Clinical mycology: Understanding pathogenesis, diagnosis, and antifungal strategies for invasive fungal infections: A review | ||
| Microbes and Infectious Diseases | ||
| Articles in Press, Accepted Manuscript, Available Online from 29 December 2024 | ||
| Document Type: Review Article | ||
| DOI: 10.21608/mid.2024.331599.2319 | ||
| Authors | ||
| Shreeya Das1; Utkalika Mallick2, 3; Binaya Krushna Sahu1; Jyotirmayee Turuk1; Mahesh Chandra Sahu* 1 | ||
| 1Division of Microbiology, ICMR-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar-751023, Odisha, India. | ||
| 2Division of Microbiology, ICMR-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar-751023, Odisha, India.. | ||
| 3Centre for Biotechnology, SOA Deemed to be University, Kalinga Nagar, Bhubaneswar-751003, Odisha, India | ||
| Abstract | ||
| Background: Invasive fungal infections (IFIs) represent a significant clinical challenge, primarily affecting immunocompromised patients but also posing risks to immunocompetent individuals. Opportunistic fungal pathogens such as Candida spp., Aspergillus spp., and emerging threats like Mucorales are responsible for a wide spectrum of infections, ranging from superficial mycoses to severe systemic diseases. The COVID-19 pandemic has further intensified these issues, particularly with the alarming rise in mucormycosis among vulnerable populations. High morbidity and mortality rates associated with IFIs are largely attributable to delayed diagnosis, antifungal resistance, and the complex biology of these pathogens. Pathogens like fungi employ diverse mechanisms, including biofilm formation, spore dissemination, and genetic adaptations, to evade host immune defenses, complicating treatment efforts. Diagnostic challenges persist, as traditional culture-based methods often fail to provide timely and accurate results. Emerging molecular diagnostic techniques, such as PCR-based methods and antigen detection assays, have shown promise in enabling rapid and precise identification, which is crucial for early and effective intervention. The increasing prevalence of antifungal resistance, particularly in pathogens like Candida auris and azole-resistant Aspergillus, further complicates clinical management. Current antifungal therapies are often limited by resistance, toxicity, and the emergence of multidrug-resistant strains. Advanced antifungal strategies, including the development of novel drugs, topical nanomaterials, and immunotherapy approaches, offer potential solutions to overcome these barriers. This review underscores the urgent need for innovative diagnostics and therapeutic approaches to reduce the burden of IFIs. It highlights interdisciplinary strategies to improve clinical outcomes and address the rising threat of invasive fungal diseases globally. | ||
| Keywords | ||
| Clinical Mycology; immunocompromised hosts; Mycotoxins; Antifungals | ||
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