Document Type : Reviews
Authors
1
Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran Department of Medical Parasitology and Mycology, School of Medicine, Babol University of Medical
2
Department of Medical Parasitology and Mycology, School of Medicine, Babol University of Medical Sciences, Babol, Iran. Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical
3
Department of Obstetrics and Gynecology, School of Medicine, Babol University of Medical Sciences, Babol, Iran.
4
Infectious Diseases & Tropical Medicine Research Center, Babol University of Medical Sciences, Babol, Iran
10.22034/cmm.2024.345286.1573
Abstract
Background and Purpose: Antifungal resistance in Nakaseomyces glabratus presents a notable obstacle in the management of vulvovaginitis. The comprehension of drug-resistance gene expression is fundamental in the development of efficacious treatment strategies. This systematic review endeavors to ascertain the existing knowledge regarding the expression of drug resistance genes in N. glabratus associated with vulvovaginal candidiasis by amalgamating published research findings.
Material and Methods: Under the PRISMA guidelines, a systematic review was conducted from January 2000 to October 2024, utilizing the articles from "Web of Sciences", "PubMed" and "Scopus". The search incorporated the terms C. glabrata complex (C. glabrata sensu stricto, C. nivariensis, C. bracarensis) in conjunction with drug resistance gene expression in N. glabratus and closely related species with vulvovaginal candidiasis. The review was restricted to publications in English. The data extraction process employed Endnote software, and a meticulous selection process was undertaken to identify pertinent studies.
Result: Three studies that met the inclusion criteria reported an increase in the expression of the CDR1 gene in fluconazole-resistant N. glabratus, suggesting the presence of efflux mechanisms that reduce drug accumulation. Another study found enhanced CDR1 expression in fluconazole-resistant C. nivariensis, indicating the existence of similar resistance mechanisms. The observed variations in gene expression profiles between N. glabratus and C. nivariensis underscore the presence of diverse resistance mechanisms.
Conclusion: The articles studied the most important factor, the CDR1 gene. The studies also showed that C. nivarensis showed more resistance than N. glabratus.
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