Emerging Fungal Infections: from the Fields to the Clinic, Resistant and Dermatophyte Species: a One Health Perspective on an Urgent Public Health Problem

Overview

Journal Curr Clin Microbiol Rep

Specialty Microbiology

Date 2022 Oct 3

PMID 36188157

Authors

Antonia Langfeldt

Jeremy A W Gold

Tom Chiller

Affiliations

Soon will be listed here.

Abstract

Purpose Of Review: For this review, we use a One Health approach to examine two globally emerging public health threats related to antifungal drug resistance: triazole-resistant infections, which can cause a life-threatening illness in immunocompromised hosts, and antifungal-resistant dermatophytosis, which is an aggressive skin infection caused by dermatophyte molds. We describe the state of current scientific knowledge and outline necessary public health actions to address each issue.

Recent Findings: Recent evidence has identified the agricultural use of triazole fungicides as an important driver of triazole-resistant infections. Antifungal-resistant dermatophyte infections are likely driven by the inappropriate use of antifungal drugs and antibacterial and corticosteroid creams.

Summary: This review highlights the need for a One Health approach to address emerging antifungal resistant infections, emphasizing judicious antifungal use to preserve available treatments; strengthened laboratory capacity to identify antifungal resistance; and improved human, animal, and environmental surveillance to detect emerging resistance, monitor trends, and evaluate the effectiveness of efforts to decrease spread.

Citing Articles

Comprehensive Review of Environmental Surveillance for Azole-Resistant : A Practical Roadmap for Hospital Clinicians and Infection Control Teams.

Tashiro M, Nakano Y, Shirahige T, Kakiuchi S, Fujita A, Tanaka T J Fungi (Basel). 2025; 11(2).

PMID: 39997390 PMC: 11856238. DOI: 10.3390/jof11020096.

Epidemiology and Antifungal Susceptibilities of Clinically Isolated Species in Tertiary Hospital of Southeast China.

Hussain A, Wang Y, Mo E, Khan M, Zhang Q, Li L Infect Drug Resist. 2024; 17:5451-5462.

PMID: 39669311 PMC: 11636293. DOI: 10.2147/IDR.S495250.

The Likelihood of Resistant Tinea Capitis Caused by Hortaea Werneckii: A Case Report.

Zheng W, Zhang M, Wu W, Tang X, Pan Z Clin Cosmet Investig Dermatol. 2024; 17:2653-2657.

PMID: 39600529 PMC: 11590628. DOI: 10.2147/CCID.S489139.

Azole resistance in Aspergillus fumigatus- comprehensive review.

Dladla M, Gyzenhout M, Marias G, Ghosh S Arch Microbiol. 2024; 206(7):305.

PMID: 38878211 DOI: 10.1007/s00203-024-04026-z.

High Prevalence of Terbinafine Resistance Among Trichophyton mentagrophytes/T. interdigitale Species Complex, a Cross-Sectional Study from 2021 to 2022 in Northern Parts of Iran.

Haghani I, Babaie M, Hoseinnejad A, Rezaei-Matehkolaei A, Mofarrah R, Yahyazadeh Z Mycopathologia. 2024; 189(4):52.

PMID: 38864945 DOI: 10.1007/s11046-024-00855-0.

References

Rhodes J, Abdolrasouli A, Dunne K, Sewell T, Zhang Y, Ballard E . Population genomics confirms acquisition of drug-resistant Aspergillus fumigatus infection by humans from the environment. Nat Microbiol. 2022; 7(5):663-674. PMC: 9064804. DOI: 10.1038/s41564-022-01091-2. View

Fisher M, Henk D, Briggs C, Brownstein J, Madoff L, McCraw S . Emerging fungal threats to animal, plant and ecosystem health. Nature. 2012; 484(7393):186-94. PMC: 3821985. DOI: 10.1038/nature10947. View

Beernaert L, Pasmans F, Van Waeyenberghe L, Dorrestein G, Verstappen F, Vercammen F . Avian Aspergillus fumigatus strains resistant to both itraconazole and voriconazole. Antimicrob Agents Chemother. 2009; 53(5):2199-201. PMC: 2681513. DOI: 10.1128/AAC.01492-08. View

Du H, Bing J, Hu T, Ennis C, Nobile C, Huang G . Candida auris: Epidemiology, biology, antifungal resistance, and virulence. PLoS Pathog. 2020; 16(10):e1008921. PMC: 7581363. DOI: 10.1371/journal.ppat.1008921. View

Goodale E, Outerbridge C, White S . Aspergillus otitis in small animals--a retrospective study of 17 cases. Vet Dermatol. 2016; 27(1):3-e2. DOI: 10.1111/vde.12283. View

