The Emerging Threat of Antifungal Resistance in Transplant Infectious Diseases

Ilan S. Schwartz, Thomas F Patterson

Research output: Contribution to journalReview article

18 Scopus citations

Abstract

Purpose of Review: The global emergence of antifungal resistance among Candida spp. and Aspergillus spp. will disproportionately affect transplantation recipients, who are prone to invasive fungal disease. Recent Findings: Invasive candidiasis is increasingly caused by non-albicans Candida species with reduced susceptibility to first-line antifungals. Echinocandin resistance in Candida glabrata is increasing in some settings. Candida auris has rapidly emerged as a global concern due to multidrug resistance and efficient nosocomial spread in healthcare settings. Azole-resistant Aspergillus fumigatus is already an important concern in some European countries and is increasingly reported elsewhere, possibly driven by agricultural use of triazole fungicides. Summary: Antifungal resistance is anticipated to expand among these and other common fungal pathogens. Culture-independent detection methods will become more important for rapid diagnosis and to guide empiric therapy. Antifungal stewardship is of critical importance to conserve our limited antifungal armamentarium for transplantation recipients and other vulnerable patients.

Original languageEnglish (US)
Article number2
JournalCurrent Infectious Disease Reports
Volume20
Issue number3
DOIs
StatePublished - Mar 1 2018

Keywords

  • Antifungal susceptibility
  • Aspergillus
  • Azole
  • Candida
  • Echinocandin
  • Hematopoietic stem cell transplant
  • Solid organ transplant
  • Stewardship

ASJC Scopus subject areas

  • Infectious Diseases

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