Evolution of antifungal-drug resistance: mechanisms and pathogen fitness

Nat Rev Microbiol. 2005 Jul;3(7):547-56. doi: 10.1038/nrmicro1179.


Like other microorganisms, fungi exist in populations that are adaptable. Under the selection imposed by antifungal drugs, drug-sensitive fungal pathogens frequently evolve resistance. Although the molecular mechanisms of resistance are well-characterized, there are few measurements of the impact of these mechanisms on pathogen fitness in different environments. To predict resistance before a new drug is prescribed in the clinic, the full spectrum of potential resistance mutations and the interactions among combinations of divergent mechanisms can be determined in evolution experiments. In the search for new strategies to manage drug resistance, measuring the limits of adaptation might reveal methods for trapping fungal pathogens in evolutionary dead ends.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antifungal Agents / chemistry
  • Antifungal Agents / pharmacology*
  • Biological Evolution
  • Candida albicans / drug effects
  • Candida albicans / isolation & purification
  • Candida albicans / pathogenicity
  • Candida albicans / physiology
  • Drug Resistance, Fungal*
  • Epistasis, Genetic
  • Forecasting
  • Fungi / drug effects*
  • Fungi / pathogenicity
  • Fungi / physiology
  • Humans
  • Microbial Sensitivity Tests
  • Mutation / drug effects
  • Saccharomyces cerevisiae / drug effects
  • Saccharomyces cerevisiae / isolation & purification
  • Saccharomyces cerevisiae / pathogenicity
  • Saccharomyces cerevisiae / physiology
  • Virulence / drug effects


  • Antifungal Agents