Addressing Critical Fungal Pathogens Under a One Health Perspective: Key Insights from the Portuguese Association of Medical Mycology

Author: mycolabadmin
8/16/2025
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Summary

This comprehensive study by Portugal’s mycology experts examines four dangerous fungi that cause severe infections: Aspergillus fumigatus, Candida auris, Candida albicans, and Cryptococcus neoformans. The research shows that Portugal’s hospitals have varying capabilities to diagnose and treat these infections, with some laboratories well-equipped and others lacking advanced diagnostic tools. The study found concerning increases in antifungal resistance and highlights that these fungi live in hospitals, water systems, soil, and even animals, emphasizing the need for integrated approaches connecting human, animal, and environmental health to better protect public health.

Background

Fungal infections caused by critical pathogens including Aspergillus fumigatus, Candida auris, Candida albicans, and Cryptococcus neoformans have emerged as significant public health concerns. These pathogens are listed as critical priorities by the WHO due to rising antifungal resistance and severe impact on immunocompromised individuals. The interconnectedness of human, animal, and environmental health requires integrated approaches to address these threats.

Objective

The Portuguese Association of Medical Mycology (ASPOMM) conducted a comprehensive national study to assess current knowledge, surveillance capabilities, and unmet needs regarding critical fungal pathogens in Portugal. The study aimed to address WHO recommendations by improving diagnostic capacity, surveillance, and antifungal resistance monitoring while raising awareness about fungal infection epidemiology and emerging issues.

Results

Portuguese laboratories primarily use automated identification (100%), classical biochemical tests (68.8%), and MALDI-TOF MS (62.5%). A. fumigatus shows 3.0% azole resistance in sensu stricto isolates. C. albicans resistance varies from 0.8-12% to azoles depending on study period. C. auris was first detected in Portugal in 2023 with Clade III and Clade I isolates subsequently identified. Environmental surveillance revealed azole-resistant A. fumigatus in occupational settings and widespread Candida species in diverse environments.

Conclusion

Portugal requires strengthened national coordination and international cooperation to address fungal threats comprehensively. Investment in diagnostic infrastructure, standardized surveillance systems, antifungal resistance monitoring, and integrated One Health approaches linking human, animal, and environmental health are essential. Enhanced preparedness and response mechanisms are crucial for managing escalating fungal infection risks.

Published in:Mycopathologia,
Study Type:Review, National Assessment Study,
Source: PMID: 40818022, DOI: 10.1007/s11046-025-00981-3