Antifungal drug resistance of oral fungi

Odontology

Volumn 98, Issue 1, 2010, Pages 15-25

  Niimi, Masakazu ^a   Firth, Norman A ^a   Cannon, Richard D ^a  

^a UNIVERSITY OF OTAGO   (New Zealand)

Author keywords

Antifungal drug resistance; Biofilms; Oral candidiasis

Indexed keywords

ANTIFUNGAL AGENT;

ANTIFUNGAL RESISTANCE; BIOFILM; DRUG EFFECT; HUMAN; MICROBIOLOGY; MOUTH DISEASE; MYCOSIS; REVIEW;

ANTIFUNGAL AGENTS; BIOFILMS; DRUG RESISTANCE, FUNGAL; HUMANS; MOUTH DISEASES; MYCOSES;

EID: 76649114370     PISSN: 16181247     EISSN: 16181255     Source Type: Journal    
DOI: 10.1007/s10266-009-0118-3     Document Type: Review

References (123)

1. Samaranayake LP, Keung Leung W, Jin L. Oral mucosal fungal infections. Periodontology 2000 2009; 49: 39-59.
2. Cannon RD, Chaffin WL. Oral colonization by Candida albicans. Crit Rev Oral Biol Med 1999; 10: 359-383.
3. Cannon RD, Holmes AR, Mason AB, Monk BC. Oral Candida: clearance, colonization, or candidiasis? J Dent Res 1995; 74: 1152-1161.
4. de Repentigny L, Lewandowski D, Jolicoeur P. Immunopathogenesis of oropharyngeal candidiasis in human immunodeficiency virus infection. Clin Microbiol Rev 2004; 17: 729-759.
5. Davies AN, Brailsford SR, Beighton D. Oral candidosis in patients with advanced cancer. Oral Oncol 2006; 42: 698-702.
6. Pfaller MA, Pappas PG, Wingard JR. Invasive fungal pathogens: current epidemiological trends. Clin Infect Dis 2006; 43: S3-S14.
7. Sanglard D, Bille J. Current understanding of the modes of action of and resistance mechanisms to conventional and emerging antifungal agents for treatment of Candida infections. In: Calderone RA, editor. Candida and Candidiasis. Washington, DC: ASM Press; 2002. p. 349-383.
8. Akins RA. An update on antifungal targets and mechanisms of resistance in Candida albicans. Med Mycol 2005; 43: 285-318.
9. Kontoyiannis DP, Lewis RE. Antifungal drug resistance of pathogenic fungi. Lancet 2002; 359: 1135-1144.
10. Cannon RD, Lamping E, Holmes AR, et al. Efflux-mediated antifungal drug resistance. Clin Microbiol Rev 2009; 22: 291-321.
11. Hojo K, Nagaoka S, Ohshima T, Maeda N. Bacterial interactions in dental biofilm development. J Dent Res 2009; 88: 982-990.
12. Seneviratne CJ, Jin L, Samaranayake LP. Biofilm lifestyle of Candida: a mini review. Oral Dis 2008; 14: 582-590.
13. Ten Cate JM, Klis FM, Pereira-Cenci T, Crielaard W, de Groot PW. Molecular and cellular mechanisms that lead to Candida biofilm formation. J Dent Res 2009; 88: 105-115.
14. Keijser BJ, Zaura E, Huse SM, et al. Pyrosequencing analysis of the oral microflora of healthy adults. J Dent Res 2008; 87: 1016-1020.
15. Aas JA, Paster BJ, Stokes LN, Olsen I, Dewhirst FE. Defining the normal bacterial flora of the oral cavity. J Clin Microbiol 2005; 43: 5721-5732.
16. Paster BJ, Boches SK, Galvin JL, et al. Bacterial diversity in human subgingival plaque. J Bacteriol 2001; 183: 3770-3783.
17. Woo PC, Lau SK, Teng JL, Tse H, Yuen KY. Then and now: use of 16S rDNA gene sequencing for bacterial identification and discovery of novel bacteria in clinical microbiology laboratories. Clin Microbiol Infect 2008; 14: 908-934.
18. Sakamoto M, Umeda M, Benno Y. Molecular analysis of human oral microbiota. J Periodont Res 2005; 40: 277-285.
19. Siqueira JF Jr, Rocas IN. Exploiting molecular methods to explore endodontic infections: Part 1. Current molecular technologies for microbiological diagnosis. J Endod 2005; 31: 411-423.
20. Sivakumar VG, Shankar P, Nalina K, Menon T. Use of CHRO-Magar in the differentiation of common species of Candida. Mycopathologia 2009; 167: 47-49.
