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Review
. 2012 Nov 4:2013:763628.
doi: 10.5402/2013/763628. eCollection 2013.

Candida infections and their prevention

M Anaul Kabir  1 , Zulfiqar Ahmad  2
Affiliations
Review

Candida infections and their prevention

M Anaul Kabir et al. ISRN Prev Med. .

Abstract

Infections caused by Candida species have been increased dramatically worldwide due to the increase in immunocompromised patients. For the prevention and cure of candidiasis, several strategies have been adopted at clinical level. Candida infected patients are commonly treated with a variety of antifungal drugs such as fluconazole, amphotericin B, nystatin, and flucytosine. Moreover, early detection and speciation of the fungal agents will play a crucial role for administering appropriate drugs for antifungal therapy. Many modern technologies like MALDI-TOF-MS, real-time PCR, and DNA microarray are being applied for accurate and fast detection of the strains. However, during prolonged use of these drugs, many fungal pathogens become resistant and antifungal therapy suffers. In this regard, combination of two or more antifungal drugs is thought to be an alternative to counter the rising drug resistance. Also, many inhibitors of efflux pumps have been designed and tested in different models to effectively treat candidiasis. However, most of the synthetic drugs have side effects and biomedicines like antibodies and polysaccharide-peptide conjugates could be better alternatives and safe options to prevent and cure the diseases. Furthermore, availability of genome sequences of Candida albicans and other non-albicans strains has made it feasible to analyze the genes for their roles in adherence, penetration, and establishment of diseases. Understanding the biology of Candida species by applying different modern and advanced technology will definitely help us in preventing and curing the diseases caused by fungal pathogens.

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Figures

Figure 1
Figure 1
Schematic diagram of the effect of 5-Fluorocytosine (5-FC) on the fungal cell. Genes for three enzymes are given in italic capital letters in the bracket. Mutations in these genes make the cells resistant to 5-FC.
Figure 2
Figure 2
Probable mechanisms of drug resistance in Candida species. (1) Drugs are pumped out by efflux pump. (2) Drug targets such as enzymes are overproduced and drugs cannot inhibit the enzymatic reactions. (3) Due to mutations, the structures of enzymes or other proteins are altered and drugs cannot bind to it. (4) Crucial enzymatic function that is inhibited by drug can be bypassed. (5) Drugs may be degraded and are used as carbon source. (6) Drugs may be modified by enzymes and become nontoxic. (7) Drugs are degraded and become nonfunctional. (8) Extracelluar enzyme may degrade the drugs outside the fungal cell and make them inactive. (9) Altered membrane may inhibit the entry of drugs into cell and drugs cannot function.
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