Current Fungal Infection Reports

, Volume 5, Issue 1, pp 23–28 | Cite as

Fluconazole-Resistant Candida: Mechanisms and Risk Factor Identification

Article

Abstract

The extensive use of fluconazole in the previous two decades has fostered the emergence of azole-resistant strains, including non-albicans species such as C. glabrata. The main mechanisms of fluconazole resistance described involve alteration of the quality or quantity of 14-alpha-demethylase enzyme or reduced access of the drug to the target enzyme by upregulation of efflux pumps. Fluconazole prophylaxis has been used successfully to prevent fungal infections in high-risk neonates, neutropenic patients, individuals with HIV infection, recipients of solid organ (eg, liver) transplants and bone marrow transplants, and patients in intensive care units, with a small increase in the risk of colonization, but not infection, with fluconazole-resistant Candida isolates. Among other risk factors, recent fluconazole exposure is associated with fluconazole-resistant candidemia.

Keywords

Fluconazole Candida Azole resistance Mechanisms Risk factors Prophylaxis 

Notes

Disclosure

No potential conflicts of interest relevant to this article were reported.

References

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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Division of Infectious DiseasesUniversity of Texas Medical SchoolHoustonUSA
  2. 2.Infectious Diseases Section, Department of MedicineTulane University School of MedicineNew OrleansUSA

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