Evidence map›Paper›PMID 30335865›Full record

ReviewPLoS pathogens2018

Fungal persister cells: The basis for recalcitrant infections?

Jurgen Wuyts, Patrick Van Dijck, Michelle Holtappels

Open access · goldAbstract readReview
In one paragraph

Review in PLoS pathogens, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 81 papers.

0numbers the graph read from it
0cells of the map it votes in
81citing papers in PubMed
6.8field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

81 citing papers in PubMed, 133 citations in OpenAlex.

  1. Article
  2. Article
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  8. Article
  9. OvercomingFrontiers in antibiotics · 2026
    Review
  10. CRISPR-driven strategies to disrupt methicillin-resistantFrontiers in cellular and infection microbiology · 2026
    Review
  11. Review
  12. StudyingPharmaceuticals (Basel, Switzerland) · 2025
    Review
  13. Review
  14. Article
  15. Article
  16. Review
  17. Review
  18. Article
  19. Fungal biofilms in human health and disease.Nature reviews. Microbiology · 2025
    Review
  20. Review

21 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 1 institution in 1 country.

Jurgen WuytsVIB-KU Leuven Center for Microbiology, Leuven, Belgium.ORCID 0000-0001-6944-6295
Patrick Van DijckVIB-KU Leuven Center for Microbiology, Leuven, Belgium.ORCID 0000-0002-1542-897X
Michelle HoltappelsVIB-KU Leuven Center for Microbiology, Leuven, Belgium.
VIB-KU Leuven Center for Microbiology · BE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Persister cells are a small subpopulation within fungal biofilms that are highly resistant to high concentrations of antifungals and therefore most likely contribute to the resistance and recalcitrance of biofilm infections. Moreover, this subpopulation is defined as a nongrowing, phenotypic variant of wild-type cells that can survive high doses of antifungals. There are high degrees of heterogeneity and plasticity associated with biofilm formation, resulting in a strong variation in the amount of persister cells. The fraction of these cells in fungal biofilms also appear to be dependent on the type of substrate. The cells can be observed immediately after their adhesion to that substrate, which makes up the initial step of biofilm formation. Thus far, persister cells have primarily been studied in Candida spp. These fungi are the fourth most common cause of nosocomial systemic infections in the United States, with C. albicans being the most prevalent species. Remarkably, persisters exhibit characteristics of a dormant state similar to what is observed in cells deprived of glucose. This dormant state, together with attachment to a substrate, appears to provide the cells with characteristics that help them overcome the challenges with fungicidal drugs such as amphotericin B (AmB). AmB is known to induce apoptosis, and persister cells are able to cope with the increase in reactive oxygen species (ROS) by activating stress response pathways and the accumulation of high amounts of glycogen and trehalose-two known stress-protecting molecules. In this review, we discuss the molecular pathways that are involved in persister cell formation in fungal species and highlight that the eradication of persister cells could lead to a strong reduction of treatment failure in a clinical setting.

Indexed as

Drug Resistance, Multiple, FungalAntifungal AgentsBiofilmsCandidaCandidiasisCross InfectionHumansAntifungal Agents

Identifiers

PMID30335865
PMCPMC6193731
OpenAlexW2897950718

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.