Resistance mechanisms to fluconazole expressed by Candida glabrata: a situation to consider in therapy
Published
Jul 22, 2020
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Leidy Yurani Cárdenas Parra
https://orcid.org/0000-0001-7505-8539
Jorge Enrique Perez Cárdenas
https://orcid.org/0000-0002-7829-6505
https://orcid.org/0000-0001-7505-8539
Jorge Enrique Perez Cárdenas
https://orcid.org/0000-0002-7829-6505
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Abstract
Introduction: Therapeutic efforts aimed at treating mycosis caused by Candida spp. have focused on the use of azoles; however, their benefits have been subject to discussion in scientific literature, due to the extensive and well-described resistance mechanisms. Objective: To describe the resistance mechanisms to fluconazole expressed by the Candida glabrata species, so they are considered within the variables of eligibility for intervention. Method: An integrative review was carried out using the guiding question: what are the fluconazole resistance mechanisms expressed by the Candida glabrata species? Twenty-nine studies obtained from the PubMed database met the criteria for the critical analysis proposed by the PRISMA instrument, which was used for the selection of articles for review included in this paper. The analysis elements were organized in the following categories: overexpression of efflux pumps and modifications in the enzyme lanosterol 14-alpha-demethylase. Results: The resistance mechanisms to fluconazole expressed by Candida glabrata are mainly determined by the upregulation of Adenosine triphosphate Binding Cassette (ABC) pumps and by the modification of the point of attachment with its pharmacological target: the enzyme lanosterol 14-alpha-demethylase. Conclusion: The resistance mechanisms expressed by Candida glabrata are associated with the structural modification of the pharmacological target and the overexpression of efflux pumps, in a way different to other species. It is suggested that Candida glabrata is intrinsically less susceptible to fluconazole.
Keywords
Candida glabrata, Candida, Azole resistant, resistance, Azoles, Fluconazole (MeSH).Candida glabrata, Candida, Resistencia, Azoles, Fluconazol (DeCS)Candida glabrata; Candida; resistência; azóis; fluconazol
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4. Goemaere B, Becker P, Van Wijngaerden E, Maertens J, Spriet I, Hendrickx M, et al. Increasing candidaemia incidence from 2004 to 2015 with a shift in epidemiology in patients preexposed to antifungals. Mycoses. 2018;61(2):127-33. https://doi.org/10.1111/myc.12714
5. Sasso M, Roger C, Sasso M, Poujol H, Barbar S, Lefrant J-Y, et al. Changes in the distribution of colonising and infecting Candida spp. isolates, antifungal drug consumption and susceptibility in a French intensive care unit: A 10-year study. Mycoses. 2017;60(12):770-80. https://doi.org/10.1111/myc.12661
6. de Bedout C, Gómez BL. Candida and candidiasis: the challenge continues for an early diagnosis. Infectio. 2010;14:s159-71.
7. Valle GMM del. Candida glabrata: un patógeno emergente. Biociencias. 2016;10(1):89-102. https://doi.org/10.18041/2390-0512/bioc..1.2859
8. Rodríguez AZ, Gómez C de B, Restrepo CAA, Parra HH, Arteaga MA, Moreno AR, et al. [Susceptibility to fluconazole and voriconazole of Candida species isolated from intensive care units patients in Medellin, Colombia (2001-2007)]. Rev Iberoam Micol. 2010;27(3):125-9. https://doi.org/10.1016/j.riam.2010.04.001
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10. Tapia P C. Candida glabrata. Rev Chil Infectol. 2008;25(4):293-293. http://dx.doi.org/10.4067/S0716-10182008000400009
11. Olaechea P, Lerma FA, Martínez MP, Ordeñana JI, López-Pueyo MJ, Betolaza IS, et al. Evolución del consumo de antifúngicos en pacientes críticos. Estudio multicéntrico observacional, 2006-2010. Enferm Infecc Microbiol Clin. 2012;30(8):435-40. https://doi.org/10.1016/j.eimc.2012.02.006
12. Sanguinetti M, Posteraro B, Lass-Flörl C. Antifungal drug resistance among Candida species: mechanisms and clinical impact. Mycoses. 2015;58 Suppl 2:2-13. https://doi.org/10.1111/myc.12330
13. Florez J, Armijo JA, De Cost MA. Reacciones adversas a los medicamentos y farmacovigilancia. En: Flórez J, Armijo JA, editores. Farmacología humana. 5.a ed. Barcelona: Masson; 2008. p. 129-46.
