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      Fungal infections in humans: the silent crisis

      editorial
      Author(s): 1 , 1 , 1 , 2 , 3 , * , 1 , *
      Publication date (Electronic, pub):
      Publication date (Electronic, collection):
      Journal: Microbial Cell
      Publisher: Shared Science Publishers OG
      Keywords: Candida, resistance, antifungals, yeast, antimycotics, drug, azoles

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          Abstract

          Annually, over 150 million severe cases of fungal infections occur worldwide, resulting in approximately 1.7 million deaths per year. Alarmingly, these numbers are continuously on the rise with a number of social and medical developments during the past decades that have abetted the spread of fungal infections. Additionally, the long-term therapeutic application and prophylactic use of antifungal drugs in high-risk patients have promoted the emergence of (multi)drug-resistant fungi, including the extremely virulent strain Candida auris. Hence, fungal infections are already a global threat that is becoming increasingly severe. In this article, we underline the importance of more and effective research to counteract fungal infections and their consequences.

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          Antibiotic resistance threats in the United States, 2019

          (2019)
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            Multidrug-Resistant Candida: Epidemiology, Molecular Mechanisms, and Treatment.

            Maiken Arendrup, Thomas Patterson (2017)
            Invasive Candida infections remain an important cause of morbidity and mortality, especially in hospitalized and immunocompromised or critically ill patients. A limited number of antifungal agents from only a few drug classes are available to treat patients with these serious infections. Resistance can be either intrinsic or acquired. Resistance mechanisms are not exchanged between Candida; thus, acquired resistance either emerges in response to an antifungal selection pressure in the individual patient or, more rarely, occur due to horizontal transmission of resistant strains between patients. Although multidrug resistance is uncommon, increasing reports of multidrug resistance to the azoles, echinocandins, and polyenes have occurred in several Candida species, most notably Candida glabrata and more recently Candida auris. Drivers are overall antifungal use, subtherapeutic drug levels at sites of infection/colonization, drug sequestration in the biofilm matrix, and, in the setting of outbreaks, suboptimal infection control. Moreover, recent research suggests that DNA mismatch repair gene mutations may facilitate acquisition of resistance mutations in C. glabrata specifically. Diagnosis of antifungal-resistant Candida infections is critical to the successful management of patients with these infections. Reduction of unnecessary use of antifungals via antifungal stewardship is critical to limit multidrug resistance emergence.
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              Antifungals.

              Sonia Campoy, Jose L. Adrio (2017)
              The need for new antifungal agents is undeniable. Current therapeutic choices for the treatment of invasive fungal infections are limited to three classes of drugs. Most used antifungal agents are not completely effective due to the development of resistance, host toxicity and undesirable side effects that limit their use in medical practice. Invasive fungal infections have significantly increased over the last decades and the mortality rates remain unacceptably high. More threatening, new resistance patterns have been observed including simultaneous resistance to different antifungal classes. In the last years, deeper insights into the molecular mechanisms for fungal resistance and virulence have yielded some new potential targets for antifungal therapeutics. Chemical genomics-based screenings, high throughput screenings of natural products and repurposing of approved drugs are some of the approaches being followed for the discovery of new antifungal molecules. However, despite the emerging need for effective antifungal agents, the current pipeline contains only a few promising molecules, with novel modes of action, in early clinical development stages.
              Article 0 comments Cited 124 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Microb Cell
                Journal ID (iso-abbrev): Microb Cell
                Journal ID (pmc): Microb Cell
                Journal ID (publisher-id): Microb Cell
                Title: Microbial Cell
                Publisher: Shared Science Publishers OG
                ISSN (Electronic): 2311-2638
                Publication date (Electronic, pub): 01 June 2020
                Publication date (Electronic, collection): 01 June 2020
                Volume: 7
                Issue: 6
                Pages: 143-145
                Affiliations
                [1 ]Institute for Molecular Biosciences, NAWI Graz, University of Graz, Graz, Austria.
                [2 ]BioHealth Graz, Graz, Austria.
                [3 ]BioTechMed Graz, Graz, Austria.
                Author notes
                * Corresponding Author: Didac Carmona-Gutierrez: Institute of Molecular Biosciences, University of Graz, Graz, Austria; E-mail: carmonag@ 123456uni-graz.at
                * Corresponding Author: Frank Madeo; Institute of Molecular Biosciences, University of Graz, Graz, Austria; E-mail: madeo@ 123456uni-graz.at

                Conflict of interest: D.C-G. and F.M. are the scientific co-founders of Samsara Therapeutics, a company that develops novel pharmacological autophagy inducers. F.M. and D.C-G. have equity interests in TLL (The Longevity Labs), a company that develops natural food extracts.

                Please cite this article as: Katharina Kainz, Maria A. Bauer, Didac Carmona-Gutierrez and Frank Madeo ( 2020). Fungal infections in humans: the silent crisis. Microbial Cell 7(6): 143-145. doi: 10.15698/mic2020.06.718

                Article
                Publisher ID: MIC0270E225
                DOI: 10.15698/mic2020.06.718
                PMC ID: 7278517
                PubMed ID: 32548176
                SO-VID: 0d81085b-462e-495b-b3ce-01daefa5012e
                Copyright © Copyright: © 2020 Kainz et al.
                License:

                This is an open-access article released under the terms of the Creative Commons Attribution (CC BY) license, which allows the unrestricted use, distribution, and reproduction in any medium, provided the original author and source are acknowledged.

                History
                Date received : 20 May 2020
                Date accepted : 25 May 2020
                Funding
                The authors are grateful to the Austrian Science Fund FWF (SFBLIPOTOX F3007&F3012, W1226, P29203, P29262, P27893) and the Austrian Federal Ministry of Education, Science and Research and the University of Graz for grants “Unkonventionelle Forschung” and “flysleep” (BMWFW-80.109/0001-WF/V/3b/2015). The authors also acknowledge the funding of DK Metabolic and Cardiovascular Disease (FWF) and the Doctoral Col-lege “Metabolic and Cardiovascular Disease” (FWFW1226) as well as support from NAWI Graz and the BioTechMed-Graz flagship project “EPIAge”.
                Categories
                Subject: Editorial
                Subject: Candida
                Subject: Resistance
                Subject: Antifungals
                Subject: Yeast
                Subject: Antimycotics
                Subject: Drug
                Subject: Azoles

                Keywords: candida,resistance,antifungals,yeast,antimycotics,drug,azoles
                Data availability:
                Keywords: candida, resistance, antifungals, yeast, antimycotics, drug, azoles

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