Tackling the emerging threat of antifungal resistance to human health

Matthew C. Fisher*, Ana Alastruey-Izquierdo, Judith Berman, Tihana Bicanic, Elaine M. Bignell, Paul Bowyer, Michael Bromley, Roger Brüggemann, Gary Garber, Oliver A. Cornely, Sarah J. Gurr, Thomas S. Harrison, Ed Kuijper, Johanna Rhodes, Donald C. Sheppard, Adilia Warris, P. Lewis White, Jianping Xu, Bas Zwaan, Paul E. Verweij*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

Invasive fungal infections pose an important threat to public health and are an under-recognized component of antimicrobial resistance, an emerging crisis worldwide. Across a period of profound global environmental change and expanding at-risk populations, human-infecting pathogenic fungi are evolving resistance to all licensed systemic antifungal drugs. In this Review, we highlight the main mechanisms of antifungal resistance and explore the similarities and differences between bacterial and fungal resistance to antimicrobial control. We discuss the research and innovation topics that are needed for risk reduction strategies aimed at minimizing the emergence of resistance in pathogenic fungi. These topics include links between the environment and One Health, surveillance, diagnostics, routes of transmission, novel therapeutics and methods to mitigate hotspots for fungal adaptation. We emphasize the global efforts required to steward our existing antifungal armamentarium, and to direct the research and development of future therapies and interventions.

Original languageEnglish
Pages (from-to)557-571
Number of pages15
JournalNature Reviews Microbiology
Volume20
Issue number9
DOIs
StatePublished - Sep 2022

Funding

FundersFunder number
Centre for Infectious Diseases Research
Commonwealth & Development Office
National Institute for Public Health and the Environment
Strategic Research and Innovation Agenda
Synergy Fungal Tolerance951475
UK MRC
Bill and Melinda Gates FoundationGROEN.2019.002
Canadian Institute for Advanced Research
Joint Programming Initiative on Antimicrobial Resistance
Medical Research CouncilMR/R015600/1
Biotechnology and Biological Sciences Research CouncilBB/PO18335
Natural Environment Research Council
European Commission
European Research Council
Nederlandse Organisatie voor Wetenschappelijk Onderzoek
Israel Science Foundation997/18
Rijksinstituut voor Volksgezondheid en Milieu
Medical Research Council Centre for Medical MycologyMR/N006364/2
Foreign, Commonwealth and Development Office

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