Invasive fungal disease in the immunocompromised host: changing epidemiology, new antifungal therapies, and management challenges
- Author(s)
- Giannella, M; Lanternier, F; Dellière, S; Groll, AH; Mueller, NJ; Alastruey-Izquierdo, A; Slavin, MA; ECCMID study groups on Invasive Fungal Infection and Infection in Immunocompromised Hosts;
- Details
- Publication Year 2025-01,Volume 31,Issue #1,Page 29-36
- Journal Title
- Clinical Microbiology and Infection
- Publication Type
- Review
- Abstract
- BACKGROUND: Invasive fungal disease (IFD) causes morbidity and mortality in immunocompromised hosts (ICHs). Based on increasing recognition of the impact of IFD on human disease, a recent WHO priority list identified key areas of need. OBJECTIVES: This review examines changes in the epidemiology of IFD, in particular the emergence of antifungal-resistant pathogens and the current availability of rapid diagnostic tests and antifungal treatment options. SOURCES: Literature between 2000 and January 2024 regarding fungal epidemiology, diagnostic tests, antifungal resistance, emerging fungal pathogens, and novel antifungal agents in both adult and paediatric ICH were reviewed. CONTENT: We describe the changing epidemiology and continued burden and mortality of IFD in ICH. Furthermore, we discuss the emergence of antifungal-resistant organisms driven by new immunosuppressed populations, climate change, and antifungal exposure in the individual and environment. We highlight novel antifungal agents and how they will address current unmet needs. IMPLICATIONS: The changing epidemiology and increased population at risk for IFD, lack of recognition or quantification of risks for IFD with new therapies, current gaps in the availability of rapid diagnostic tests, and the imminent availability of novel antifungals with distinct spectra of activity argue for improved availability of and access to rapid diagnostics, antifungal stewardship programmes, and global access to antifungal agents.
- Publisher
- Elsevier
- Keywords
- Humans; *Antifungal Agents/therapeutic use; *Immunocompromised Host; *Invasive Fungal Infections/drug therapy/epidemiology/microbiology; *Drug Resistance, Fungal; Fungi/drug effects; Antifungal resistance; Aspergillosis; Candidiasis; Epidemiology; Invasive fungal diseases
- Department(s)
- Infectious Diseases
- Publisher's Version
- https://doi.org/10.1016/j.cmi.2024.08.006
- Terms of Use/Rights Notice
- Refer to copyright notice on published article.
Creation Date: 2025-01-21 12:27:23
Last Modified: 2025-01-21 12:27:42