21. Odds FC, Bernaerts R. CHROMagar Candida, a new differential isolation medium for presumptive identification of clinically important Candida species. J Clin Microbiol 1994; 32: 1923-1929.
22. Sullivan D, Coleman D. Candida dubliniensis: characteristics and identification. J Clin Microbiol 1998; 36: 329-334.
23. Williams DW, Lewis MA. Isolation and identification of Candida from the oral cavity. Oral Dis 2000; 6: 3-11.
24. Richardson MD, Carlson P. Culture- and non-culture-based diagnostics for Candida species. In: Calderone R, editor. Candida and candidiasis. Washington, DC: ASM Press; 2002. p. 387-394.
25. Liguori G, Di Onofrio V, Lucariello A, et al. Oral candidiasis: a comparison between conventional methods and multiplex polymerase chain reaction for species identification. Oral Microbiol Immunol 2009; 24: 76-78.
26. Wall-Manning GM, Sissons CH, Anderson SA, Lee M. Checkerboard DNA-DNA hybridisation technology focused on the analysis of gram-positive cariogenic bacteria. J Microbiol Methods 2002; 51: 301-311.
27. do Nascimento C, Ferreira de Albuquerque R Jr, Issa JP, et al. Use of the DNA checkerboard hybridization method for detection and quantitation of Candida species in oral microbiota. Can J Microbiol 2009; 55: 622-626.
28. Davies AN, Brailsford S, Broadley K, Beighton D. Oral yeast carriage in patients with advanced cancer. Oral Microbiol Immunol 2002; 17: 79-84.
29. Liguori G, Lucariello A, Colella G, De Luca A, Marinelli P. Rapid identification of Candida species in oral rinse solutions by PCR. J Clin Pathol 2007; 60: 1035-1039.
30. White PL, Williams DW, Kuriyama T, et al. Detection of Candida in concentrated oral rinse cultures by real-time PCR. J Clin Microbiol 2004; 42: 2101-2107.
31. Odds FC. Candida and candidiasis. Second edn. London: Baillière Tindall; 1988.
32. Sullivan DJ, Westerneng TJ, Haynes KA, Bennett DE, Coleman DC. Candida dubliniensis sp. nov.: phenotypic and molecular characterization of a novel species associated with oral candidosis in HIV-infected individuals. Microbiology 1995; 141: 1507-1521.
33. Sullivan DJ, Moran GP, Coleman DC. Candida dubliniensis: ten years on. FEMS Microbiol Lett 2005; 253: 9-17.
34. Arendorf TM, Walker DM. The prevalence and intra-oral distribution of Candida albicans in man. Arch Oral Biol 1980; 25: 1-10.
35. Radford DR, Challacombe SJ, Walter JD. Denture plaque and adherence of Candida albicans to denture-base materials in vivo and in vitro. Crit Rev Oral Biol Med 1999; 10: 99-116.
36. Schaeken MJ, Creugers TJ, van der Hoeven JS. Relationship between dental plaque indices and bacteria in dental plaque and those in saliva. J Dent Res 1987; 66: 1499-1502.
37. Sekino S, Ramberg P, Uzel NG, Socransky S, Lindhe J. Effect of various chlorhexidine regimens on salivary bacteria and de novo plaque formation. J Clin Periodontol 2003; 30: 919-925.
38. Cannon RD, Firth NA. Fungi and fungal infections of the oral cavity. In: Lamont RJ, Burne RA, Lantz MS, LeBlanc DJ, editors. Oral microbiology and immunology. Washington, DC: ASM Press; 2006. p. 333-348.
39. Baccaglini L, Atkinson JC, Patton LL, et al. Management of oral lesions in HIV-positive patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007; 103(suppl S50): e1-23.
40. Ship JA, Vissink A, Challacombe SJ. Use of prophylactic antifungals in the immunocompromised host. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007; 103(suppl S6): e1-14.
41. Pereira-Cenci T, Del Bel Cury AA, Crielaard W, Ten Cate JM. Development of Candida-associated denture stomatitis: new insights. J Appl Oral Sci 2008; 16: 86-94.
42. Loeffler J, Stevens DA. Antifungal drug resistance. Clin Infect Dis 2003; 36: S31-41.
43. Sheehan DJ, Hitchcock CA, Sibley CM. Current and emerging azole antifungal agents. Clin Microbiol Rev 1999; 12: 40-79.
