Mechanisms of Developing Antifungal Drug Resistance of Candida spp. in Reccurent Urogenital Candidiasis


Urogenital candidiasis is an infectious disease caused by Candida sp., a long recurrent course of which can reduce human reproductive health. Its frequent recurrence is associated with constant influence of provoking factors, noncompliance with treatment regimens, treatment without determining the sensitivity of individual antifungal drugs, local immunity disorders, and increasing antifungal drug resistance. Major drugs for genital candidiasis treatment are azole drugs, but at present there is a tendency toward growing antifungal drug resistance of Candida spp. This review describes antifungal drug resistance mechanisms that are currently under study: the ability of Candida spp. to form biofilms, changes in lipid composition of the fungal cell wall, and genetic mutations of Candida spp. The bulk of the accumulated material concerns the structure and role of the ERG11 gene encoding the sterol-14α-demethylase enzyme, the efflux pump genes CDR1 and CDR2, and the membrane transporter gene MDR1, which are associated with azole drug resistance. These genes are suggested for laboratory diagnostics as molecular genetic markers of antifungal resistance in order to select effective antimycotic therapy. For this review, we used sources from the Scopus, CyberLeninka, MedLine, and Russian Science Citation Index databases.

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Correspondence to M. B. Bezhenar or K. I. Plakhova.

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Bezhenar, M.B., Plakhova, K.I. Mechanisms of Developing Antifungal Drug Resistance of Candida spp. in Reccurent Urogenital Candidiasis. Mol. Genet. Microbiol. Virol. 35, 14–21 (2020).

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  • Candida spp.
  • resistance
  • antifungal drugs
  • gene ERG11
  • gene CDR1
  • gene CDR2
  • gene MDR1
  • 14α-demethylase
  • recurrent candidiasis
  • review