Population dynamics and the evolution of antifungal drug resistance in Candida albicans

Abstract

Candida albicans is an important human fungal pathogen. Resistance to all major antifungal agents has been observed in clinical isolates of Candida spp. and is a major clinical challenge. The rise and expansion of drug-resistant mutants during exposure to antifungal agents occurs through a process of adaptive evolution, with potentially complex population dynamics. Understanding the population dynamics during the emergence of drug resistance is important for determining the fundamental principles of how fungal pathogens evolve for resistance. While few detailed reports that focus on the population dynamics of C. albicans currently exist, several important features on the population structure and adaptive landscape can be elucidated from existing evolutionary studies in in vivo and in vitro systems.

Synergistic effects of tea catechin epigallocatechin gallate and antimycotics against oral Candida species

“…This rising problem is largely related to the resistance of Candida species to conventional antifungal agents. Drug resistance may be contributed by a series of mechanisms, including biofilm formation, changes in ergosterol, decreased permeability of cell membranes and an enhanced efflux system (Huang & Kao, 2012;Gao et al, 2013). Strategies to resolve this problem have focused on searching for new antimycotics, developing new formulations or strengthening the effects of antimycotics by using them in combinations (Andes et al, 2006;Sharma, Maarlal, Negi, & Prasad, 2010).…”

Effects of Cinnamaldehyde, Ocimene, Camphene, Curcumin and Farnesene on <i>Candida albicans</i>

“…It indicates that plant molecules tested could find use in combination therapy against difficult-to-treat infections of C. albicans [9] [14]- [16]. It is significant as it could lower the dosage further reducing risk of side effects associated with higher dosage and prolonged use of antifungal agents [8] [9] [14]- [16]. Synergistic activity was found to be dependent on accessibility of the cells i.e.…”

“…Being eukaryotic organisms, fungal specific drug targets are very few and thus limited numbers of antifungal agents like azoles, polyenes, allylamines, and echinocandins etc., are available in the market [7]. Among these, azoles and polyenes were the most promising ones but emergence of azole resistance among the C. albicans isolates and severe toxicities of polyenes in hosts has limited their use especially in difficult-to-treat infections like biofilms and invasive candidaisis [8] [9]. This situation has compelled scientific community to expedite the search for novel, potent and host friendly antifungal agents as well as look for alternative options like combination antifungal therapy [7]- [10].…”

In vitro evaluation of the acquisition of resistance, antifungal activity and synergism of Brazilian red propolis with antifungal drugs on Candida spp.

“…; Pfaller ). The limited number of therapeutic options and the inappropriate use of antifungal drugs cause selection of resistant micro‐organisms (Huang and Kao ). Besides prolonging and increasing the costs of hospitalizations (Tortorano et al .…”