species are the leading cause of invasive fungal infections worldwide and are associated with acute mortality rates of ~50%. Mortality rates are further augmented in the context of host immunosuppression and infection with drug-resistant species. In this review, we outline antifungal drugs already in clinical use for invasive candidiasis and candidaemia, their targets and mechanisms of resistance in clinically relevant species, encompassing not only classical resistance, but also heteroresistance and tolerance. We describe novel antifungal agents and targets in pre-clinical and clinical development, including their spectrum of activity, antifungal target, clinical trial data and potential in treatment of drug-resistant . Lastly, we discuss the use of combination therapy between conventional and repurposed agents as a potential strategy to combat the threat of emerging resistance in .
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http://dx.doi.org/10.3389/fcimb.2021.759408 | DOI Listing |
Genetics
January 2025
Dept. of Genetics, Stanford University, Stanford CA 94305-5120, USA.
The Candida Genome Database (CGD; www.candidagenome.org) is unique in being both a model organism database and a fungal pathogen database.
View Article and Find Full Text PDFMycoses
January 2025
Infectious Diseases Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Background: Infections with fluconazole-resistant Candida parapsilosis have been increasing in Israeli hospitals with unclear implications for patient outcomes.
Objectives: To determine the frequency, mechanisms, molecular epidemiology, and outcomes of azole-resistant C. parapsilosis bloodstream infections in four hospitals in Israel.
Antibiotics (Basel)
December 2024
Neonatal Intensive Care Unit, School of Medicine, University of Ioannina, 45500 Ioannina, Greece.
The neonatal intensive care unit (NICU) population, especially low birth weight and critically ill neonates, is at risk of invasive infections, which are associated with high mortality rates and unfavorable long-term outcomes. The timely initiation of an appropriate antifungal treatment has been demonstrated to enhance the prognosis. Factors that should be considered in the choice of an antifungal agent include the causative strain, the presence and location of deep tissue infection, any previous use of antifungal prophylaxis, and the presence of implanted devices.
View Article and Find Full Text PDFJ Leukoc Biol
January 2025
Center for Engineering in Medicine and Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA.
In tissues, neutrophils neutralize Candida albicans through phagocytosis and delay C. albicans hyphae growth by deploying neutrophil extracellular traps (NETs). However, in the bloodstream, the dynamic interactions between NETs and C.
View Article and Find Full Text PDFMed Mycol Case Rep
December 2024
Public Health Wales Mycology Reference Laboratory, University Hospital of Wales, Heath Park Way, CF14 4XW, Cardiff, United Kingdom.
Refractory invasive fungal disease is a significant clinical problem, with high morbidity, mortality and costs. The complex causes of refractory infection include breakthrough infection due to antifungal resistance (both innate and acquired), suboptimal therapy and impaired immune responses in critically ill or immunocompromised patients. This case series details three reports on the identification and management of refractory fungal infections, two cases of azole resistance and one case of resistant candidiasis, highlighting the importance of accurate diagnosis, monitoring, implementation of biomarkers (serological markers, PCR), antifungal susceptibility testing and antifungal stewardship to optimise management and minimise risks of emergence of drug resistance.
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