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全球范围内念珠菌对唑类药物和棘白菌素类药物的耐药性。

Resistance of Candida to azoles and echinocandins worldwide.

机构信息

Center for Medical Mycology, Case Western Reserve University, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.

Center for Medical Mycology, Case Western Reserve University, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.

出版信息

Clin Microbiol Infect. 2019 Jul;25(7):792-798. doi: 10.1016/j.cmi.2019.03.028. Epub 2019 Apr 6.

Abstract

BACKGROUND

Recently there has been an increase in Candida infections worldwide. A handful of species in the genus Candida are opportunistic pathogens and have been known to cause infections in immunocompromised or otherwise impaired hosts. These infections can be superficial, affecting the skin or mucous membrane, or invasive, which can be life-threatening. Azoles and echinocandins are antifungal drugs used globally to treat Candida infections. However, resistance to these antifungal drugs has increased in many of the Candida species, and the effects this has in the clinical setting can be seen.

OBJECTIVES

Here, we discuss the mechanisms that Candida albicans, Candida dubliniensis, Candida glabrata, Candida parapsilosis, Candida tropicalis and Candida auris are implementing to increase resistance to azoles and echinocandins, and how they are affecting clinical, or hospital, settings worldwide.

SOURCES

Different studies and papers describing the mechanisms of antifungal drugs and Candida species evolution to becoming resistant to these drugs were looked at for this review.

CONTENT

We discuss the mechanisms that azoles and echinocandins use against Candida species to treat infections, as well as the evolution of these fungi to become resistant to these drugs, and the effect this has in the clinical settings around the globe.

IMPLICATIONS

Increased resistance to azoles and echinocandins by Candida species is an increasingly serious problem in clinical settings worldwide. Understanding the mechanisms used against antifungal drugs is imperative for patient treatment.

摘要

背景

最近,全球范围内的念珠菌感染有所增加。念珠菌属中的少数几种物种是机会性病原体,已知会在免疫功能低下或其他受损宿主中引起感染。这些感染可以是浅表的,影响皮肤或粘膜,也可以是侵袭性的,可能危及生命。唑类和棘白菌素类是全球用于治疗念珠菌感染的抗真菌药物。然而,许多念珠菌物种对这些抗真菌药物的耐药性有所增加,这在临床环境中的影响是显而易见的。

目的

在这里,我们讨论白色念珠菌、都柏林念珠菌、光滑念珠菌、近平滑念珠菌、热带念珠菌和耳念珠菌增加对唑类和棘白菌素类药物耐药性的机制,以及它们如何影响全球的临床或医院环境。

来源

为了进行这项综述,我们研究了不同的研究和论文,描述了抗真菌药物的作用机制和念珠菌物种对这些药物产生耐药性的进化。

内容

我们讨论了唑类和棘白菌素类药物用于治疗感染的机制,以及这些真菌对这些药物产生耐药性的进化,以及这在全球临床环境中的影响。

意义

念珠菌对唑类和棘白菌素类药物的耐药性增加是全球临床环境中一个日益严重的问题。了解针对抗真菌药物的作用机制对于患者的治疗至关重要。

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