section: Discussionmentioning

confidence: 99%

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Prevalence, virulence factors and antifungal susceptibility ofCandidaspp. isolated from bloodstream infections in a tertiary care hospital in Brazil

Canela

Cardoso

Vitali

et al. 2017

Mycoses

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SummaryCandida spp. are responsible for 80% of all systemic fungal infections and are associated with high mortality rates. This study characterised 79 bloodstream isolates of C. albicans, C. glabrata, C. orthopsilosis, C. parapsilosis and C. tropicalis from patients in a Brazilian hospital. The susceptibility to amphotericin B, caspofungin, fluconazole and voriconazole was determined; virulence factor production was assessed based on haemolysin, phospholipase and proteinase activities, and the patients' clinical characteristics were analysed. C. albicans was the predominant species (44%), followed by C. glabrata (19%), C. tropicalis (19%), C. parapsilosis (14%) and C. orthopsilosis (4%). The candidemia incidence was 1.52 per 1000 admissions, and the crude mortality rate was 52%. One C. albicans isolate was resistant to fluconazole and voriconazole. Moreover, 20.2%, 2.5% and 3.8% of the isolates exhibited dosedependent susceptibility to fluconazole, voriconazole and caspofungin, respectively.In conclusion, although the C. glabrata incidence was higher than that usually described in Brazil, its increase was previously observed in studies conducted worldwide. Furthermore, the azole resistance of the C. albicans isolate could be due to previous exposure to these antifungals. These results highlight the importance of epidemiological studies and will facilitate an improved understanding of candidemia in the studied hospital. K E Y W O R D Santifungal susceptibility, Candida spp., candidemia, virulence factors

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Section: Discussioncontrasting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Prevalence, virulence factors and antifungal susceptibility ofCandidaspp. isolated from bloodstream infections in a tertiary care hospital in Brazil

Canela

Cardoso

Vitali

et al. 2017

Mycoses

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“…In several of the studies, the frequency of fluconazole-resistant C. albicans was reported to be 9.3, 12.2, 16, 17.6, 25.97, and 56.7%, whereas the frequency of fluconazole-resistant C. glabrata was reported to range from 50 to 52% (Nadagir et al, 2008 ; Mulu et al, 2013 ; Ho et al, 2014 ; Katiraee et al, 2015 ; Rosana et al, 2015 ; Salari et al, 2016 ; Terças et al, 2017 ). C. glabrata possesses the ability to develop resistance to fluconazole after exposure, whereas C. krusei has innate resistance to this anti-fungal agent (Terças et al, 2017 ).…”

Section: Candida Profile In Aids Patients In the Post-haart mentioning

confidence: 99%

“…Acquired resistance is uncommon but has been reported to be escalating at present (Cassone and Cauda, 2012 ; Pfaller, 2012 ; Sanguinetti et al, 2015 ). The collected data show that the frequency of resistant C. albicans in HIV-positive patients ranges from 9.3 to 56.7% (Nadagir et al, 2008 ; Mulu et al, 2013 ; Ho et al, 2014 ; Katiraee et al, 2015 ; Rosana et al, 2015 ; Salari et al, 2016 ; Terças et al, 2017 ). Acquired resistance to fluconazole is mainly attributed to repeated and prolonged exposure or suppressive courses of low doses of the drug combined with severe immune suppression (Patton et al, 2001 ; Lortholary et al, 2012 ; Liu et al, 2015 ).…”

Section: Current Therapeutic Challengesmentioning

confidence: 99%

Oropharyngeal Candidosis in HIV-Infected Patients—An Update

Patil

Majumdar²,

Sarode

et al. 2018

Front. Microbiol.

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Oropharyngeal candidosis (OPC) is an opportunistic fungal infection that is commonly found in HIV-infected patients, even in the twenty-first century. Candida albicans is the main pathogen, but other Candida species have been isolated. OPC usually presents months or years before other severe opportunistic infections and may indicate the presence or progression of HIV disease. The concept of OPC as a biofilm infection has changed our understanding of its pathobiology. Various anti-fungal agents (both topical and systemic) are available to treat OPC. However, anti-fungal resistance as a result of the long-term use of anti-fungal agents and recurrent oropharyngeal infection in AIDS patients require alternative anti-fungal therapies. In addition, both identifying the causative Candida species and conducting anti-fungal vulnerability testing can improve a clinician's ability to prescribe effective anti-fungal agents. The present review focuses on the current findings and therapeutic challenges for HIV-infected patients with OPC.

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“…Acquired resistance to fluconazole has been reported in C. albicans isolates from patients with advanced AIDS, receiving prolonged azole treatment [6, 7]. As evidences from different recent studies suggest, there has been a shift towards fluconazole resistance in other Candida species, particularly C. glabrata [8-10].…”

Section: Introductionmentioning

confidence: 99%

In vitro activity of econazole in comparison with three common antifungal agents against clinical Candida strains isolated from superficial infections

Abastabar

Shokohi

et al. 2015

mazu-cmm

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Background and Purpose: Candida species are the most common organisms involved in superficial fungal infections, worldwide. Although econazole is among the most frequently used topical formulations for the treatment of candidiasis, no information is available regarding the susceptibility profiles of Candida species in Iran.Materials and Methods: In vitro susceptibility of 100 clinical Candida isolates belonging to 6 species from superficial candidiasis of Iran towards to econazole was compared with three other common antifungal agents including itraconazole, fluconazole, and miconazole. Minimum inhibitory concentrations (MICs) values were analyzed according to the Clinical and Laboratory Standards Institute (CLSI) M38-A3 document. All isolates were previously identified to the species level, using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) on ITS region. Results:The MIC of econazole, itraconazole, miconazole, and fluconazole were within the range of 0.016-16, 0.032-16, 0.016-16, and 0.25-64 μg/ml, respectively. In general, econazole and miconazole were more active against Candida isolates, compared to the other two agents.Conclusion:The present study demonstrated that for Candida albicans isolates, miconazole and econazole had the best effect, but in non-albicans Candida species, itraconazole and miconazole displayed more activity than other antifungal agents.

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Overexpression and mutation as a genetic mechanism of fluconazole resistance in Candida albicans isolated from human immunodeficiency virus patients in Indonesia

Cited by 30 publications

References 22 publications

Prevalence, virulence factors and antifungal susceptibility ofCandidaspp. isolated from bloodstream infections in a tertiary care hospital in Brazil

Prevalence, virulence factors and antifungal susceptibility ofCandidaspp. isolated from bloodstream infections in a tertiary care hospital in Brazil

Oropharyngeal Candidosis in HIV-Infected Patients—An Update

In vitro activity of econazole in comparison with three common antifungal agents against clinical Candida strains isolated from superficial infections

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