Medical Mycology Seen Through a One Health Approach

In clinical settings, the number of immune compromised patients have increased as a result of developments in medical technology (e.g., organ transplantation, anticancer drugs, steroids, TNF inhibitors, etc.). However, patients with fungal diseases are also increasing globally. In recent years, the distribution and pathogenicity of fungi worldwide have been changing, with reports that new fungi are emerging, and antifungal-resistant fungi are spreading globally. Global warming, globalization, human activities, and other factors have been suggested as contributing to the emergence of new fungi. Some of the antifungals against which resistant fungi have emerged are commonly used not only for human but also for animal health care and crop protection. Consequently, the occurrence of antifungal-resistant fungi has become a clinical issue. Solving these problems entails continuing the "One Health" approach, which in turn requires updating medical mycology information with regard to the emerging pathogenic fungi. In particular, this paper reviews the recent information on Cryptococcus gattii, Candia auris, and azole-resistant Aspergillus fumigatus.