Antifungal Susceptibility in Candida Species
Summary
Candida species are opportunistic yeasts responsible for a range of infections from superficial mucosal disease to life-threatening invasive candidiasis. The genus encompasses both Candida albicans and a growing number of non-albicans Candida such as C. glabrata, C. parapsilosis and the emerging multidrug-resistant pathogen C. auris. Antifungal susceptibility testing guides therapy by determining the minimum inhibitory concentration (MIC) of agents across major drug classes: azoles, echinocandins and polyenes. Mechanisms of resistance include mutations in drug targets (for example ERG11 in azole resistance), upregulation of efflux pumps and biofilm formation, which collectively reduce drug penetration. Global surveillance reveals shifting epidemiology with rising non-albicans infections and regional outbreaks of multidrug-resistant strains. Standardised methodologies such as broth microdilution and automated platforms enable reproducible MIC determinations, while molecular assays and whole-genome sequencing illuminate the genetic basis of resistance. Understanding species-specific susceptibility patterns informs empirical treatment guidelines and underpins stewardship strategies to preserve existing antifungals and stimulate development of novel therapeutics.
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Antifungal Susceptibility in Candida Species publication trend
The graph below shows the total number of articles in antifungal susceptibility in candida species across all publications each year (not limited to Nature Index journals).
Technical terms
Minimum inhibitory concentration (MIC): The lowest concentration of an antifungal agent that prevents visible growth of a fungal isolate in vitro.
Biofilm: A structured community of yeast cells embedded in an extracellular matrix that confers protection against antifungal agents and host defences.
Azoles: A class of antifungal drugs that inhibit ergosterol synthesis by targeting the lanosterol 14α-demethylase enzyme.
Echinocandins: Antifungal agents that inhibit β-1,3-D-glucan synthase, disrupting fungal cell-wall integrity.
Broth microdilution: A standardized laboratory method for determining MIC values by exposing fungi to serial dilutions of antifungal drugs in liquid medium.
References
- Early Release - Candida vulturna Outbreak Caused by Cluster of Multidrug-Resistant Strains, China - Volume 29, Number 7—July 2023 - Emerging Infectious Diseases journal - CDC. Emerging Infectious Diseases (2023).
- In Vitro Antifungal Activity of Three Synthetic Peptides against Candida auris and Other Candida Species of Medical Importance. Antibiotics (2023).
- Patterns recovered in phylogenomic analysis of Candida auris and close relatives implicate broad environmental flexibility in Candida/Clavispora clade yeasts. Microbial Genomics (2024).
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