Summary
Fungal resistance is caused by an acquisition of intrinsically resistant species, by selection of resistant strains from a population or by mutation of an initially susceptible strain. According to different classes of antimycotics there are different resistance mechanisms: differences in the uptake mechanisms, drug target alterations, mostly the ergosterolbiosynthesis pathway, and the efflux or pumping mechanisms to the outside.
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Rex, J. H., Rinaldi, M. G., Pfaller, M. A.: Resistance ofCandida species to fluconazole. Antimicrob. Agents Chemother. 39 (1995) 1–8.
Fridkin, S. K., Jarvis, W. R.: Epidemiology of nosocomial fungal infections. Clin. Microbiol. Rev. 9 (1996) 499–511.
Laguma, F., Rodriguez-Tudela, J. C., Martinez-Suarez, J. V.: Patterns of fluconazole susceptibility in isolates for human immunodeficiency virus-infected patients with oropharyngeal candidiasis due toCandida albicans. Clin. Infect. Dis. 23 (1996) 125–130.
Paya, C. V.: Fungal infections in solid-organ transplantation. Clin. Infect. Dis. 16 (1993) 677–688.
Schmalreck, A. F., Kottmann, I., Reiser, A., Tränkle, P., Vanca, E.: Improvement of testing of fluconazole (FCA), voriconazole (VOR) and itraconazole (ITR) by modification of recommended media for yeast susceptibility testing. Clin. Microbiol. Infect. 5 (Suppl. 3) (1999) 400.
Van den Bossche, H., Marichal, P., Odds, F. C.: Molecular mechanisms of drug resistance in fungi. Trends in Microbiology 2 (1994) 393–400.
Van den Bossche, H.: Anti-candida drugs: the biochemical basis for their activity. Crit. Rev. Microbiol. 15 (1987) 57–72.
Walsh, Th. J., Melcher, G. P., Rinaldi, M. G., Lecciones, J., McGough, D. A., Kelly, P., Lee, J., Callender, D., Rubin, M., Pizzo, P. A.:Trichosporon beigelii, an emerging pathogen resistant to amphotericin B. J. Clin. Microbiol. 7 (1990) 1616–1622.
Alexander, B. D., Perfect, J. R.: Antifungal resistance trends towards the year 2000. Drugs 51 (1997) 657–678.
Kelly, S. L., Lamb, D. C., Taylor, M.: Resistance to amphotericin B associated with defective sterol Δ8→7 isomerase in aCryptococcus neoformans strain from an AIDS patient. FEMS Microbiol. Lett. 122 (1994) 39–42.
Nolte, F. S., Parkinson, T., Falconer, D. J.: Isolation and characterization of fluconazole- and amphotericin B-resistantCandida albicans from blood of two patients with leukemia. Antimicrob. Agents Chemother. 41 (1997) 196–199.
Sugar, A. M.: Use of amphotericin B with azole antifungal drugs: what are we doing? Antimicrob. Agents Chemother. 39 (1995) 1907–1912.
Van den Bossche, H., Dromer, F., Improvisi, I., Lozano-Chiu, M., Rex, J. H., Sanglards, D.: Antifungal drug resistance in pathogenic fungi. Med. Mycol. 36 (1998) 119–128.
Franz, R., Kelly, St. L., Lamb, D. C., Kelly, D. E., Ruhnke, M., Morschhäuser, J.: Multiple molecular mechanisms contribute to a stepwise development of fluconazole resistance in clinicalCandida albicans strains. Antimicrob. Agents Chemother. 42 (1998) 3065–3072.
Watson, P. F., Rose, M. E., Ellis, S. W.: Defective sterol C5-6 desaturation and azole resistance: a new hypothesis for the mode of action of azole antifungals. Biochem. Biophys. Res. Commun. 164 (1989) 1170–1175.
Denning, D. W., Baily, G. G., Hood, S. V.: Azole resistance inCandida. Eur. J. Clin. Microbiol. Infect. Dis. 16 (1997) 261–280.
Sanglard, D., Kuchler, K., Ischer, E., Pagani, J.-L., Monod, M., Bille, J.: Mechanisms of resistance to azole antifungal agents inCandida albicans isolates from AIDS patients involve specific multidrug transporters. Antimicrob. Agents Chemother. 39 (1995) 2378–2386.
Dupont, B. F., Dromer, F., Improvisi, L.: The problem of azole resistance inCandida. J. Mycol. Med. 6 (1996) 12–19.
Belanger, P., Nast, C. C., Fratti, R., Sanati, H., Ghannoum, M.: Voriconazole (UK-109,496) inhibits the growth and alters the morphology of fluconazole-susceptible and-resistantCandida species. Antimicrob. Agents Chemother. 41 (1997) 1840–1842.
Manavathu, E. K., Cutright, J. L., Chandrasekar, P. H.: Organismdependent fungicidal activities of azoles. Antimicrob. Agents Chemother. 42 (1998) 3018–3021.
McGinnis, M. R., Pasarell, L., Sutton, D. A., Fothergill, A. W., Cooper, Ch. R., Rinaldi, M. G.:In vitro evaluation of voriconazole against some clinically important fungi. Antimicrob. Agents Chemother. 41 (1997) 1832–1834.
Pfaller, M. A., Marco, F., Messer, S. A., Jones, R. N.:In vitro activity of two echinocandin derivatives, LY303366 and MK-0991 (L-743,792), against clinical isolates ofAspergillus, Fusarium, Rhizopus, and other filamentous fungi. Diagn. Microbiol. Infect. Dis. 30 (1998) 251–255.
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Bernhardt, H., Zimmermann, K. & Knoke, M. Fungal resistance. Infection 27 (Suppl 2), S52–S54 (1999). https://doi.org/10.1007/BF02561673
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DOI: https://doi.org/10.1007/BF02561673