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Drug-Resistant Fungi: An Emerging Challenge Threatening Our Limited Antifungal Armamentarium

Amir Arastehfar1, Toni Gabaldón2,3,4, Rocio Garcia-Rubio1

  • 1Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ 07110, USA.

Antibiotics (Basel, Switzerland)
|December 11, 2020
PubMed

Insights

Antifungal drug resistance is increasing in invasive fungal infections (IFIs) and agriculture, driven by various factors. Strategies like stewardship programs and new drug development are crucial to combat resistant fungi.

Area of Science:

  • Medical Mycology
  • Antimicrobial Resistance
  • Drug Discovery

Background:

  • Invasive fungal infections (IFIs) cause high mortality and economic losses.
  • Widespread antifungal agent use has led to increased drug resistance in fungi.
  • Limited systemic antifungal drugs face challenges from fungal, host, and drug-related factors.

Purpose of the Study:

  • To review the current landscape of antifungal resistance in clinical and agricultural settings.
  • To discuss the mechanisms and contributing factors to antifungal resistance.
  • To highlight strategies for mitigating antifungal resistance and managing IFIs.

Main Methods:

  • Literature review of antifungal resistance trends.
  • Analysis of factors contributing to resistance.
  • Evaluation of current and future management strategies.

Main Results:

  • Significant antifungal resistance observed in Candida, Aspergillus, Cryptococcus, and Pneumocystis species.
  • Environmental drug-resistant fungi are increasingly found in clinical settings.
  • Limited understanding of resistance mechanisms in emerging Candida species.

Conclusions:

  • Antifungal stewardship programs and susceptibility testing are vital to minimize resistance.
  • New antifungal drugs and adjuvants are needed to treat resistant infections.
  • Addressing antifungal tolerance is key to preventing resistance emergence.
Keywords:
antifungal resistanceantifungal susceptibility testingazoleechinocandinidentificationtherapeutic drug monitoringwhole-genome sequencing

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