Candida glabrata: Multidrug resistance and increased virulence in a major opportunistic fungal pathogen

C. glabrata is widely acknowledged to be an important and potentially antifungal resistant cause of invasive candidiasis (IC). In the United States (US) both the frequency of C. glabrata as a cause of IC and in vitro resistance to fluconazole has increased steadily since 1992. Although this species is generally considered to be less virulent than C. albicans, recent findings suggest that gain of function (GOF) mutations in the transcriptional regulator CgPdr1p results not only in broad resistance to azole antifungals but also an increase in both fitness and virulence in animal models. Furthermore, case reports and case series suggest the emergence of multidrug resistance (MDR) in this species. Recent data from multicenter surveys conducted in the US have demonstrated the emergence of coresistance to both azoles and echinocandins in clinical isolates of C. glabrata. These findings are highlighted in an effort to bring attention to this important development. © Springer Science+Business Media, LLC 2012.