Echinocandin resistance in Candida

Abstract

Abstract:

Invasive candidiasis (IC) is an important concern for patients,especially immunocompromised patients.Antifungal therapy is critical for patient,but antifungals are limited.Antifungal resistance,particularly multidrug resistance aggravates this problem.The echinocandins which targeting fungal-specific enzyme glucan synthase are the preferred choice to treat IC.The resistance rate of echinocandins has increased recently,and echinocandin resistant isolates are frequently resistant to other antifungals.The mechanism of echinocandin resistance involves amino acid changes of FKS,cellular processes and biofilms.The clinical factors that promote echinocandin resistance include prophylaxis,intra-abdominal candidiasis and host reservoirs.An understanding of the mechanisms and factors that promote echinocandin resistance is critical to develop better diagnostic tools and therapeutic strategies.

Key words: Echinocandins, invasive candidiasis, mechanism of resistance, FKS

CLC Number:

R978.5

HOU Xin, XU Ying-chun, ZHAO Yu-pe. Echinocandin resistance in Candida[J]. Chinese Journal of Mycology, 2018, 13(1): 40-45.

References

[1] Brown GD,Denning DW,Gow NA,et al.Hidden killers:human fungal infections[J].Sci Transl Med,2012,4(165):165rv113.
[2] Perlin DS.Mechanisms of echinocandin antifungal drug resistance[J].Ann N Y Acad Sci,2015,1354(1):1-11.
[3] Cleveland AA,Farley MM,Harrison LH,et al.Changes in incidence and antifungal drug resistance in candidemia:results from population-based laboratory surveillance in Atlanta and Baltimore,2008-2011[J].Clin Infect Dis,2012,55(10):1352-1361.
[4] Perlin DS.Current perspectives on echinocandin class drugs[J].Future Microbiol,2011,6(4):441-457.
[5] Pappas PG,Kauffman CA,Andes DR,et al.Clinical practice guideline for the management of candidiasis:2016 update by the Infectious Diseases Society of America[J].Clin Infect Dis,2016,62(4):e1-50.
[6] Barchiesi F,Spreghini E,Tomassetti S,et al.Comparison of the fungicidal activities of caspofungin and amphotericin B against Candida glabrata[J].Antimicrob Agents Chemother,2005,49(12):4989-4992.
[7] Pfaller MA,Boyken L,Hollis RJ,et al.Wild-type MIC distributions and epidemiological cutoff values for the echinocandins and Candida spp[J].J Clin Microbiol,2010,48(1):52-56.
[8] Lewis JS,Wiederhold NP,Wickes BL,et al.Rapid emergence of echinocandin resistance in Candida glabrata resulting in clinical and microbiologic failure[J].Antimicrob Agents Chemother,2013,57(9):4559-4561.
[9] Pfaller MA,Castanheira M,Lockhart SR,et al.Frequency of decreased susceptibility and resistance to echinocandins among fluconazole-resistant bloodstream isolates of Candida glabrata[J].J Clin Microbiol,2012,50(4):1199-1203.
[10] Alexander BD,Johnson MD,Pfeiffer CD,et al.Increasing echinocandin resistance in Candida glabrata:clinical failure correlates with presence of FKS mutations and elevated minimum inhibitory concentrations[J].Clin Infect Dis,2013,56(12):1724-1732.
[11] Hou X,Xiao M,Chen SC,et al.Molecular epidemiology and antifungal susceptibility of Candida glabrata in China (August 2009 to July 2014):a multi-center study[J].Front Microbiol,2017,8:880.
[12] Xiao M,Fan X,Chen SC,et al.Antifungal susceptibilities of Candida glabrata species complex,Candida krusei,Candida parapsilosis species complex and Candida tropicalis causing invasive candidiasis in China:3 year national surveillance[J].J Antimicrob Chemother,2015,70(3):802-810.
[13] 李岷,沈永年,吕桂霞,等.棘白菌素对氟康唑耐药的念珠菌体外药物敏感性的研究[J].中国真菌学杂志,2009,4(2):78-81.
[14] Pfaller MA,Diekema DJ,Andes D,et al.Clinical breakpoints for the echinocandins and Candida revisited:integration of molecular,clinical,and microbiological data to arrive at species-specific interpretive criteria[J].Drug Resist Updat,2011,14(3):164-176.
[15] Arendrup MC,Pfaller MA,Danish Fungaemia Study G.Caspofungin Etest susceptibility testing of Candida species:risk of misclassification of susceptible isolates of C.glabrata and C.krusei when adopting the revised CLSI caspofungin breakpoints[J].Antimicrob Agents Chemother,2012,56(7):3965-3968.
[16] Eschenauer GA,Nguyen MH,Shoham S,et al.Real-world experience with echinocandin MICs against Candida species in a multicenter study of hospitals that routinely perform susceptibility testing of bloodstream isolates[J].Antimicrob Agents Chemother,2014,58(4):1897-1906.
