Drug-Resistant Fungi: An Emerging Challenge Threatening Our Limited Antifungal Armamentarium.
Drug-Resistant Fungi: An Emerging Challenge Threatening Our Limited Antifungal Armamentarium.
复制标题
DOI：
10.3390/antibiotics9120877
复制
发表时间：
2020-12-08
期刊：
影响因子：
--
通讯作者：
Perlin DS
中科院分区：
文献类型：
--
作者：
Arastehfar A;Gabaldón T;Garcia-Rubio R;Jenks JD;Hoenigl M;Salzer HJF;Ilkit M;Lass-Flörl C;Perlin DS
侵袭性真菌感染（IFIs）造成的高临床死亡率和经济负担，沿着由各种真菌物种引起的显著农作物损失，已经导致抗真菌剂的广泛使用。选择性药物压力、真菌属性以及宿主和药物相关因素抵消了有限的全身性抗真菌药物的疗效，并改变了IFIs的流行病学格局。属于念珠菌属、曲霉属、隐球菌属和肺孢子虫属的菌种是显示出显著抗真菌耐药率的真菌病原体。临床环境中越来越多地发现来自环境的耐药真菌。此外，我们对新兴念珠菌属的药物类别特异性耐药机制的了解有限。在临床和农业领域建立抗真菌管理计划，并在临床中纳入菌种鉴定、抗真菌药敏试验和治疗药物监测实践，可以最大限度地减少耐药真菌的出现。新的抗真菌药物具有很好的治疗效果，在临床上治疗耐药真菌有很大的希望。减轻抗真菌耐受性是出现耐药性的前奏，也需要开发有效的真菌特异性佐剂与全身性抗真菌药联合使用。
The high clinical mortality and economic burden posed by invasive fungal infections (IFIs), along with significant agricultural crop loss caused by various fungal species, has resulted in the widespread use of antifungal agents. Selective drug pressure, fungal attributes, and host- and drug-related factors have counteracted the efficacy of the limited systemic antifungal drugs and changed the epidemiological landscape of IFIs. Species belonging to Candida, Aspergillus, Cryptococcus, and Pneumocystis are among the fungal pathogens showing notable rates of antifungal resistance. Drug-resistant fungi from the environment are increasingly identified in clinical settings. Furthermore, we have a limited understanding of drug class-specific resistance mechanisms in emerging Candida species. The establishment of antifungal stewardship programs in both clinical and agricultural fields and the inclusion of species identification, antifungal susceptibility testing, and therapeutic drug monitoring practices in the clinic can minimize the emergence of drug-resistant fungi. New antifungal drugs featuring promising therapeutic profiles have great promise to treat drug-resistant fungi in the clinical setting. Mitigating antifungal tolerance, a prelude to the emergence of resistance, also requires the development of effective and fungal-specific adjuvants to be used in combination with systemic antifungals.
登录
查看更多内容
最近土耳其氟康唑不敏感热带念珠菌血液分离株患病率增加：唑不敏感和氟康唑耐受表型和基因分型的临床意义
影响因子：
5.2
作者：
Arastehfar A;Hilmioğlu-Polat S;Daneshnia F;Hafez A;Salehi M;Polat F;Yaşar M;Arslan N;Hoşbul T;Ünal N;Metin DY;Gürcan Ş;Birinci A;Koç AN;Pan W;Ilkit M;Perlin DS;Lass-Flörl C
通讯作者：
Lass-Flörl C
2015 年至 2018 年多中心研究中从血液样本中回收的伊朗光滑念珠菌分离株的低水平抗真菌耐药性以及 PDR1 基因分型和测序的潜在预后价值
影响因子：
4.9
作者：
Arastehfar, Amir;Daneshnia, Farnaz;Boekhout, Teun
通讯作者：
Boekhout, Teun
伊朗近平滑念珠菌种复合血液分离株的分子流行病学、临床特征、抗真菌药敏概况和抗真菌耐药性分子机制的评估
影响因子：
5.7
作者：
Arastehfar, Amir;Daneshnia, Farnaz;Lass-Floerl, Cornelia
通讯作者：
Lass-Floerl, Cornelia
土耳其光滑念珠菌血液分离株的抗真菌耐药性水平较低：氟康唑最低抑菌浓度和 FKS 突变可以预测治疗失败
影响因子：
4.9
作者：
Arastehfar, Amir;Daneshnia, Farnaz;Lass-Floerl, Cornelia
通讯作者：
Lass-Floerl, Cornelia
影响因子：
14.2
作者：
Arendrup, M. C.;Meletiadis, J.;Howard, S. J.
通讯作者：
Howard, S. J.