14. Isaza G, Fuentes J, Marulanda T, Buriticá O, Machado J, Moncada J. Generalidades de farmacología. En: Isaza G, Fuentes J, Marulanda T, et al., editores. Fundamentos de farmacología en terapéutica. 6.a ed. Bogotá: Celsus; 2014. p. 27-31.
15. Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 21 de julio de 2009;6(7):e1000097. https://doi.org/10.1371/journal.pmed.1000097
16. Deorukhkar SC, Saini S. Virulence factors attributed to pathogenicity of non albicans Candida species isolated from Human Immunodeficiency virus infected patients with oropharyngeal candidiasis. Ann Pathol Lab Med. 2015;2(2):A62-66. https://doi.org/10.1155/2014/456878
17. Ahmad KM, Kokošar J, Guo X, Gu Z, Ishchuk OP, Piškur J. Genome structure and dynamics of the yeast pathogen Candida glabrata. FEMS Yeast Res. 2014;14(4):529-35. https://doi.org/10.1111/1567-1364.12145
18. Muller H, Hennequin C, Gallaud J, Dujon B, Fairhead C. The asexual yeast Candida glabrata maintains distinct a and alpha haploid mating types. Eukaryot Cell. 2008;7(5):848-58. https://doi.org/10.1128/EC.00456-07
19. Bairwa G, Rasheed M, Taigwal R, Sahoo R, Kaur R. GPI (glycosylphosphatidylinositol)-linked aspartyl proteases regulate vacuole homoeostasis in Candida glabrata. Biochem J. 2014;458(2):323-34. https://doi.org/10.1042/BJ20130757
20. Lesage G, Bussey H. Cell Wall Assembly in Saccharomyces cerevisiae. Microbiol Mol Biol Rev. 2006;70(2):317-43. https://doi.org/10.1128/MMBR.00038-05
21. Pontón J. La pared celular de los hongos y el mecanismo de acción de la anidulafungina. Rev Iberoam Micol. 2008;25(2):78-82. https://doi.org/10.1016/S1130-1406(08)70024-X
22. Chaffin WL, López-Ribot JL, Casanova M, Gozalbo D, Martínez JP. Cell wall and secreted proteins of Candida albicans: identification, function, and expression. Microbiol Mol Biol Rev MMBR. 1998;62(1):130-80
23. Okada H, Abe M, Asakawa-Minemura M, Hirata A, Qadota H, Morishita K, et al. Multiple functional domains of the yeast l,3-beta-glucan synthase subunit Fks1p revealed by quantitative phenotypic analysis of temperature-sensitive mutants. Genetics. 2010;184(4):1013-24. https://doi.org/10.1534/genetics.109.109892
24. Spanova M, Czabany T, Zellnig G, Leitner E, Hapala I, Daum G. Effect of lipid particle biogenesis on the subcellular distribution of squalene in the yeast Saccharomyces cerevisiae. J Biol Chem. 2010;285(9):6127-33. https://doi.org/10.1074/jbc.M109.074229
25. Base de datos en farmacología Drugbank. Fluconazole [Internet]. Washington: FDA. 2018 [citado 2018 oct 7]. Disponible en: https://www.drugbank.ca/drugs/DB00196
26. Tuck SF, Patel H, Safi E, Robinson CH. Lanosterol 14 alpha-demethylase (P45014DM): effects of P45014DM inhibitors on sterol biosynthesis downstream of lanosterol. J Lipid Res. 1991;32(6):893-902.
27. Fonseca E, Silva S, Rodrigues CF, Alves CT, Azeredo J, Henriques M. Effects of fluconazole on Candida glabrata biofilms and its relationship with ABC transporter gene expression. Biofouling. 2014;30(4):447-57. https://doi.org/10.1080/08927014.2014.886108
28. Castanheira M, Messer SA, Jones RN, Farrell DJ, Pfaller MA. Activity of echinocandins and triazoles against a contemporary (2012) worldwide collection of yeast and moulds collected from invasive infections. Int J Antimicrob Agents. 2014;44(4):320-6. https://doi.org/10.1016/j.ijantimicag.2014.06.007
29. Roetzer A, Gratz N, Kovarik P, Schüller C. Autophagy supports Candida glabrata survival during phagocytosis. Cell Microbiol. 2010;12(2):199-216. https://doi.org/10.1111/j.1462-5822.2009.01391
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How to Cite
Cárdenas Parra, L. Y., & Perez Cárdenas, J. E. (2020). Resistance mechanisms to fluconazole expressed by Candida glabrata: a situation to consider in therapy. Investigación En Enfermería Imagen Y Desarrollo, 22. https://doi.org/10.11144/Javeriana.ie22.mrfe
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