Epidemiology of echinocandin resistance in Candida
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Epidemiology of echinocandin resistance in Candida

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  • Alternative Title:
    Curr Fungal Infect Rep
  • Description:
    Echinocandins are the newest antifungal agents approved for use in treating | infections in the US. They act by interfering with 1,3-β-D-glucan synthase and therefore disrupt cell wall production and lead to | cell death. There is no intrinsic resistance to echinocandins among | species, and isolates from historic collections archived before the release of the echinocandins show no resistance. Resistance to the echinocandins remains low among most | species and ranges overall from 0-1%. Among isolates of |, the proportion of resistant isolates is higher and has been reported to be as high as 13.5% in at least one hospital. Antifungal resistance is due to specific amino acid mutations in the Fksp subunit(s) of the 1,3-β-D-glucan synthase protein which are localized to one of two hotspots. These mutations are being recognized in isolates from patients who have failed echinocandin therapy, and often lead to a poor outcome. While the future looks bright for the echinocandins against most | species, | remains a species of concern and resistance rates of | to the echinocandins should be monitored closely.
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