Worldwide Emergence of Drug Resistant Fungi: from Basic to Clinic

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About this Research Topic

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Background

Fungal infections lead to 14.9 million cases and 1.7 million deaths globally every year, and are ranked 3rd among the most common pathogens causing bloodstream infections. The most prevalent pathogenic fungal species, such Candida, Aspergillus, and Cryptococcus, are now in a shift towards increasing resistance to polyenes, azoles, allylamines, flucytosine, and echinocandins. Emerging multi-drug resistant species come to be a rising threat, e.g. Candida auris has been documented in the hospitals from 36 countries. However, the detection and control of antifungal resistant infections are challenged by inadequant knowledge of multicenter surveillant data, limited kinds of rapid diagnostic tools and unavailability of novel antifungal agents. In addition, mechanisms contributing to antifungal drug resistance still remain to be further explored.

Resistance to currently available antifungals is a rising concern to healthcare workers, especially when they encounter the following situations in clinical settings:
• emerging species of multidrug resistance (resistant to at least 2 classes of agents), such as Candida auris;
• increasing antifungal resistant rate among prevalent species, such as increased azole resistance in Aspergillus spp.;
• lack of diagnostic kits for multidrug resistant species and drug-resistant mutations;
• Limited antifungal options and strategies;
• multiple comorbidities of hosts with resistant fungal infection.

Herein, the purpose of our Research Topic is to discuss and demonstrate the current trends in antifungal surveillance, diagnostic tools development, drug discovery, antifungal strategies, and mechanism of resistant fungal infection. We hope any of the progress in the Research Topic can improve the clinical outcomes or scientific researches.

The current Research Topic focus on surveillance, diagnostic tools, drug discovery, therapeutic strategies and mechanism of antifungal resistance. We welcome Original Research and Review regarding the following themes but not limited to:
• Prevalence of antifungal resistant mycoses and factors driving resistance;
• Mechanisms of antifungal resistance;
• Identification of antifungal resistance;
• Treating antifungal resistant mycoses using synthetic drugs and drugs in the pipeline showing optimal efficacy;
• Role of therapeutic drug monitoring and antifungal stewardship in attainment of right dosage and minimizing resistance;
• The potential of compounds, herbal extract, peptide, nanomaterials in treating antifungal resistant mycoses, and novel strategies for detecting drug targets;
• Role of biofilm in fungal species showing high rate of antifungal resistance;
• Pathogenicity of prevalent fungal species and their implication for development of novel antifungal drugs.

Keywords: fungal resistance surveillance, drug discovery, diagnosis, antifungal susceptibility testing, biofilm

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