Room 304 West Patient Tower, LeBonheur Children's Medical Center, 50 North Dunlap Street, Memphis, TN 38103, USA.
Curr Infect Dis Rep. 2006 Nov;8(6):449-56. doi: 10.1007/s11908-006-0019-3.
The incidence of fungal infections has increased in recent years, particularly among immunocompromised individuals. Treatment of invasive fungal infections has been hampered by a limited number of available antifungal agents and both intrinsic and acquired resistance to these agents among many fungal pathogens. Therefore, much interest has focused on elucidating the molecular basis for antifungal resistance. Recent efforts have increased our understanding of this process, including the transcriptional regulation of azole resistance in Candida spp, mechanisms of intrinsic resistance to amphotericin B, and mechanisms of acquired resistance to the new echinocandin class of antifungal agents. This review discusses these and other newly clarified resistance mechanisms, as well as the direction of future antifungal resistance research. Despite these advances, undiscovered resistance determinants exist, and resistance to newer agents likely will continue to emerge.
近年来，真菌感染的发病率有所增加，尤其是在免疫功能低下的人群中。由于可用的抗真菌药物数量有限，以及许多真菌病原体对这些药物的固有和获得性耐药，侵袭性真菌感染的治疗受到了阻碍。因此，人们对阐明抗真菌耐药性的分子基础产生了浓厚的兴趣。最近的努力增加了我们对这一过程的理解，包括对念珠菌属唑类耐药的转录调控、对两性霉素 B 的固有耐药机制，以及对新型棘白菌素类抗真菌药物获得性耐药的机制。本文讨论了这些和其他新阐明的耐药机制，以及未来抗真菌耐药性研究的方向。尽管取得了这些进展，但仍存在未被发现的耐药决定因素，而且对新型药物的耐药性可能会继续出现。
