Huang Yuyan, Su Yanyu, Chen Xinfei, Xiao Meng, Xu Yingchun
Department of Laboratory Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, China.
Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases (BZ0447), Beijing 100730, China.
J Fungi (Basel). 2024 Aug 28;10(9):615. doi: 10.3390/jof10090615.
The complex includes emerging opportunistic human fungal pathogens with documented multidrug-resistance profiles. It comprises , var. , , , and . In recent years, rates of clinical isolation of strains from this complex have increased in multiple countries, including China, Malaysia, and Brazil. Biofilm formation, hydrolytic enzymes, surface interaction properties, phenotype switching and cell aggregation abilities, extracellular vesicles production, stress response, and immune evasion help these fungi to infect the host and exert pathological effects. Multidrug resistance profiles also enhance the threat they pose; they exhibit low susceptibility to echinocandins and azoles and an intrinsic resistance to amphotericin B (AMB), the first fungal-specific antibiotic. AMB is commonly employed in antifungal treatments, and it acts via several known mechanisms. Given the propensity of clinical species to initiate bloodstream infections, clarifying how resists AMB is of critical clinical importance. This review outlines our present understanding of the complex's virulence factors, the mechanisms of action of AMB, and the mechanisms underlying AMB resistance.
该复合体包括已记录有多药耐药谱的新兴机会性人类真菌病原体。它包括 变种 、 、 、 和 。近年来，包括中国、马来西亚和巴西在内的多个国家中，从该复合体分离出的菌株的临床分离率有所上升。生物膜形成、水解酶、表面相互作用特性、表型转换和细胞聚集能力、细胞外囊泡产生、应激反应和免疫逃避有助于这些真菌感染宿主并发挥病理作用。多药耐药谱也增加了它们构成的威胁；它们对棘白菌素和唑类药物敏感性较低，对首个真菌特异性抗生素两性霉素B（AMB）具有固有抗性。AMB常用于抗真菌治疗，其作用通过几种已知机制。鉴于临床 菌种引发血流感染的倾向，阐明 对AMB的耐药机制具有至关重要的临床意义。本综述概述了我们目前对该复合体毒力因子、AMB的作用机制以及AMB耐药机制的理解。