44. Douglas CM. Fungal beta(1, 3)-d-glucan synthesis. Med Mycol 2001; 39(suppl 1): 55-66.
45. Gomez-Lopez A, Garcia-Effron G, Mellado E, et al. In vitro activities of three licensed antifungal agents against Spanish clinical isolates of Aspergillus spp. Antimicrob Agents Chemother 2003; 47: 3085-3088.
46. Steinbach WJ, Benjamin DK Jr, Kontoyiannis DP, et al. Infections due to Aspergillus terreus: a multicenter retrospective analysis of 83 cases. Clin Infect Dis 2004; 39: 192-198.
47. Steinbach WJ, Perfect JR, Schell WA, Walsh TJ, Benjamin DK Jr. In vitro analyses, animal models, and 60 clinical cases of invasive Aspergillus terreus infection. Antimicrob Agents Chemother 2004; 48: 3217-3225.
48. Chamilos G, Kontoyiannis DP. Update on antifungal drug resistance mechanisms of Aspergillus fumigatus. Drug Resist Update 2005; 8: 344-358.
49. Walsh TJ, Petraitis V, Petraitiene R, et al. Experimental pulmonary aspergillosis due to Aspergillus terreus: pathogenesis and treatment of an emerging fungal pathogen resistant to amphotericin B. J Infect Dis 2003; 188: 305-319.
50. Kelly SL, Lamb DC, Kelly DE, et al. Resistance to fluconazole and cross-resistance to amphotericin B in Candida albicans from AIDS patients caused by defective sterol delta5, 6-desaturation. FEBS Lett 1997; 400: 80-82.
51. Kanafani ZA, Perfect JR. Antimicrobial resistance: resistance to antifungal agents: mechanisms and clinical impact. Clin Infect Dis 2008; 46: 120-128.
52. Saag MS, Graybill RJ, Larsen RA, et al. Practice guidelines for the management of cryptococcal disease. Infectious Diseases Society of America. Clin Infect Dis 2000; 30: 710-718.
53. Douglas CM, D'Ippolito JA, Shei GJ, et al. Identification of the FKS1 gene of Candida albicans as the essential target of 1, 3-beta-d-glucan synthase inhibitors. Antimicrob Agents Chemother 1997; 41: 2471-2479.
54. Kurtz MB, Abruzzo G, Flattery A, et al. Characterization of echinocandin-resistant mutants of Candida albicans: genetic, biochemical, and virulence studies. Infect Immun 1996; 64: 3244-3251.
55. Douglas CM, Marrinan JA, Li W, Kurtz MB. A Saccharomyces cerevisiae mutant with echinocandin-resistant 1, 3-beta-d-glucan synthase. J Bacteriol 1994; 176: 5686-5696.
56. Baixench MT, Aoun N, Desnos-Ollivier M, et al. Acquired resistance to echinocandins in Candida albicans: case report and review. J Antimicrob Chemother 2007; 59: 1076-1083.
57. Perlin DS. Resistance to echinocandin-class antifungal drugs. Drug Resist Update 2007; 10: 121-130.
58. Cowen LE, Steinbach WJ. Stress, drugs, and evolution: the role of cellular signaling in fungal drug resistance. Eukaryot Cell 2008; 7: 747-764.
59. White TC, Marr KA, Bowden RA. Clinical, cellular, and molecular factors that contribute to antifungal drug resistance. Clin Microbiol Rev 1998; 11: 382-402.
60. Marichal P, Koymans L, Willemsens S, et al. Contribution of mutations in the cytochrome P450 14-alpha-demethylase (Erg11p, Cyp51p) to azole resistance in Candida albicans. Microbiology 1999; 145: 2701-2713.
61. Perea S, Lopez-Ribot JL, Kirkpatrick WR, et al. Prevalence of molecular mechanisms of resistance to azole antifungal agents in Candida albicans strains displaying high-level fluconazole resistance isolated from human immunodeficiency virusinfected patients. Antimicrob Agents Chemother 2001; 45: 2676-2684.
62. Sanglard D, Ischer F, Koymans L, Bille J. Amino acid substitutions in the cytochrome P-450 lanosterol 14-alpha-demethylase (CYP51A1) from azole-resistant Candida albicans clinical isolates contribute to resistance to azole antifungal agents. Antimicrob Agents Chemother 1998; 42: 241-253.
