The Role of Resistance in Candida Infections: Epidemiology and Treatment

Abstract

Clinically refractory candidiasis remains uncommon. Following the introduction of antiretroviral therapy, the prevalence of resistant oropharyngeal and esophageal candidiasis dramatically decreased in HIV positive individuals. Nevertheless occasional cases of clinical and in vitro resistant mucosal candidiasis due to C. albicans continue to be reported; however the availability of new azoles, e.g., posaconazole and parenteral echinocandins, usually resolves the therapeutic challenge. Unfortunately recent reports of echinocandin resistance in patients with invasive C. glabrata infection serve as a cause of concern. Considerable progress has been made in determining risk factors for and mechanisms of azole resistance in Candida species.