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Whole Genome Sequencing of Candida glabrata for Detection of Markers of Antifungal Drug Resistance
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The rapid emergence of antifungal-resistant human-pathogenic fungi

Shawn R Lockhart1, Anuradha Chowdhary2,3, Jeremy A W Gold4

  • 1Mycotic Diseases Branch, Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA. gyi2@cdc.gov.

Nature Reviews. Microbiology
|August 30, 2023
PubMed

Insights

Emerging antifungal-resistant fungi like Candida auris and azole-resistant Aspergillus fumigatus pose a growing public health threat. Vigilance is critical for monitoring fungal emergence and rising antifungal resistance due to diverse drivers.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Public Health

Background:

  • Pathogenic fungi are an increasing global health concern, exacerbated by a limited arsenal of effective antifungal drugs.
  • Invasive fungal infections present a significant challenge to healthcare systems worldwide.

Purpose of the Study:

  • To review the global emergence and spread of three key antifungal-resistant fungi.
  • To identify the distinct drivers contributing to the rise of these resistant fungal pathogens.
  • To emphasize the need for ongoing surveillance of fungal emergence and antifungal resistance.

Main Methods:

  • Review of current literature on emerging fungal pathogens.
  • Analysis of factors contributing to antifungal resistance in clinical and environmental settings.
  • Synthesis of information on transmission routes and selection pressures.

Main Results:

  • Candida auris emergence is linked to global healthcare transmission and potentially climate change.
  • Azole-resistant Aspergillus fumigatus is driven by agricultural and environmental azole fungicide use.
  • Trichophyton indotineae resistance is associated with over-the-counter corticosteroid-antifungal cream misuse.

Conclusions:

  • The diverse nature of emerging fungi and their drivers necessitates continuous monitoring.
  • Proactive surveillance is essential to anticipate and manage future antifungal resistance threats.
  • A multifaceted approach is required to address the complex issue of antifungal resistance.

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