Antifungal drug resistance in molds: Clinical and microbiological factors

Abstract

The incidence of fungal infections has increased over the past decade. In addition to classical pathogens, such as Aspergillus spp, new fungal species are increasingly reported. Despite the availability of new antifungals, mortality of invasive fungal infections remains very high. The host immune status is the main factor for survival. However, most of these pathogens have high minimum inhibitory concentrations (MICs) to antifungals, and therefore, the influence of these high MICs in the outcome of the patients have begun to be addressed. Several strains of Aspergillus fumigatus showing resistance to itraconazole have been isolated, and the molecular-resistance mechanisms have been characterized. In addition, attempts to correlate high MICs with patient outcome have been performed. Although correlation is far from perfect, a clear trend between high MICs and poor outcome has been established. Resistance of fungi to antifungals is a health problem requiring support from research agencies.