Macedo Daiana, Leonardelli Florencia, Gamarra Soledad, Garcia-Effron Guillermo
Consejo Nacional de Investigaciones Científicas y Tecnológicas, Santa Fe, Argentina.
Laboratorio de Micología y Diagnóstico Molecular, Cátedra de Parasitología y Micología, Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Santa Fe, Argentina.
Curr Fungal Infect Rep. 2021;15(3):93-103. doi: 10.1007/s12281-021-00418-6. Epub 2021 May 19.
Azole resistance in spp. is becoming a public health problem worldwide. However, data about this subject is lacking in Latin American countries. This review focuses in the epidemiology and molecular mechanisms of azole resistance in spp. emphasizing in Latin America. Data on stands out because it is the most prevalent spp. pathogen.
Azole resistance in spp. emergence was linked with intensive use of these antifungals both in the clinical setting and in the environment (as pesticides). Reports on azole-resistant strains are being constantly published in different countries. Molecular mechanisms of resistance mainly involve substitution in the azole target () and/or overexpression of this gene. However, several other non--related mechanisms were described. Moreover, intrinsically resistant cryptic species are starting to be reported as human pathogens.
After a comprehensive literature review, it is clear that azole resistance in spp. is emerging in Latin America and perhaps it is underestimated. All the main molecular mechanisms of azole resistance were described in patients and/or environmental samples. Moreover, one of the molecular mechanisms was described only in South America. Cryptic intrinsic azole-resistant species are also described.
某属真菌对唑类药物的耐药性正在成为全球范围内的一个公共卫生问题。然而，拉丁美洲国家缺乏关于这一主题的数据。本综述聚焦于某属真菌对唑类药物耐药性的流行病学和分子机制，重点关注拉丁美洲地区。关于某菌的数据尤为突出，因为它是最常见的某属真菌病原体。
某属真菌对唑类药物耐药性的出现与这些抗真菌药物在临床环境和环境（作为农药）中的大量使用有关。不同国家不断有关于唑类耐药某菌菌株的报道。耐药的分子机制主要涉及唑类靶点（某基因）的取代和/或该基因的过度表达。然而，还描述了其他几种与该基因无关的机制。此外，具有内在耐药性的隐匿某菌物种开始被报道为人类病原体。
经过全面的文献综述，很明显拉丁美洲正在出现某属真菌对唑类药物的耐药性，而且可能被低估了。在患者和/或环境样本中描述了唑类耐药的所有主要分子机制。此外，其中一种分子机制仅在南美洲被描述。还描述了具有内在唑类耐药性的隐匿物种。
