Mechanisms of Antifungal Resistance in Candida albicans: Challenges and Clinical Implications

Abstract: Candida albicans is a major opportunistic fungal pathogen responsible for a range of infections, from superficial mucosal infections to life-threatening systemic diseases. The rise of antifungal resistance in C. albicans has become a significant concern, complicating treatment outcomes and increasing mortality rates. This review discusses the primary mechanisms of antifungal resistance, including mutations in drug targets, efflux pump overexpression, biofilm formation, and alterations in ergosterol biosynthesis. Resistance to azoles, echinocandins, and polyenes, the major classes of antifungals, is explored, with a focus on the genetic and molecular underpinnings of resistance. The clinical impact of multidrug-resistant strains and the growing global prevalence of antifungal resistance are highlighted. Strategies to overcome resistance include the development of novel antifungals, antifungal stewardship programs, and advancements in rapid diagnostic tools. Future challenges and directions for research are discussed, emphasizing the need for continued investigation into resistance mechanisms and new therapeutic approaches to manage infections effectively.