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Abstract
Fluconazole resistance occurs in > 10% of cases of candidosis during the late stages
of AIDS. We show here in two clinical isolates that resistance was caused by defective
sterol delta5,6-desaturation. This altered the type of sterol accumulating under fluconazole
treatment from 14alpha-methylergosta-8,24(28)-dien-3beta,6alpha -diol to 14alpha-methylfecosterol
which is capable of supporting growth. A consequence of this mechanism of azole resistance
is that an absence of ergosterol causes cross-resistance to the other major antifungal
agent available, amphotericin B. The results also show that growth arrest after fluconazole
treatment of C. albicans in clinical conditions is caused by 14alpha-methylergosta-8,24(28)-dien-3beta,6alpha
-diol accumulation.