阴道白念珠菌对氟康唑耐药机制的研究进展

Research progress on mechanisms of resistance to fluconazole of vaginal Candida albicans

外阴阴道念珠菌病(vulvovaginal candidiasis,VVC)是除细菌性阴道病外的第二大阴道感染性疾病,主要是由白念珠菌感染所致的机会性阴道黏膜感染。唑类抗真菌药物氟康唑是临床治疗VVC的首选药物,由于临床广泛及不规范的使用,阴道白念珠菌对氟康唑的耐药呈上升趋势。本文就阴道白念珠菌对氟康唑的耐药机制,包括药物作用的靶点突变或高表达、药物外排泵的过度表达、应激反应的调节及生物膜的形成等进行综述,以期为VVC的治疗提供新的策略。

Vulvovaginal candidiasis(VVC)is an opportunistic infection of the vaginal mucosa mainly caused by Candida albicans,which is the second most common vaginal infection other than bacterial vaginosis.The azole antifungal agent fluconazole is the drug of the first choice for treatment of VVC.With the widespread and non-standard use in clinical practice,the resistance of Candida albicans to fluconazole is on the rise.This article reviews the mechanisms of vaginal Candida vaginalis resistance to fluconazole,including the target mutations or high expression of drug action-related genes,the overexpression of drug efflux pump,the regulation of stress response,and the formation of biofilms,in order to provide information for a new strategy of VVC treatment.