Antifungal drug resistance: do molecular methods provide a way forward?
OBJECTIVE
Antifungal drug resistance is a confounding factor that negatively impacts clinical outcome for patients with serious mycoses. Early detection of fungi in blood or other specimens with a rapid assessment of drug susceptibility could improve the survival of patients with invasive disease by accelerating the initiation of appropriate antifungal treatment. Recent years have seen the growth of molecular technology that is ideally suited for fungal identification and assessment of drug resistance mechanisms.


RESULTS
Elucidation of the genetic mechanisms responsible for triazole and echinocandin resistance in prominent Candida spp. and Aspergillus spp. provides an opportunity to develop molecular diagnostic platforms suitable for rapid detection of primary and secondary drug resistance. Several highly dynamic and robust amplification/detection methodologies are now available that can provide simultaneous species identification and high fidelity discrimination of resistance alleles.


CONCLUSIONS
Molecular diagnostic platforms are ideal for rapid detection of fungal pathogens and they provide an opportunity to develop in parallel molecular assays that can evaluate antifungal drug resistance.
Perlin
David S
DS
Public Health Research Institute, New Jersey Medical School, UMDNJ, Newark, New Jersey, USA. perlinds@umdnj.edu
D000935:Antifungal Agents / Q000627:therapeutic use*; D001230:Aspergillus / Q000187:drug effects / Q000235:genetics; D002175:Candida / Q000187:drug effects / Q000235:genetics; D004271:DNA, Fungal / Q000032:analysis / Q000235:genetics; D025141:Drug Resistance, Fungal / Q000235:genetics*; D006801:Humans; D025202:Molecular Diagnostic Techniques; D009181:Mycoses / Q000188:drug therapy*; D016133:Polymerase Chain Reaction
D000935:Antifungal Agents; D004271:DNA, Fungal