Virulence factors of Candida spp and molecular mechanisms of resistance to azoles expressed by Candida tropicalis

Introduction: Due to the epidemiological panorama of candidiasis caused by Candida tropicalis and the marked resistance generated towards azoles, it is necessary to deepen the knowledge of virulence and drug resistance mechanisms. Objective: To synthesize the virulence factors of Candida spp. and the molecular mechanisms of azole resistance expressed by Candida tropicalis. Materials and methods: The bibliographical search were conducted in the PubMed database and manuscripts were selected according to the critical analysis criteria proposed by the PRISMA instrument. The guiding question for the search was: What are the virulence factors of Candida spp, and the azole resistance mechanisms expressed by the species C. tropicalis? The results were organized into two categories: Virulence factors of Candida spp and molecular mechanisms of resistance to azoles. Results: The virulence factors of Candida spp. are represented by toxin and enzyme production, biofilm formation, environmental modification, filamentation, and hyphal growth. The mechanisms of resistance to azoles expressed by C. tropicalis are mainly determined by overexpression of the ERG11 and MDR1 genes and by mutations in the ERG11 gene. Conclusion: Virulence factors are similar among Candida species and the molecular mechanisms of resistance to azoles expressed by C. tropicalis fundamentally result in decreased affinity for the pharmacological target and lower intracellular concentration of the drug.