Chapter 3 - Evolution of antimicrobial drug resistance in human pathogenic fungi

Abstract

Every year millions of individuals die because of fungal infections/diseases caused by various fungal pathogens. These fungal pathogens generally infect individuals with a compromised immune system. The species belonging to Candida, Cryptococcus, Aspergillus genera cause serious human diseases including Candidiasis, Aspergillosis, and Cryptococcosis. Candida albicans, Cryptococcus neoformans, and Aspergillus fumigatus represent the major widespread pathogenic species of fungi. These fungal pathogens evolve various drug-resistance mechanisms to attain resistance and to restrict the effect of different antifungals. Unfortunately, there are limited classes of antifungal drugs available for clinical usage, which restrict the treatment options. Polyenes, azoles, allylamines, flucytosine, and echinocandins are the most frequently used antifungal drug classes. Hence it becomes imperative to recognize different resistance procedures to overcome the globally increasing infectious diseases as well as for the establishment of appropriate treatment and control strategies. In this chapter, we are providing a detailed account of the expansion of antimicrobial resistance in the key human pathogenic species of fungi, in a manner that will provide meaningful insights into the disease pathogenesis mechanisms and eventually help in the identification of novel targets/strategies. Moreover, we believe that having a thorough knowledge of the molecular basis governing the drug-resistance procedures in the pathogenic fungi will aid us in improving the antifungal therapeutics and the development of improved control and treatment strategies against the emerging fungal infectious diseases.