{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T06:00:46Z","timestamp":1787032846479,"version":"build-2736575974"},"reference-count":31,"publisher":"Instituto Nacional de Salud (Colombia)","issue":"4","license":[{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["revistabiomedica.org"],"crossmark-restriction":false},"short-container-title":["biomedica"],"abstract":"<jats:p>Introducci\u00f3n. El fluconazol es el antif\u00fangico m\u00e1s utilizado para la prevenci\u00f3n y el tratamiento de infecciones causadas por el g\u00e9nero Cryptococcus, agente etiol\u00f3gico de la criptococosis. La resistencia al fluconazol en los aislamientos de Cryptoccocus neoformans puede hacer fracasar el tratamiento y generar reca\u00eddas de la infecci\u00f3n.Objetivo. Evaluar los perfiles de expresi\u00f3n de los genes AFR1, MDR1 y ERG11 en aislamientos cl\u00ednicos de C. neoformans var. grubii, durante la respuesta in vitro a la inducci\u00f3n con fluconazol.Materiales y m\u00e9todos. Se estudiaron 14 aislamientos de C. neoformans var. grubii provenientes de pacientes con HIV, de los cuales 6 eran sensibles al fluconazol y 8 presentaban sensibilidad disminuida. Los niveles de expresi\u00f3n de los genes ERG11, AFR1 y MDR1 se determinaron mediante PCR en tiempo real.Resultados. Los aislamientos resistentes al fluconazol mostraron sobreexpresi\u00f3n de los genes AFR1 y MDR1, mientras que la expresi\u00f3n de los fenotipos de resistencia evaluados se mantuvo homog\u00e9nea en ERG11, en todos los aislamientos de C. neoformans var. grubii.Conclusiones. La sobreexpresi\u00f3n de los genes AFR1 y MDR1 que codifican las bombas de eflujo, contribuye a la resistencia al fluconazol en los aislamientos estudiados. Sin embargo, los patrones de resistencia que se registran en este hongo, sumado a los casos de reca\u00eddas en pacientes con HIV, no pueden atribuirse \u00fanicamente a los casos de resistencia por exposici\u00f3n al f\u00e1rmaco. Otros mecanismos podr\u00edan tambi\u00e9n estar involucrados en este fen\u00f3meno, como la resistencia emergente (resistencia mediante otros genes ERG) y la heterorresistencia, los cuales deben ser estudiados en estos aislamientos.<\/jats:p>","DOI":"10.7705\/biomedica.6519","type":"journal-article","created":{"date-parts":[[2022,12,12]],"date-time":"2022-12-12T16:32:12Z","timestamp":1670862732000},"page":"697-706","update-policy":"https:\/\/doi.org\/10.7705\/crossmark","source":"Crossref","is-referenced-by-count":3,"title":["Perfiles de expresi\u00f3n de los genes ERG11, MDR1 y AFR1 en Cryptococcus neoformans var. grubii aislados de pacientes con VIH"],"prefix":"10.7705","volume":"42","author":[{"given":"Isaura","family":"Torres","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan E.","family":"Gallo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oscar Mauricio","family":"G\u00f3mez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1lvaro","family":"R\u00faa-Giraldo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan G.","family":"McEwen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Mar\u00eda","family":"Garc\u00eda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4444","published-online":{"date-parts":[[2022,12,1]]},"reference":[{"key":"112859","doi-asserted-by":"crossref","unstructured":"Perfect JR, Dismukes WE, Dromer F, Goldman DL, Graybill JR, Hamill RJ, et al. Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the infectious diseases society of America. Clin Infect Dis. 2010;50:291-322. https:\/\/doi.org\/10.1086\/649858","DOI":"10.1086\/649858"},{"key":"112860","doi-asserted-by":"crossref","unstructured":"Rajasingham R, Smith RM, Park BJ, Jarvis JN, Govender NP, Chiller TM, et al. Global burden of disease of HIV-associated cryptococcal meningitis: An updated analysis. Lancet Infect Dis. 2017;17:873-81. https:\/\/doi.org\/10.1016\/S1473-3099(17)30243-8","DOI":"10.1016\/S1473-3099(17)30243-8"},{"key":"112861","doi-asserted-by":"crossref","unstructured":"Escand\u00f3n P, Lizarazo J, Agudelo CI, Casta\u00f1eda E. Cryptococcosis in Colombia: Compilation and analysis of data from laboratory-based surveillance. J Fungi (Basel). 2018;4(1). https:\/\/doi.org\/10.3390\/jof4010032","DOI":"10.3390\/jof4010032"},{"key":"112862","doi-asserted-by":"crossref","unstructured":"Kwon-Chung KJ, Bennett JE, Wickes BL, Meyer W, Cuomo CA, Wollenburg KR, et al. The case for adopting the \u201cSpecies Complex\u201d nomenclature for the etiologic agents of cryptococcosis. mSphere. 2017;2:e00357-16. https:\/\/doi.org\/10.1128\/mSphere.00357-16","DOI":"10.1128\/mSphere.00357-16"},{"key":"112863","doi-asserted-by":"crossref","unstructured":"Hagen F, Khayhan K, Theelen B, Kolecka A, Polacheck I, Sionov E, et al. Recognition of seven species in the Cryptococcus gattii\/Cryptococcus neoformans species complex. Fungal Genet Biol. 2015;78:16-48. https:\/\/doi.org\/10.1016\/j.fgb.2015.02.009","DOI":"10.1016\/j.fgb.2015.02.009"},{"key":"112864","doi-asserted-by":"crossref","unstructured":"Idnurm A, Lin X. Rising to the challenge of multiple Cryptococcus species and the diseases they cause. Fungal Genet Biol. 2015;78:1-6. https:\/\/doi.org\/10.1016\/j.fgb.2015.05.002","DOI":"10.1016\/j.fgb.2015.05.002"},{"key":"112865","doi-asserted-by":"crossref","unstructured":"Serna-Espinosa BN, Guzm\u00e1n-Sanabria D, Forero-Castro M, Escand\u00f3n P, S\u00e1nchez-Quitian ZA. Environmental Status of Cryptococcus neoformans and Cryptococcus gattii in Colombia. J Fungi (Basel). 2021;7. https:\/\/doi.org\/10.3390\/jof7060410","DOI":"10.3390\/jof7060410"},{"key":"112866","doi-asserted-by":"crossref","unstructured":"Gushiken AC, Saharia KK, Baddley JW. Cryptococcosis. Infect Dis Clin North Am. 2021;35:493-514. https:\/\/doi.org\/10.1016\/j.idc.2021.03.012","DOI":"10.1016\/j.idc.2021.03.012"},{"key":"112867","unstructured":"World Health Organization. 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