ArticleAntimicrobial agents and chemotherapy2001
Prevalence of molecular mechanisms of resistance to azole antifungal agents in Candida albicans strains displaying high-level fluconazole resistance isolated from human immunodeficiency virus-infected patients.
Article in Antimicrobial agents and chemotherapy, 2001. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 207 papers.
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207 citing papers in PubMed, 466 citations in OpenAlex.
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- Recurrent mutations in the stress regulator Cap1 reveal a trade-off between azole resistance and oxidative stress response in Candida albicans.PLoS biology · 2026Article
- Experimental Evolution of PathogenicMicroorganisms · 2026Review
- Pooled CRISPRi screening reveals fungal-specific vulnerabilities across environments and genetic backgrounds.bioRxiv : the preprint server for biology · 2026Article
- A Novel Erg3 T208Is Substitution Associated with Reduced Fluconazole and Voriconazole Susceptibility in ClinicalInfection and drug resistance · 2026Article
- Evaluation of Candida Species Colonization and Fungal Susceptibility Profile in the Oropharyngeal Mucosa of Patients Receiving Head and Neck Radiotherapy.TheScientificWorldJournal · 2026Article
- Contribution of the CYP51A Y119F Mutation to Azole Resistance inJournal of fungi (Basel, Switzerland) · 2025Article
- Understanding the mechanisms of resistance to azole antifungals inJAC-antimicrobial resistance · 2025Review
- Functional analysis of Candida albicans Cdr1 through homologous and heterologous expression studies.FEMS yeast research · 2025Review
- Is there a difference in the expression levels of genes responsible for fluconazole resistance inCurrent medical mycology · 2025Review
- Highly sensitive voltammetric determination of the fungicide fenhexamid using a cost-effective and disposable pencil graphite electrode.Mikrochimica acta · 2024Article
- Single-cell detection of copy number changes reveals dynamic mechanisms of adaptation to antifungals in Candida albicans.Nature microbiology · 2024Article
- Adaptation of Candida albicans to specific host environments by gain-of-function mutations in transcription factors.PLoS pathogens · 2024Review
- Cryo-EM structures of Candida albicans Cdr1 reveal azole-substrate recognition and inhibitor blocking mechanisms.Nature communications · 2024Article
- Evolution and strain diversity advance exploration ofmSphere · 2024Review
- Step-wise evolution of azole resistance through copy number variation followed by KSR1 loss of heterozygosity in Candida albicans.PLoS pathogens · 2024Article
- Erg251 has complex and pleiotropic effects on sterol composition, azole susceptibility, filamentation, and stress response phenotypes.PLoS pathogens · 2024Article
- Invasive candidiasis.Nature reviews. Disease primers · 2024Review
147 more citing papers are in PubMed but not listed here.
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Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
Abstract
Molecular mechanisms of azole resistance in Candida albicans, including alterations in the target enzyme and increased efflux of drug, have been described, but the epidemiology of the resistance mechanisms has not been established. We have investigated the molecular mechanisms of resistance to azoles in C. albicans strains displaying high-level fluconazole resistance (MICs, > or =64 microg/ml) isolated from human immunodeficiency virus (HIV)-infected patients with oropharyngeal candidiasis. The levels of expression of genes encoding lanosterol 14alpha-demethylase (ERG11) and efflux transporters (MDR1 and CDR) implicated in azole resistance were monitored in matched sets of susceptible and resistant isolates. In addition, ERG11 genes were amplified by PCR, and their nucleotide sequences were determined in order to detect point mutations with a possible effect in the affinity for azoles. The analysis confirmed the multifactorial nature of azole resistance and the prevalence of these mechanisms of resistance in C. albicans clinical isolates exhibiting frank fluconazole resistance, with a predominance of overexpression of genes encoding efflux pumps, detected in 85% of all resistant isolates, being found. Alterations in the target enzyme, including functional amino acid substitutions and overexpression of the gene that encodes the enzyme, were detected in 65 and 35% of the isolates, respectively. Overall, multiple mechanisms of resistance were combined in 75% of the isolates displaying high-level fluconazole resistance. These results may help in the development of new strategies to overcome the problem of resistance as well as new treatments for this condition.
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