Urban K, Chu S, Scheufele C, Giesey R, Mehrmal S, Uppal P . The global, regional, and national burden of fungal skin diseases in 195 countries and territories: A cross-sectional analysis from the Global Burden of Disease Study 2017. JAAD Int. 2021; 2:22-27. PMC: 8362308. DOI: 10.1016/j.jdin.2020.10.003. View

Edriss M, Parker J, Pritchett E . Response to Gu et al's "Treatment-resistant dermatophytosis: A representative case highlighting an emerging public health threat". JAAD Case Rep. 2023; 32:88-89. PMC: 9851833. DOI: 10.1016/j.jdcr.2021.12.044. View

Verma S . Emergence of recalcitrant dermatophytosis in India. Lancet Infect Dis. 2018; 18(7):718-719. DOI: 10.1016/S1473-3099(18)30338-4. View

Gold J, Ahmad F, Cisewski J, Rossen L, Montero A, Benedict K . Increased Deaths From Fungal Infections During the Coronavirus Disease 2019 Pandemic-National Vital Statistics System, United States, January 2020-December 2021. Clin Infect Dis. 2022; 76(3):e255-e262. PMC: 9214147. DOI: 10.1093/cid/ciac489. View

10.

Hoenigl M, Salmanton-Garcia J, Walsh T, Nucci M, Neoh C, Jenks J . Global guideline for the diagnosis and management of rare mould infections: an initiative of the European Confederation of Medical Mycology in cooperation with the International Society for Human and Animal Mycology and the American Society for.... Lancet Infect Dis. 2021; 21(8):e246-e257. DOI: 10.1016/S1473-3099(20)30784-2. View

11.

Bradley K, Le-Mahajan A, Morris B, Peritz T, Chiller T, Forsberg K . Fatal Fungicide-Associated Triazole-Resistant Aspergillus fumigatus Infection, Pennsylvania, USA. Emerg Infect Dis. 2022; 28(9):1904-1905. PMC: 9423893. DOI: 10.3201/eid2809.220517. View

12.

Jabet A, Brun S, Normand A, Imbert S, Akhoundi M, Dannaoui E . Extensive Dermatophytosis Caused by Terbinafine-Resistant Trichophyton indotineae, France. Emerg Infect Dis. 2021; 28(1):229-233. PMC: 8714191. DOI: 10.3201/eid2801.210883. View

13.

Verweij P, Chowdhary A, Melchers W, Meis J . Azole Resistance in Aspergillus fumigatus: Can We Retain the Clinical Use of Mold-Active Antifungal Azoles?. Clin Infect Dis. 2015; 62(3):362-8. PMC: 4706635. DOI: 10.1093/cid/civ885. View

14.

Begum J, Kumar R . Prevalence of dermatophytosis in animals and antifungal susceptibility testing of isolated Trichophyton and Microsporum species. Trop Anim Health Prod. 2020; 53(1):3. DOI: 10.1007/s11250-020-02476-3. View

15.

Posso-De Los Rios C, Tadros E, Summerbell R, Scott J . Terbinafine Resistant Isolated in Patients With Superficial Dermatophyte Infection in Canadian Patients. J Cutan Med Surg. 2022; 26(4):371-376. DOI: 10.1177/12034754221077891. View

16.

Jorgensen L, Heick T . Azole Use in Agriculture, Horticulture, and Wood Preservation - Is It Indispensable?. Front Cell Infect Microbiol. 2021; 11:730297. PMC: 8453013. DOI: 10.3389/fcimb.2021.730297. View

17.

Jain A, Sarsaiya S, Wu Q, Lu Y, Shi J . A review of plant leaf fungal diseases and its environment speciation. Bioengineered. 2019; 10(1):409-424. PMC: 6779379. DOI: 10.1080/21655979.2019.1649520. View

18.

Lestrade P, Bentvelsen R, Schauwvlieghe A, Schalekamp S, van der Velden W, Kuiper E . Voriconazole Resistance and Mortality in Invasive Aspergillosis: A Multicenter Retrospective Cohort Study. Clin Infect Dis. 2018; 68(9):1463-1471. DOI: 10.1093/cid/ciy859. View

19.

Barber A, Scheufen S, Walther G, Kurzai O, Schmidt V . Low rate of azole resistance in cases of avian aspergillosis in Germany. Med Mycol. 2020; 58(8):1187-1190. DOI: 10.1093/mmy/myaa045. View

20.

Slocombe R, Slauson D . Invasive pulmonary aspergillosis of horses: an association with acute enteritis. Vet Pathol. 1988; 25(4):277-81. DOI: 10.1177/030098588802500405. View