63. Albertson GD, Niimi M, Cannon RD, Jenkinson HF. Multiple efflux mechanisms are involved in Candida albicans fluconazole resistance. Antimicrob Agents Chemother 1996; 40: 2835-2841.
64. Goffeau A, Barrell BG, Bussey H, et al. Life with 6000 genes. Science 1996; 274: 546-567.
65. Decottignies A, Goffeau A. Complete inventory of the yeast ABC proteins. Nat Genet 1997; 15: 137-145.
66. Taglicht D, Michaelis S. Saccharomyces cerevisiae ABC proteins and their relevance to human health and disease. Methods Enzymol 1998; 292: 130-162.
67. Gaur M, Choudhury D, Prasad R. Complete inventory of ABC proteins in human pathogenic yeast, Candida albicans. J Mol Microbiol Biotechnol 2005; 9: 3-15.
68. Dujon B, Sherman D, Fischer G, et al. Genome evolution in yeasts. Nature (Lond) 2004; 430: 35-44.
69. Nierman WC, Pain A, Anderson MJ, et al. Genomic sequence of the pathogenic and allergenic filamentous fungus Aspergillus fumigatus. Nature (Lond) 2005; 438: 1151-1156.
70. Loftus BJ, Fung E, Roncaglia P, et al. The genome of the basidiomycetous yeast and human pathogen Cryptococcus neoformans. Science 2005; 307: 1321-1324.
71. Liu TT, Znaidi S, Barker KS, et al. Genome-wide expression and location analyses of the Candida albicans Tac1p regulon. Eukaryot Cell 2007; 6: 2122-2138.
72. Rogers PD, Barker KS. Genome-wide expression profile analysis reveals coordinately regulated genes associated with stepwise acquisition of azole resistance in Candida albicans clinical isolates. Antimicrob Agents Chemother 2003; 47: 1220-1227.
73. White TC. Increased mRNA levels of ERG16, CDR, and MDR1 correlate with increases in azole resistance in Candida albicans isolates from a patient infected with human immunodeficiency virus. Antimicrob Agents Chemother 1997; 41: 1482-1487.
74. Bennett JE, Izumikawa K, Marr KA. Mechanism of increased fluconazole resistance in Candida glabrata during prophylaxis. Antimicrob Agents Chemother 2004; 48: 1773-1777.
75. Sanglard D, Ischer F, Calabrese D, Majcherczyk PA, Bille J. The ATP binding cassette transporter gene CgCDR1 from Candida glabrata is involved in the resistance of clinical isolates to azole antifungal agents. Antimicrob Agents Chemother 1999; 43: 2753-2765.
76. Posteraro B, Sanguinetti M, Sanglard D, et al. Identification and characterization of a Cryptococcus neoformans ATP binding cassette (ABC) transporter-encoding gene, CnAFR1, involved in the resistance to fluconazole. Mol Microbiol 2003; 47: 357-371.
77. Sanguinetti M, Posteraro B, La Sorda M, et al. Role of AFR1, an ABC transporter-encoding gene, in the in vivo response to fluconazole and virulence of Cryptococcus neoformans. Infect Immun 2006; 74: 1352-1359.
78. Katiyar SK, Edlind TD. Identification and expression of multidrug resistance-related ABC transporter genes in Candida krusei. Med Mycol 2001; 39: 109-116.
79. Lamping E, Ranchod A, Nakamura K, et al. Abc1p is a multidrug efflux transporter that tips the balance in favor of innate azole resistance in Candida krusei. Antimicrob Agents Chemother 2009; 53: 354-369.
80. Arnaud MB, Costanzo MC, Skrzypek MS, et al. Sequence resources at the Candida Genome Database. Nucleic Acids Res 2007; 35: D452-D456.
81. Kohli A, Gupta V, Krishnamurthy S, Hasnain SE, Prasad R. Specificity of drug transport mediated by CaMDR1: a major facilitator of Candida albicans. J Biosci 2001; 26: 333-339.
82. Nakamura K, Niimi M, Niimi K, et al. Functional expression of Candida albicans drug efflux pump Cdr1p in a Saccharomyces cerevisiae strain deficient in membrane transporters. Antimicrob Agents Chemother 2001; 45: 3366-3374.
