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The epidemiology of antifungal resistance

Abstract number: 1133_236

Pfaller A.

Invasive fungal infections are a significant cause of morbidity and mortality worldwide. They exert a growing clinical and economic burden on healthcare systems and patients. The increasing concern regarding antifungal resistance among both common and uncommon fungal pathogens over the past 10–15 years further drives this burden of disease. Typically species such as Candida albicans, C. glabrata, C. krusei,Cryptococcus neoformans and Aspergillus species exhibit different resistance phenotypes. The impact of resistance has only recently been fully appreciated with clinical failures due to both established and recently introduced agents being reported. As both acquired and intrinsic resistance continues to emerge it is recognized that a successful clinical outcome depends on several factors including the patient, selection of the appropriate agent, and the local epidemiology of the likely pathogen. Persistent drug pressure may result in acquired resistance in normally susceptible species or select for intrinsically resistant fungi from the patients endogenous flora or the extrinsic environment. In the hospital setting nosocomial transmission coupled with drug pressure may produce an endemic strain with progressively developing resistance. It is now apparent that the antifungal susceptibility profiles of Candida and Cryptococcus species may vary considerably from region-to-region or even among different hospital settings. Detection of specific DNA clades that are enriched for antifungal resistance phenotypes is a recent finding of great interest. Although new antifungal agents with novel mechanisms of action may temporarily improve our ability to treat certain fungal infections, the emergence of resistant fungi is inevitable and deserves our constant attention.

Session Details

Date: 01/08/2007
Time: 00:00-00:00
Session name: XXIst ISTH Congress
Subject:
Location: Oxford, UK
Presentation type:
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