[17] De Carolis E,Vella A,Florio AR,et al.Use of matrix-assisted laser desorption ionization-time of flight mass spectrometry for caspofungin susceptibility testing of Candida and Aspergillus species[J].J Clin Microbiol,2012,50(7):2479-2483.
[18] Vella A,De Carolis E,Vaccaro L,et al.Rapid antifungal susceptibility testing by matrix-assisted laser desorption ionization-time of flight mass spectrometry analysis[J].J Clin Microbiol,2013,51(9):2964-2969.
[19] Park S,Kelly R,Kahn JN,et al.Specific substitutions in the echinocandin target Fks1p account for reduced susceptibility of rare laboratory and clinical Candida sp isolates[J].Antimicrob Agents Chemother,2005,49(8):3264-3273.
[20] Garcia-Effron G,Katiyar SK,Park S,et al.A naturally occurring proline-to-alanine amino acid change in Fks1p in Candida parapsilosis,Candida orthopsilosis,and Candida metapsilosis accounts for reduced echinocandin susceptibility[J].Antimicrob Agents Chemother,2008,52(7):2305-2312.
[21] Kale-Pradhan PB,Morgan G,Wilhelm SM,et al.Comparative efficacy of echinocandins and nonechinocandins for the treatment of Candida parapsilosis infections:a meta-analysis[J].Pharmacotherapy,2010,30(12):1207-1213.
[22] Ghannoum MA,Chen A,Buhari M,et al.Differential in vitro activity of anidulafungin,caspofungin and micafungin against Candida parapsilosis isolates recovered from a burn unit[J].Clin Microbiol Infect,2009,15(3):274-279.
[23] Garcia-Effron G,Lee S,Park S,et al.Effect of Candida glabrata FKS1 and FKS2 mutations on echinocandin sensitivity and kinetics of 1,3-beta-D-glucan synthase:implication for the existing susceptibility breakpoint[J].Antimicrob Agents Chemother,2009,53(9):3690-3699.
[24] Shields RK,Nguyen MH,Press EG,et al.The presence of an FKS mutation rather than MIC is an independent risk factor for failure of echinocandin therapy among patients with invasive candidiasis due to Candida glabrata[J].Antimicrob Agents Chemother,2012,56(9):4862-4869.
[25] Perlin DS.Resistance to echinocandin-class antifungal drugs[J].Drug Resist Updat,2007,10(3):121-130.
[26] Katiyar S,Pfaller M,Edlind T.Candida albicans and Candida glabrata clinical isolates exhibiting reduced echinocandin susceptibility[J].Antimicrob Agents Chemother,2006,50(8):2892-2894.
[27] Arendrup MC,Perlin DS.Echinocandin resistance:an emerging clinical problem[J].Curr Opin Infect Dis,2014,27(6):484-492.
[28] Walker LA,Gow NaR,Munro CA.Fungal echinocandin resistance[J].Fungal Genetics and Biology,2010,47(2):117-126.
[29] Johnson ME,Katiyar SK,Edlind TD.New Fks hot spot for acquired echinocandin resistance in Saccharomyces cerevisiae and its contribution to intrinsic resistance of Scedosporium species[J].Antimicrob Agents Chemother,2011,55(8):3774-3781.
[30] Slater JL,Howard SJ,Sharp A,et al.Disseminated candidiasis caused by Candida albicans with amino acid substitutions in FKS1 at position ser645 cannot be successfully treated with micafungin[J].Antimicrob Agents Chemother,2011,55(7):3075-3083.
[31] Singh SD,Robbins N,Zaas AK,et al.Hsp90 governs echinocandin resistance in the pathogenic yeast Candida albicans via calcineurin[J].Plos Pathogens,2009,5(7):e1000532.
[32] Singh-Babak SD,Babak T,Diezmann S,et al.Global analysis of the evolution and mechanism of echinocandin resistance in Candida glabrata[J].Plos Pathogens,2012,8(5).
[33] Lee KK,Maccallum DM,Jacobsen MD,et al.Elevated cell wall chitin in Candida albicans confers echinocandin resistance in vivo[J].Antimicrob Agents Chemother,2012,56(1):208-217.
[34] Stevens DA,Ichinomiya M,Koshi Y,et al.Escape of Candida from caspofungin inhibition at concentrations above the MIC (paradoxical effect) accomplished by increased cell wall chitin;evidence for beta-1,6-glucan synthesis inhibition by caspofungin[J].Antimicrob Agents Chemother,2006,50(9):3160-3161.
[35] Healey KR,Katiyar SK,Castanheira M,et al.Candida glabrata mutants demonstrating paradoxical reduced caspofungin susceptibility but increased micafungin susceptibility[J].Antimicrob Agents Chemother,2011,55(8):3947-3949.
[36] Desai JV,Bruno VM,Ganguly S,et al.Regulatory role of glycerol in Candida albicans biofilm formation[J].MBio,2013,4(2):e00637-00612.