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Antifungal Resistance in Cryptococcal Infections.

Authors :
Melhem, Marcia S. C.
Leite Júnior, Diniz Pereira
Takahashi, Juliana P. F.
Macioni, Milena Bronze
Oliveira, Lidiane de
de Araújo, Lisandra Siufi
Fava, Wellington S.
Bonfietti, Lucas X.
Paniago, Anamaria M. M.
Venturini, James
Espinel-Ingroff, Ana
Source :
Pathogens; Feb2024, Vol. 13 Issue 2, p128, 16p
Publication Year :
2024

Abstract

Antifungal therapy, especially with the azoles, could promote the incidence of less susceptible isolates of Cryptococcus neoformans and C. gattii species complexes (SC), mostly in developing countries. Given that these species affect mostly the immunocompromised host, the infections are severe and difficult to treat. This review encompasses the following topics: 1. infecting species and their virulence, 2. treatment, 3. antifungal susceptibility methods and available categorical endpoints, 4. genetic mechanisms of resistance, 5. clinical resistance, 6. fluconazole minimal inhibitory concentrations (MICs), clinical outcome, 7. environmental influences, and 8. the relevance of host factors, including pharmacokinetic/pharmacodynamic (PK/PD) parameters, in predicting the clinical outcome to therapy. As of now, epidemiologic cutoff endpoints (ECVs/ECOFFs) are the most reliable antifungal resistance detectors for these species, as only one clinical breakpoint (amphotericin B and C. neoformans VNI) is available. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
20760817
Volume :
13
Issue :
2
Database :
Complementary Index
Journal :
Pathogens
Publication Type :
Academic Journal
Accession number :
175656275
Full Text :
https://doi.org/10.3390/pathogens13020128