Pfaller Michael A, Castanheira Mariana, Lockhart Shawn R, Jones Ronald N
JMI Laboratories, North Liberty, Iowa, USA.
University of Iowa, Iowa City, Iowa, USA.
Curr Fungal Infect Rep. 2012 Jun;6(3):154-164. doi: 10.1007/s12281-012-0091-0.
is widely acknowledged to be an important and potentially antifungal resistant cause of hematogenously disseminated candidiasis (HDC). In the United States (US) both the frequency of as a cause of HDC and in vitro resistance to fluconazole has increased steadily since 1992. Although this species is generally considered to be less virulent than , recent findings suggest that gain of function (GOF) mutations in the transcriptional regulator CgPdr1p results not only in broad resistance to azole antifungals but also an increase in both fitness and virulence in animal models. Furthermore, case reports and case series suggest the emergence of multidrug resistance (MDR) in this species. Recent data from multicenter surveys conducted in the US have demonstrated the emergence of co-resistance to both azoles and echinocandins in clinical isolates of . These findings are highlighted in an effort to bring attention to this important development.
普遍认为是血行播散性念珠菌病(HDC)的一个重要且可能导致抗真菌耐药的病因。在美国,自1992年以来,作为HDC病因的频率以及对氟康唑的体外耐药性均稳步上升。尽管该菌种通常被认为毒力低于 ,但最近的研究结果表明,转录调节因子CgPdr1p中的功能获得(GOF)突变不仅导致对唑类抗真菌药物产生广泛耐药性,还会增加动物模型中的适应性和毒力。此外,病例报告和病例系列表明该菌种出现了多药耐药(MDR)。美国多中心调查的最新数据表明,临床分离株中出现了对唑类和棘白菌素的共同耐药性。强调这些发现是为了引起人们对这一重要进展的关注。