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Fungal infections have become one of the major causes of morbidity and mortality in immunocompromised patients. Despite increased awareness and improved treatment strategies, the frequent development of resistance to the antifungal drugs used in clinical settings contributes to the increasing toll of mycoses. Although a natural phenomenon, antifungal drug resistance can compromise advances in the development of effective diagnostic techniques and novel antifungals. In this review, we will discuss the advent of cellular-microarrays, microfluidics, genomics, proteomics and other state-of-the art technologies in conquering antifungal drug resistance. [Copyright &y& Elsevier]

Objective: The aim was to determine the ability of several thin-film polymer formulations, with and without incorporated antifungals, to inhibit Candida albicans biofilm growth on denture material. The inhibition of C. albicans biofilms on maxillary dentures could play a significant role in preventing the development of denture stomatitis. Study design: Low-porosity and high-porosity thin-film polymer formulations were used and one of the following fungicides was added: 1) chlorhexidine diacetate at 1.0%; 2) nystatin at 1.0%; or 3) amphotericin B at 0.1%. These coatings were placed on rectangular (12 × 10 mm) dental resin material samples. A subset of the coated dental materials were brushed to simulate denture cleaning for 1 minute per day for 1 year. Candida albicans biofilms were formed on polymethylmethacrylate (PMMA) specimens placed in 24-well polystyrene plates, and the extent of biofilm formation on coated and noncoated specimens was assessed using a 2,3-bis(2-methoxy-4-nitro-5-sulfo-phenyl)-2H-tetrazolium-5-carboxanilide (XTT) reduction assay. Results: Thin-film polymer PMMA coatings alone, without an antifungal agent, produced a small significant reduction in C. albicans biofilm formation compared with control PMMA. However, incorporation of antifungal medications into the thin-film polymer reduced biofilm formation between 70% and 80% with nystatin, and between 50% and 60% with amphotericin B. Biofilm reduction with chlorhexidine (up to 98%) was significantly greater than all other formulations tested (P < .025). Conclusion: This novel thin-film coating with various antifungals effectively inhibits C. albicans biofilm formation and should be evaluated as a potential preventive therapy for denture stomatitis. [Copyright &y& Elsevier]

• Biofilm formation is a major contributor to pathogenesis during Candida infection. • C. albicans biofilm formation is a multi-step, highly regulated process. • Cells in biofilms are protected from environmental stresses and host defenses. • Dispersal is critical for the propagation of cells into the bloodstream. The fungal species Candida albicans is most frequently associated with biofilm formation in immune-compromised and medically compromised patients, and it is now firmly established that biofilm formation represents a major virulence factor during candidiasis. A growing body of evidence has demonstrated that C. albicans biofilm development is a highly regulated and coordinated process, where adhesive interactions, morphogenetic conversions, and consortial behavior play significant roles. Cells within the biofilms are protected from environmental stresses including host immune defenses and antifungal treatment, which carries important clinical consequences for the treatment of biofilm-associated infections. Dispersal of cells from biofilms represents one of the hallmarks of the biofilm life-style, and in the case of C. albicans dispersed cells are responsible for candidemia and dissemination leading to the establishment of invasive disease. [ABSTRACT FROM AUTHOR]