Treatment of invasive candidiasis in the era of Candida resistance

• Tipo: Outra Publicação em Revista Científica Internacional
• Data: 2023

Autores

Paiva, J-A (Autor) FMUP; Pereira, JM (Autor) Outra

Revista

A Revista está pendente de validação pelos Serviços Administrativos.

Título: CURRENT OPINION IN CRITICAL CARE

Vol. 29

Páginas: 457-462

ISSN: 1070-5295

Editora: Lippincott Williams & Wilkins

Indexação

ISI Web of Knowledge - 0 Citações

Scopus - 0 Citações

Outras Informações

ID Authenticus: P-00Z-0ZM

DOI: 10.1097/mcc.0000000000001077

Abstract (EN): Purpose of reviewThe increasing incidence of drug-resistant Candida brings a new challenge to the treatment of invasive candidiasis. Although cross-resistance among azoles and echinocandins was generally uncommon, reports of multidrug-resistant (MDR) Candida markedly increased in the last decade. The purpose of this review is to understand mechanisms and risk factors for resistance and how to tackle antifungal resistance.Recent findingsThe paper describes the action of the three main classes of antifungals - azoles, echinocandins and polyenes - and Candida's mechanisms of resistance. The current evolution from cross-resistance to multiresistance among Candida explains the modern glossary - multidrug-resistant (MDR), extensively drug-resistant (XDR), and pandrug-resistant (PDR) - imported from bacteria. MDR Candida most commonly involves acquired resistance in species with intrinsic resistance, therefore it mostly involves C. glabrata, C. parapsilosis, C. krusei, C guilliermondii or C. auris, which is intrinsically multidrug resistant. Finally, strategies to tackle antifungal resistance became clearer, ideally implemented through antifungal stewardship.SummaryAvoiding antifungal's overuse and selecting the best drug, dose and duration, when they are needed, is fundamental. Knowledge of risk factors for resistance, microbiological diagnosis to the species, use of susceptibility test supported by antifungal stewardship programs help attaining effective therapy and sustaining the effectiveness of the current antifungal armamentarium.

Idioma: Inglês

Tipo (Avaliação Docente): Científica

Nº de páginas: 6