Contemporary Questions in Pulmonary and Critical Care Infections-Resistant Fungal Pathogens Exaggerated or Underestimated Chaturvedi

Resistant Fungal Pathogens Exaggerated or Underestimated Chaturvedi

Pdf Summary

The document discusses the growing challenge of antifungal resistance in pulmonary and critical care infections, examining whether it is underestimated in the medical community. Key objectives include assessing current trends in antifungal resistance, understanding the complexities of resistance testing, and recognizing the progress and future challenges in regulatory practices.<br /><br />Antifungal resistance is defined microbiologically as the nonsusceptibility of a fungal pathogen to an antifungal drug, as determined by in-vitro testing. Resistance can be intrinsic or acquired, with common examples being Candida krusei's resistance to fluconazole and acquired resistance in Candida albicans and Aspergillus strains. Clinical resistance occurs when a fungal infection is not eradicated despite treatment with an initially effective antifungal agent.<br /><br />The threat of antifungal resistance is potentially underestimated due to several factors:<br /><br />1. **Rising Incidence**: Invasive fungal infections are increasing, especially in patients undergoing immunosuppressive therapies, making Candida a significant cause of bloodstream infections in the U.S.<br /><br />2. **Outbreaks**: There is a notable rise in hospital outbreaks caused by drug-resistant fungi like Candida auris, highlighting in-hospital transmission of multidrug-resistant strains.<br /><br />3. **Lab Capacity**: The capacity for accurate laboratory testing is limited, making the detection and reporting of resistant strains less reliable.<br /><br />4. **Limited Drug Arsenal**: Unlike antibacterials, there are significantly fewer antifungal drugs available, which restricts treatment options. The slow development of new drugs further exacerbates this issue, increasing vulnerabilities to resistant strains.<br /><br />These factors, combined with the current healthcare infrastructure, impede effective management and acknowledgment of antifungal resistance, underscoring a pressing need for expanded research and development in antifungal therapies.

Keywords

antifungal resistance

pulmonary infections

critical care

Candida auris

drug-resistant fungi

invasive fungal infections

Candida krusei

antifungal drugs

resistance testing

immunosuppressive therapies