83. Franz R, Kelly SL, Lamb DC, et al. Multiple molecular mechanisms contribute to a stepwise development of fluconazole resistance in clinical Candida albicans strains. Antimicrob Agents Chemother 1998; 42: 3065-3072.
84. Sullivan DJ, Moran GP, Pinjon E, et al. Comparison of the epidemiology, drug resistance mechanisms, and virulence of Candida dubliniensis and Candida albicans. FEMS Yeast Res 2004; 4: 369-376.
85. Holmes AR, Lin YH, Niimi K, et al. ABC transporter Cdr1p contributes more than Cdr2p does to fluconazole efflux in fluconazole-resistant Candida albicans clinical isolates. Antimicrob Agents Chemother 2008; 52: 3851-3862.
86. Holmes AR, van der Wielen P, Cannon RD, Ruske D, Dawes P. Candida albicans binds to saliva proteins selectively adsorbed to silicone. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006; 102: 488-494.
87. Kojic EM, Darouiche RO. Candida infections of medical devices. Clin Microbiol Rev 2004; 17: 255-267.
88. Elving GJ, van der Mei HC, Busscher HJ, van Weissenbruch R, Albers FW. Comparison of the microbial composition of voice prosthesis biofilms from patients requiring frequent versus infrequent replacement. Ann Otol Rhinol Laryngol 2002; 111: 200-203.
89. Cannon RD, Nand AK, Jenkinson HF. Adherence of Candida albicans to human salivary components adsorbed to hydroxylapatite. Microbiology 1995; 141: 213-219.
90. Holmes AR, Bandara BM, Cannon RD. Saliva promotes Candida albicans adherence to human epithelial cells. J Dent Res 2002; 81: 28-32.
91. Jenkinson HF, Lala HC, Shepherd MG. Coaggregation of Streptococcus sanguis and other streptococci with Candida albicans. Infect Immun 1990; 58: 1429-1436.
92. O'sullivan JM, Cannon RD, Sullivan PA, Jenkinson HF. Identification of salivary basic proline-rich proteins as receptors for Candida albicans adhesion. Microbiology 1997; 143(pt 2): 341-348.
93. O'sullivan JM, Jenkinson HF, Cannon RD. Adhesion of Candida albicans to oral streptococci is promoted by selective adsorption of salivary proteins to the streptococcal cell surface. Microbiology 2000; 146(pt 1): 41-48.
94. Nobile CJ, Nett JE, Andes DR, Mitchell AP. Function of Candida albicans adhesin Hwp1 in biofilm formation. Eukaryot Cell 2006; 5: 1604-1610.
95. Zhao X, Daniels KJ, Oh SH, et al. Candida albicans Als3p is required for wild-type biofilm formation on silicone elastomer surfaces. Microbiology 2006; 152: 2287-2299.
96. Nobile CJ, Andes DR, Nett JE, et al. Critical role of Bcr1-dependent adhesins in C. albicans biofilm formation in vitro and in vivo. PLoS Pathog 2006; 2: e63.
97. Hornby JM, Jensen EC, Lisec AD, et al. Quorum sensing in the dimorphic fungus Candida albicans is mediated by farnesol. Appl Environ Microbiol 2001; 67: 2982-2992.
98. Ramage G, Bachmann S, Patterson TF, Wickes BL, Lopez-Ribot JL. Investigation of multidrug efflux pumps in relation to fluconazole resistance in Candida albicans biofilms. J Antimicrob Chemother 2002; 49: 973-980.
99. Alem MA, Oteef MD, Flowers TH, Douglas LJ. Production of tyrosol by Candida albicans biofilms and its role in quorum sensing and biofilm development. Eukaryot Cell 2006; 5: 1770-1779.
100. Bamford CV, d'Mello A, Nobbs AH, et al. Streptococcus gordonii modulates Candida albicans biofilm formation through intergeneric communication. Infect Immun 2009; 77: 3696-3704.
101. Hogan DA, Vik A, Kolter R. A Pseudomonas aeruginosa quorumsensing molecule influences Candida albicans morphology. Mol Microbiol 2004; 54: 1212-1223.
102. Douglas LJ. Candida biofilms and their role in infection. Trends Microbiol 2003; 11: 30-36.
103. Ramage G, Vande Walle K, Wickes BL, Lopez-Ribot JL. Standardized method for in vitro antifungal susceptibility testing of Candida albicans biofilms. Antimicrob Agents Chemother 2001; 45: 2475-2479.
