Abstract：
The emergence of fungal pathogens and changes in the epidemiological landscape are prevalent issues in clinical mycology. Reports of resistance to antifungals have been reported. This review aims to evaluate molecular and nonmolecular mechanisms related to antifungal resistance. Mutations in the ERG genes and overexpression of the efflux pump (MDR1, CDR1 and CDR2 genes) were the most reported molecular mechanisms of resistance in clinical isolates, mainly related to Azoles. For echinocandins, a molecular mechanism described was mutation in the FSK genes. Furthermore, nonmolecular virulence factors contributed to therapeutic failure, such as biofilm formation and selective pressure due to previous exposure to antifungals. Thus, there are many public health challenges in treating fungal infections.
[Box: see text].
[Box: see text].
摘要：
真菌病原体的出现和流行病学景观的变化是临床真菌学中普遍存在的问题。已经报道了对抗真菌药的抗性。本文旨在评估与抗真菌耐药相关的分子和非分子机制。ERG基因突变和外排泵（MDR1，CDR1和CDR2基因）的过表达是临床分离株中报道最多的耐药分子机制，主要与Azoles有关。对于棘白菌素，所描述的分子机制是FSK基因的突变。此外，非分子毒力因素导致治疗失败，如生物膜的形成和由于先前暴露于抗真菌剂的选择压力。因此，在治疗真菌感染方面存在许多公共卫生挑战。
[方框：见正文]。
[方框：见正文]。
