Mellado Emilia, Cuenca-Estrella Manuel, Rodríguez-Tudela Juan Luis
Unidad de Micología. Centro Nacional de Microbiología. Instituto de Salud Carlos III. Madrid. España.
Enferm Infecc Microbiol Clin. 2002 Dec;20(10):523-29; quiz 530, 539. doi: 10.1016/s0213-005x(02)72856-5.
In the last years, the incidence of the invasive infection by moulds has increased. Also, the characteristics of invasive mycosis are changing due to the description of new pathogenic species and also because strains and species resistant to antifungal drugs are appearing. The development of mould antifungal drug resistance is the inevitable and logical consequence of their clinical use, although the frequency and clinical relevance of this is unknown. In this text current mould antifungal drugs resistance mechanisms are reviewed. The study of molecular mechanisms of antifungal drug resistance is the most valuable strategy to resistance development control and also in helping to develop safer and more active molecules able to avoid them. In the meanwhile is important the correct use of the available tools: epidemiological surveillance of resistance emergence and to use all the efforts towards prompt diagnosis in order to accomplish an adequate and effective treatment.
在过去几年中,霉菌侵袭性感染的发生率有所上升。此外,由于新致病菌种的发现以及对抗真菌药物耐药的菌株和菌种的出现,侵袭性真菌病的特征也在发生变化。霉菌抗真菌药物耐药性的产生是其临床应用不可避免的合理结果,尽管其发生频率和临床相关性尚不清楚。本文综述了目前霉菌抗真菌药物的耐药机制。对抗真菌药物耐药分子机制的研究是控制耐药性发展的最有价值策略,同时也有助于开发能够避免耐药性的更安全、活性更强的分子。与此同时,正确使用现有工具也很重要:对抗药性出现进行流行病学监测,并尽一切努力进行快速诊断,以实现充分有效的治疗。