Antimicrobial resistance: resistance to antifungal agents: mechanisms and clinical impact.

Journal Article (Journal Article;Review)

Despite advances in preventive, diagnostic, and therapeutic interventions, invasive fungal infections cause significant morbidity and mortality in immunocompromised patients. The burden of antifungal resistance in such high-risk patients is becoming a major concern. A better understanding of the mechanisms and clinical impact of antifungal resistance is essential to the prompt and efficient treatment of patients with invasive mycoses and to improving the outcome of such infections. Although recent guidelines have attempted to standardize antifungal susceptibility testing, limitations still exist as a result of the incomplete correlation between in vitro susceptibility and clinical response to treatment. Four major mechanisms of resistance to azoles have been identified, all of which rely on altered gene expression. Mechanisms responsible for polyene and echinocandin resistance are less well understood. In addition to discussing the molecular mechanisms of antifungal resistance, this article elaborates on the concept of clinical resistance, which is critical to the understanding of treatment failure in patients with invasive fungal infections.

Full Text

Duke Authors

Cited Authors

  • Kanafani, ZA; Perfect, JR

Published Date

  • January 1, 2008

Published In

Volume / Issue

  • 46 / 1

Start / End Page

  • 120 - 128

PubMed ID

  • 18171227

Electronic International Standard Serial Number (EISSN)

  • 1537-6591

Digital Object Identifier (DOI)

  • 10.1086/524071


  • eng

Conference Location

  • United States