What is the Impact of Anti-fungal Drug Resistance in Medical Mycology? | Professor Neil A.R. Gow

September 25, 2019

Antifungal drug research is clearly a
very important area for now and for the future.
We have antifungal drugs, but it’s fair to say there’s nothing quite as broad
spectrum or as effective as some of the drugs we use to treat bacteria. One of
the great challenges for the next 20, 30, 40 years, is antimicrobial drug
resistance and unfortunately, from the perspective of somebody like myself who
works in mycology, that term AMR is often taken to mean just bacteria. And
you may say, well maybe there is no problem with drug resistance against
fungi, but this is not the case and in fact this is a very important area, again,
covered in this book. For example, Aspergillus drug resistance has
increased significantly over the last 10, 20 years and there is the worry that the
increase in resistance is being driven, not in the hospital, but actually in
agricultural fields, because some of the classes of antifungals which are used to
treat crop diseases cross-react and are the same general classes which we also
have to use in a hospital. So you can get a drug-resistant fungus in the field, the
spores can get into a hospital setting. This is all concern. We also now know, in
recent years, that our emerging pathogens, one very notable example is Candida Oris,
first really recognised in 2009 in Japan and now present endemically around the world. Candida Oris is an example of an often multiply
drug-resistant organism. Some strains, in fact, resistant to the three major
classes which we use to treat fungal infections. A very serious scenario. So it
is absolutely not the case that we do not have to worry about drug resistance
for a fungi. We have a number of classes of agent. Not enough.
Not with the ideal spectrum of properties as yet and we have to protect
and look after them, because drug resistance is a significant problem for
many species.

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