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Antifungal Resistance in Invasive Candida and Aspergillus Species: Molecular Mechanisms, Global Epidemiology, and the Emerging Therapeutic Pipeline


Sr No:
Page No: 8-23
Language: English
Authors: Njaprim Edward Rihnwi*1, Mukube Kelson Ntuba2
Affiliation: 1*Department of Medical Laboratory Science, Faculty of Health Sciences, University of Bamenda, Cameroon, 2Cameroon Baptist Convention Health Services, Cameroon
Received: 2026-04-03
Accepted: 2026-05-21
Published Date: 2026-06-25
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Abstract:
Invasive fungal infections, predominantly caused by Candida and Aspergillus species, represent a major global mortality burden that is increasingly threatened by escalating resistance to primary antifungal classes such as azoles, echinocandins, and polyenes. This convergent crisis is clearly exemplified by the simultaneous global rise of multidrug-resistant Candida auris and the emergence of pan-azole-resistant Aspergillus fumigatus driven by environmental agricultural fungicide use. To bridge the gap between isolated resistance mechanisms and broader epidemiological trends, this review synthesises contemporary data across four core themes: molecular resistance pathways (including CYP51A, FKS, and ERG11 mutations, alongside efflux and biofilm-associated resistance), the clade-structured transmission dynamics of C. auris, the environmental selection of azole-resistant A. fumigatus, and the therapeutic pipeline of novel agents like olorofim, ibrexafungerp, fosmanogepix, and rezafungin. Ultimately, the manuscript argues that fungal resistance must be managed as a complex "One Health" systems phenomenon spanning hospitals, farms, and the environment, requiring harmonised global surveillance, robust stewardship, and a reconceptualisation of invasive mycoses as a central priority within the global antimicrobial resistance agenda.
Keywords: Invasive fungal infections; Candida auris; Aspergillus fumigatus; antifungal resistance; CYP51A mutations; echinocandin resistance; novel antifungals.

Journal: IRASS Journal of Applied Medical and Pharmaceutical Sciences
ISSN(Online): 3049-0901
Publisher: IRASS Publisher
Frequency: Monthly
Language: English

Antifungal Resistance in Invasive Candida and Aspergillus Species: Molecular Mechanisms, Global Epidemiology, and the Emerging Therapeutic Pipeline