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Clinical Mycology Today: Emerging Challenges and Opportunities

Summary

Fungal infections are becoming more common due to new cancer treatments and other medical advances, while some fungal species are developing resistance to standard antifungal medications. The good news is that several new antifungal drugs are in development with better safety profiles and novel mechanisms to fight these infections. However, the field faces challenges including limited specialized mycologists and difficulty designing clinical trials to properly test new treatments.

Background

Invasive fungal diseases (IFDs) pose a growing global threat with expanding patient populations at risk due to novel immunotherapies, advances in transplantation, and emerging drug-resistant pathogens. The Mycoses Study Group Education and Research Consortium held their 2022 biennial meeting to discuss pressing contemporary issues in clinical mycology.

Objective

This review synthesizes discussions from the Clinical Mycology Today 2022 meeting to highlight emerging challenges and opportunities in the field of mycology, with emphasis on novel host risk factors, emerging resistant fungal pathogens, the evolving antifungal pipeline, and critical issues affecting mycology research advancement.

Results

The review identifies four major areas: novel host risk factors from immunotherapies (monoclonal antibodies, small molecules, cellular therapies) and genetic susceptibility; emerging antifungal resistance in dermatophytes, Aspergillus species, and Candida auris; a flourishing antifungal pipeline with new agents including oteseconazole, rezafungin, ibrexafungerp, olorofim, and fosmanogepix; and critical challenges including clinical trial design, response criteria limitations, and severe workforce shortages.

Conclusion

Clinical mycology stands at a pivotal inflection point requiring improved understanding of host risk factors, enhanced epidemiologic surveillance of resistant pathogens, and expansion of clinical and basic research pipelines to improve patient outcomes and address the growing threat of invasive fungal diseases.
  • Published in:Open Forum Infectious Diseases,
  • Study Type:Review,
  • Source: PMID: 39045011, DOI: 10.1093/ofid/ofae363
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