Evaluation of molecular mechanisms of Candida albicans resistance to fluconazole in isolates obtained from blood cultures processed in 25 tertiary hospitals in Brazil

• Grant number: 24/18140-8
• Support Opportunities: Scholarships in Brazil - Program to Stimulate Scientific Vocations
• Start date: January 17, 2025
• End date: March 08, 2025
• Field of knowledge: Biological Sciences - Microbiology
• Principal Investigator: Arnaldo Lopes Colombo
• Grantee: Adryan Aparecido da Silva
• Host Institution: Escola Paulista de Medicina (EPM). Universidade Federal de São Paulo (UNIFESP). Campus São Paulo. São Paulo , SP, Brazil

Abstract

In recent decades, tertiary hospitals in various regions of the world have faced a significant increase in cases of invasive infections caused by Candida spp. These infections have high rates of morbidity and mortality, and early identification of affected patients often fails. As a result, prophylactic and empirical antifungal therapeutic practices have been increasingly employed. However, the frequent use of these approaches is associated with an increased risk of Candida developing resistance to antifungal medications. In Latin America, over the past 10 years, resistance rates to fluconazole have been reported to range from 0.5% to 18%. Nevertheless, the underlying molecular mechanisms of this resistance have been documented in only a limited number of studies. Therefore, it is necessary to conduct surveillance studies to determine the prevalence of Candida isolates with a dose-dependent sensitivity phenotype and resistance to triazoles, especially among clinical samples from patients treated in medical centers in Brazil. The primary focus of these studies will be to characterize the most commonly observed resistance mechanism in Candida spp., involving changes in the target of action of triazoles, with an emphasis on mutations in the ERG11 gene.