Table 2.

Most Common Resistance Mechanisms of Major Candida Species

Candida Species	Resistance Mechanisms
C. albicans	Fluconazole – efflux transporters (MDR1, CDR1, CDR2) with amino acid substitutions less frequently observed
C. glabrata	Azoles – Changes in drug efflux (Cdr1 and Cdr2)
	Echinocandins – FKS1 polymorphisms in glucan synthase gene
	Mutator phenotype – Mismatch repair defect causing multiple antifungal resistance phenotypes
C. krusei	Fluconazole – Intrinsically resistant due to changes within ERG11 with other azoles often spared
C. parapsilosis	Fluconazole – amino acid substitution (mainly Y132F) within ERG11 most commonly with resultant variable susceptibility to voriconazole
C. lusitaniae	Amphotericin B – Mutation or altered expression of ergosterol biosynthetic genes (ERG3, etc).
C. auris	Azoles – Majority are fluconazole resistant (ERG11 mutations) with variable susceptible to other azoles
	Amphotericin B – Hypothesized to be due to alterations in ergosterol biosynthesis
	Echinocandins – Due to mutations in FKS1