Antifungal drug resistance to azoles and polyenes

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Whole Genome Sequencing of Candida glabrata for Detection of Markers of Antifungal Drug Resistance
08:45

Whole Genome Sequencing of Candida glabrata for Detection of Markers of Antifungal Drug Resistance

Published on: December 28, 2017

Mar Masiá Canuto1, Félix Gutiérrez Rodero

  • 1Infectious Diseases Unit, Elche University General Hospital, Alicante, Spain.

The Lancet. Infectious Diseases
|September 11, 2002
PubMed

Insights

Antifungal drug resistance in fungal infections is a growing concern, particularly in immunocompromised patients. New therapeutic strategies and antifungal control programs are crucial to combat rising morbidity and mortality.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Pharmacology

Background:

  • Fungal infections pose significant morbidity and mortality risks, especially in vulnerable patient populations.
  • Antifungal drug resistance is an increasing challenge, driven by factors like azole exposure in Candida species.
  • Patients with hematological malignancies and prolonged neutropenia are at high risk for invasive mycoses caused by resistant fungi.

Purpose of the Study:

  • To highlight the growing problem of antifungal resistance in fungal infections.
  • To identify key risk factors associated with the development of antifungal resistance.
  • To explore potential therapeutic strategies to overcome antifungal resistance.

Main Methods:

  • Review of epidemiological studies on antifungal drug resistance.
  • Analysis of risk factors contributing to resistance, including patient groups and drug exposure.
  • Evaluation of emerging therapeutic options and control strategies.

Main Results:

  • Azole exposure is a key driver of fluconazole resistance in Candida species.
  • Hematological malignancies and neutropenia are significant risk factors for invasive infections by resistant filamentous fungi (e.g., Fusarium, Scedosporium, Aspergillus).
  • High mortality rates persist for certain resistant mycoses, underscoring the need for novel treatments.

Conclusions:

  • Development of new antifungal drugs, such as beta-glucan synthesis inhibitors and novel azole/triazole derivatives, is essential.
  • Improving current therapies with lipid formulations of amphotericin B, combination therapy, and immune modulation shows promise.
  • Antifungal stewardship programs are necessary to prevent the inappropriate use of antifungals and mitigate resistance.

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