Time to Think Antifungal Resistance
Increased antifungal resistance is exacerbating the burden of invasive fungal infections, as well as potentially contributing to the increase in resistant dermatomycoses. In this commentary, we focus on antifungal drug resistance, in contrast to antibacterial resistance. We provide a brief historic...
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| Format: | Article |
| Language: | English |
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Case Western Reserve University
2024-03-01
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| Series: | Pathogens and Immunity |
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| Online Access: | https://www.paijournal.com/index.php/paijournal/article/view/656 |
| _version_ | 1797271679549833216 |
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| author | Thomas McCormick Mahmoud Ghannoum |
| author_facet | Thomas McCormick Mahmoud Ghannoum |
| author_sort | Thomas McCormick |
| collection | DOAJ |
| description |
Increased antifungal resistance is exacerbating the burden of invasive fungal infections, as well as potentially contributing to the increase in resistant dermatomycoses. In this commentary, we focus on antifungal drug resistance, in contrast to antibacterial resistance. We provide a brief historical perspective on the emergence of antifungal resistance and propose measures for combating this growing health concern. The increase in the incidence of invasive and cutaneous fungal infections parallels advancements in medical interventions, such as immunosuppressive drugs, to manage cancer and reduce organ rejection following transplant. A disturbing relatively new trend in antifungal resistance is the observation of several fungal species that now exhibit multidrug resistance (eg, Candida auris, Trichophyton indotineae). Increasing awareness of these multidrug-resistant species is paramount. Therefore, increased education regarding potential fungus-associated infections is needed to address awareness in the general healthcare setting, which may result in a more realistic picture of the prevalence of antifungal-resistant infections. In addition to education, increased use of diagnostic tests (eg, micro and macro conventional assays or molecular testing) should be routine for healthcare providers facing an unknown fungal infection. Two critical barriers that affect the low rates for Antifungal Susceptibility Testing (AST) are low (or a lack of) sufficient insurance reimbursement rates and the low number of qualified laboratories with the capacity to perform AST. The ultimate aim is to improve the quality of patient care through fungal identification, diagnosis, and, where appropriate, susceptibility testing. Here we propose an all-encompassing call to action to address this emerging challenge.
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| first_indexed | 2024-03-07T14:11:56Z |
| format | Article |
| id | doaj.art-9be7d39313f847fa993b3baf4e1c8908 |
| institution | Directory Open Access Journal |
| issn | 2469-2964 |
| language | English |
| last_indexed | 2024-03-07T14:11:56Z |
| publishDate | 2024-03-01 |
| publisher | Case Western Reserve University |
| record_format | Article |
| series | Pathogens and Immunity |
| spelling | doaj.art-9be7d39313f847fa993b3baf4e1c89082024-03-06T16:12:27ZengCase Western Reserve UniversityPathogens and Immunity2469-29642024-03-018210.20411/pai.v8i2.656Time to Think Antifungal ResistanceThomas McCormick0https://orcid.org/0000-0002-3294-0326Mahmoud Ghannoum1Department of Dermatology, Center for Medical Mycology, Case Western Reserve University, Cleveland, OhioDepartment of Dermatology, Center for Medical Mycology, Case Western Reserve University; University Hospitals Cleveland Medical Center, Cleveland, Ohio Increased antifungal resistance is exacerbating the burden of invasive fungal infections, as well as potentially contributing to the increase in resistant dermatomycoses. In this commentary, we focus on antifungal drug resistance, in contrast to antibacterial resistance. We provide a brief historical perspective on the emergence of antifungal resistance and propose measures for combating this growing health concern. The increase in the incidence of invasive and cutaneous fungal infections parallels advancements in medical interventions, such as immunosuppressive drugs, to manage cancer and reduce organ rejection following transplant. A disturbing relatively new trend in antifungal resistance is the observation of several fungal species that now exhibit multidrug resistance (eg, Candida auris, Trichophyton indotineae). Increasing awareness of these multidrug-resistant species is paramount. Therefore, increased education regarding potential fungus-associated infections is needed to address awareness in the general healthcare setting, which may result in a more realistic picture of the prevalence of antifungal-resistant infections. In addition to education, increased use of diagnostic tests (eg, micro and macro conventional assays or molecular testing) should be routine for healthcare providers facing an unknown fungal infection. Two critical barriers that affect the low rates for Antifungal Susceptibility Testing (AST) are low (or a lack of) sufficient insurance reimbursement rates and the low number of qualified laboratories with the capacity to perform AST. The ultimate aim is to improve the quality of patient care through fungal identification, diagnosis, and, where appropriate, susceptibility testing. Here we propose an all-encompassing call to action to address this emerging challenge. https://www.paijournal.com/index.php/paijournal/article/view/656Antifungal ResistanceDermatophytosisTerbinafine ResistanceTrichophytan indotineaRecommendation |
| spellingShingle | Thomas McCormick Mahmoud Ghannoum Time to Think Antifungal Resistance Pathogens and Immunity Antifungal Resistance Dermatophytosis Terbinafine Resistance Trichophytan indotinea Recommendation |
| title | Time to Think Antifungal Resistance |
| title_full | Time to Think Antifungal Resistance |
| title_fullStr | Time to Think Antifungal Resistance |
| title_full_unstemmed | Time to Think Antifungal Resistance |
| title_short | Time to Think Antifungal Resistance |
| title_sort | time to think antifungal resistance |
| topic | Antifungal Resistance Dermatophytosis Terbinafine Resistance Trichophytan indotinea Recommendation |
| url | https://www.paijournal.com/index.php/paijournal/article/view/656 |
| work_keys_str_mv | AT thomasmccormick timetothinkantifungalresistance AT mahmoudghannoum timetothinkantifungalresistance |