104. Baillie GS, Douglas LJ. Effect of growth rate on resistance of Candida albicans biofilms to antifungal agents. Antimicrob Agents Chemother 1998; 42: 1900-1905.
105. Chandra J, Kuhn DM, Mukherjee PK, et al. Biofilm formation by the fungal pathogen Candida albicans: development, architecture, and drug resistance. J Bacteriol 2001; 183: 5385-5394.
106. Mateus C, Crow SA Jr, Ahearn DG. Adherence of Candida albicans to silicone induces immediate enhanced tolerance to fluconazole. Antimicrob Agents Chemother 2004; 48: 3358-3366.
107. Mukherjee PK, Chandra J, Kuhn DM, Ghannoum MA. Mechanism of fluconazole resistance in Candida albicans biofilms: phase-specific role of efflux pumps and membrane sterols. Infect Immun 2003; 71: 4333-4340.
108. Perumal P, Mekala S, Chaffin WL. Role for cell density in antifungal drug resistance in Candida albicans biofilms. Antimicrob Agents Chemother 2007; 51: 2454-2463.
109. Won Song J, Shin JH, Kee SJ, et al. Expression of CgCDR1, CgCDR2, and CgERG11 in Candida glabrata biofilms formed by bloodstream isolates. Med Mycol 2008; 2008: 1-4.
110. Garcia-Sanchez S, Aubert S, Iraqui I, et al. Candida albicans biofilms: a developmental state associated with specific and stable gene expression patterns. Eukaryot Cell 2004; 3: 536-545.
111. Andes D, Nett J, Oschel P, et al. Development and characterization of an in vivo central venous catheter Candida albicans biofilm model. Infect Immun 2004; 72: 6023-6031.
112. Cannon RD, Lamping E, Holmes AR, et al. Candida albicans drug resistance another way to cope with stress. Microbiology 2007; 153: 3211-3217.
113. Al-Fattani MA, Douglas LJ. Biofilm matrix of Candida albicans and Candida tropicalis: chemical composition and role in drug resistance. J Med Microbiol 2006; 55: 999-1008.
114. Nett J, Lincoln L, Marchillo K, et al. Putative role of beta-1, 3 glucans in Candida albicans biofilm resistance. Antimicrob Agents Chemother 2007; 51: 510-520.
115. Nobile CJ, Nett JE, Hernday AD, et al. Biofilm matrix regulation by Candida albicans Zap1. PLoS Biol 2009; 7: e1000133.
116. LaFleur MD, Kumamoto CA, Lewis K. Candida albicans biofilms produce antifungal-tolerant persister cells. Antimicrob Agents Chemother 2006; 50: 3839-3846.
117. Bachmann SP, VandeWalle K, Ramage G, et al. In vitro activity of caspofungin against Candida albicans biofilms. Antimicrob Agents Chemother 2002; 46: 3591-3596.
118. Lazzell AL, Chaturvedi AK, Pierce CG, et al. Treatment and prevention of Candida albicans biofilms with caspofungin in a novel central venous catheter murine model of candidiasis. J Antimicrob Chemother 2009; 64: 567-570.
119. Shuford JA, Rouse MS, Piper KE, Steckelberg JM, Patel R. Evaluation of caspofungin and amphotericin B deoxycholate against Candida albicans biofilms in an experimental intravascular catheter infection model. J Infect Dis 2006; 194: 710-713.
120. Jain N, Kohli R, Cook E, et al. Biofilm formation by and antifungal susceptibility of Candida isolates from urine. Appl Environ Microbiol 2007; 73: 1697-1703.
121. Torosantucci A, Chiani P, Bromuro C, et al. Protection by antibeta-glucan antibodies is associated with restricted beta-1, 3 glucan binding specificity and inhibition of fungal growth and adherence. PLoS One 2009; 4: e5392.
122. Steinbach WJ, Reedy JL, Cramer RA Jr, Perfect JR, Heitman J. Harnessing calcineurin as a novel anti-infective agent against invasive fungal infections. Nat Rev Microbiol 2007; 5: 418-430.
123. Uppuluri P, Nett J, Heitman J, Andes D. Synergistic effect of calcineurin inhibitors and fluconazole against Candida albicans biofilms. Antimicrob Agents Chemother 2008; 52: 1127-1132.