Chapter 17 - Drug resistance in pathogenic species of Candida

Abstract

Candidiasis is the most common type of fungal infection caused by Candida species. It is becoming a worldwide public health threat because of its multidrug resistance (MDR) ability reported against three major classes of antifungal drugs: azoles, echinocandins, and polyenes. MDR was reported maximum with Candida albicans but other species of Candida have also shown resistance. However, Candida auris, Candida glabrata, and Candida parapsilosis are reported with major emerging MDR species in Candida. The gene expression and gene regulation mutation play a pivotal role in the adaptation of drug resistance in Candida species. Moreover the ability to survive at high temperatures and pH, long-time persistence, and pathogenicity are unique properties of the species, which are becoming challenging for the scientific community. This is why more studies are needed to defeat these challenges. In this chapter, we discuss the pathogenic species of Candida, current scenarios in drug targeting, drug resistance, brief epidemiology, and molecular mechanism of drug resistance. We have emphasized and highlighted the major sites and factors facilitating drug resistance in Candida, the molecular mechanism of drug resistance, and its therapeutic challenges, which would be an informative and important inventory for persons related to the field.