title: Current status of antifungal resistance and its impact on clinical practice.
abstract: Mortality linked to invasive fungal diseases remains very high despite the availability of novel antifungals and new therapeutic strategies. Candida albicans and Aspergillus fumigatus account for most invasive mycosis produced by yeast or moulds, respectively. Other Candida non-albicans are increasingly being reported and newly emerging, as well as cryptic, filamentous fungi often cause disseminated infections in immunocompromised hosts. Management of invasive fungal infections is becoming a challenge as emerging fungal pathogens generally show poor response to many antifungals. The ability of reference antifungal susceptibility testing methods to detect emerging resistance patterns, together with the molecular characterization of antifungal resistance mechanisms, are providing useful information to optimize the effectiveness of antifungal therapy. The current status of antifungal resistance epidemiology with special emphasis on the molecular resistant mechanisms that have been described in the main pathogenic fungal species are reviewed.
authors.affiliation: Mycology Reference Laboratory, Centro Nacional de Microbiologia, Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: Laura
authors.initials: L
authors.lastname: Alcazar-Fuoli
authors.forename: Emilia
authors.initials: E
authors.lastname: Mellado
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use*; D025141:Drug Resistance, Fungal; D006801:Humans; D008826:Microbial Sensitivity Tests; D009181:Mycoses / Q000188:drug therapy* / Q000453:epidemiology
chemical_list: D000935:Antifungal Agents
keywords: Aspergillus spp; Candida spp.; antifungal drug resistance; epidemiology; resistance mechanisms