The rapid emergence of antifungal-resistant human-pathogenic fungi

Nat Rev Microbiol. 2023 Dec;21(12):818-832. doi: 10.1038/s41579-023-00960-9. Epub 2023 Aug 30.

Abstract

During recent decades, the emergence of pathogenic fungi has posed an increasing public health threat, particularly given the limited number of antifungal drugs available to treat invasive infections. In this Review, we discuss the global emergence and spread of three emerging antifungal-resistant fungi: Candida auris, driven by global health-care transmission and possibly facilitated by climate change; azole-resistant Aspergillus fumigatus, driven by the selection facilitated by azole fungicide use in agricultural and other settings; and Trichophyton indotineae, driven by the under-regulated use of over-the-counter high-potency corticosteroid-containing antifungal creams. The diversity of the fungi themselves and the drivers of their emergence make it clear that we cannot predict what might emerge next. Therefore, vigilance is critical to monitoring fungal emergence, as well as the rise in overall antifungal resistance.

Publication types

  • Review

MeSH terms

  • Antifungal Agents* / pharmacology
  • Aspergillus fumigatus
  • Azoles / pharmacology
  • Drug Resistance, Fungal
  • Fungi*
  • Humans
  • Microbial Sensitivity Tests

Substances

  • Antifungal Agents
  • Azoles