{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T16:24:18Z","timestamp":1791563058540,"version":"4.3.4"},"reference-count":35,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,1,8]],"date-time":"2022-01-08T00:00:00Z","timestamp":1641600000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100005001","name":"Ahvaz Jundishapur University of Medical Sciences","doi-asserted-by":"publisher","award":["OG\u20109733"],"award-info":[{"award-number":["OG\u20109733"]}],"id":[{"id":"10.13039\/501100005001","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Laboratory Analysis"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Resistance to azole drugs has been observed in candidiasis due to their long\u2010term use and poor response to treatment. Resistance to azole drugs in<jats:italic>Candida albicans<\/jats:italic>isolates is controlled by several genes including<jats:italic>ERG11<\/jats:italic>,<jats:italic>CDR1<\/jats:italic>,<jats:italic>CDR2<\/jats:italic>, and<jats:italic>MDR1<\/jats:italic>. In this study, the expression of the mentioned genes was evaluated in<jats:italic>C.\u00a0albicans<\/jats:italic>isolates susceptible and resistant to fluconazole.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>After identifying the<jats:italic>Candida isolates<\/jats:italic>using morphological and molecular methods, the minimum inhibitory concentration (MIC) and drug susceptibility were determined using the European Committee on Antimicrobial Susceptibility Testing (EUCAST) method. RNA was then extracted and cDNA was synthesized from 24<jats:italic>C.\u00a0albicans<\/jats:italic>isolates from patients with cancer. Then, the mean expressions of these genes were compared in two groups using real\u2010time polymerase chain reaction (RT\u2010PCR).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 74<jats:italic>Candida<\/jats:italic>isolates were obtained from the oral cavity of 61 cancer patients with oral candidiasis. After 24\u00a0h, 21.6% of the isolates were fluconazole\u2010resistant, 10.8% were identified as dose\u2010dependent, and the rest of the isolates (67.6%) were fluconazole\u2010sensitive. The mean expressions of the<jats:italic>CDR1<\/jats:italic>and<jats:italic>MDR1<\/jats:italic>\u00a0genes were significantly higher in the resistant isolates than in the sensitive ones. However, the<jats:italic>ERG11<\/jats:italic>and<jats:italic>CDR2<\/jats:italic>\u00a0genes were not significantly increased in the resistant isolates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The increased mean expressions of the<jats:italic>CDR1<\/jats:italic>and<jats:italic>MDR1<\/jats:italic>\u00a0genes had a greater effect on fluconazole resistance among the drug\u2010resistant strains of<jats:italic>C.\u00a0albicans<\/jats:italic>in chemotherapy patients. It seemed that the accumulation of chemotherapeutic drugs in this organism stimulated some regulatory factors and increased the expression of these two genes and ultimately helped to further increase their expression and resistance to fluconazole.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcla.24208","type":"journal-article","created":{"date-parts":[[2022,1,8]],"date-time":"2022-01-08T17:33:55Z","timestamp":1641663235000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["The evaluation of the overexpression of the<i>ERG\u201011<\/i>,<i>MDR\u20101<\/i>,<i>CDR\u20101<\/i>, and<i>CDR\u20102<\/i>genes in fluconazole\u2010resistant<i>Candida albicans<\/i>isolated from Ahvazian cancer patients with oral candidiasis"],"prefix":"10.1002","volume":"36","author":[{"given":"Mehrnoush","family":"Maheronnaghsh","sequence":"first","affiliation":[{"name":"Department of Medical Mycology School of Medicine Ahvaz Jundishapur University of Medical Sciences Ahvaz Iran"},{"name":"Department of Parasitology and Mycology School of Medicine Isfahan University of Medical Sciences Isfahan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Teimoori","sequence":"additional","affiliation":[{"name":"Department of Virology Faculty of Medicine Hamadan University of Medical Sciences Hamadan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parvin","family":"Dehghan","sequence":"additional","affiliation":[{"name":"Department of Parasitology and Mycology School of Medicine Isfahan University of Medical Sciences Isfahan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6898-1309","authenticated-orcid":false,"given":"Mahnaz","family":"Fatahinia","sequence":"additional","affiliation":[{"name":"Department of Medical Mycology School of Medicine Ahvaz Jundishapur University of Medical Sciences Ahvaz Iran"},{"name":"Infectious and Tropical Diseases Research Center, Health Research Institute Ahvaz Jundishapur University of Medical Sciences Ahvaz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,1,8]]},"reference":[{"issue":"6","key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"279","DOI":"10.7883\/yoken.JJID.2004.279","article-title":"Isolation and characterization of Candida spp. in Jordanian cancer patients: prevalence, pathogenic determinants, and antifungal sensitivity","volume":"57","author":"Al\u2010Abeid HM","year":"2004","journal-title":"Jpn J Infect Dis"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1086\/430918"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0714.2010.00937.x"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1074\/jbc.M117.778308"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1099\/00221287-145-10-2701"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/147323001003800216"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbrc.2008.06.093"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.45.10.2676-2684.2001"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.50.4.1365-1371.2006"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00463-08"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.ppat.0030164"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1089\/mdr.2005.11.232"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00504-18"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/nature06836"},{"issue":"2","key":"e_1_2_10_16_1","first-page":"170","article-title":"Relation of ALS 1 and ALS3 genes and fluconazole resistance in Candida albicans isolated from vaginal candidacies","volume":"2","author":"Roudbary M","year":"2012","journal-title":"Int J Mol Clin Microbiol"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-12-230"},{"key":"e_1_2_10_18_1","volume-title":"Clinical Breakpoints and Dosing of Antibiotics","author":"Testing ECoAS","year":"2020"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2007.01935.x"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1080\/13693780701581458"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-018-3082-0"},{"issue":"2","key":"e_1_2_10_22_1","first-page":"21622","article-title":"Nosocomial candiduria in critically Ill patients admitted to intensive care units in Qazvin, Iran. 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