ArticleMicrobiology spectrum2026
Dynamics associated with the efflux pumps in biofilms and persister cells of
Article in Microbiology spectrum, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Cryptococcosis is a systemic mycosis affecting immunocompromised individuals (mainly IMPORTANCE: Cryptococcosis is a fungal infection with mortality exceeding 75%, predominantly affecting immunocompromised individuals-including transplant recipients and people living with HIV-but also capable of infecting healthy people. Treatments are lengthy, toxic, and increasingly ineffective due to antifungal resistance. Two major contributors to therapeutic failure are biofilms-protective fungal communities encased in a self-produced matrix-and persister cells, a dormant subpopulation that survives lethal drug concentrations and reactivates infection once treatment stops. This study reveals that efflux pumps-proteins that expel drugs from fungal cells-are not only resistance mechanisms but also active contributors to biofilm construction. Critically, persister cells reactivate their efflux pumps upon recovery, providing a biological explanation for infection recurrence. Two drug combinations-fluconazole + FK506 and fluconazole + octyl protocatechuate-synergistically disrupted biofilms and reduced persister cell viability while potentially lowering drug doses and toxicity, pointing toward safer, more effective strategies for cryptococcosis.
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