Special Issue "Treatments for Fungal Infections"
A special issue of Journal of Fungi (ISSN 2309-608X).
Deadline for manuscript submissions: closed (31 July 2018)
Prof. Esther Segal
Department of Clinical Microbiology and Immunology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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Interests: fungal virulence factors and pathogenesis of fungal infections; therapy of fungal infections; prevention of infection by intervention with the pathogenic process
Antimycotic therapy, until the 1980s, was a rather mundane affair. Many cutaneous and mucous infections were treated topically. When systemic administration of antimycotic drugs was deemed necessary, dermatophytoses, by far the most common fungal infections, were treated with griseofulvin and other mycoses were treated with amphotericin B, with or without 5 fluorocytosine (5FC). Resistance, except for 5FC, was not considered a problem. Subsequently, all this changed.
Immunosuppression, whether pathological (AIDS) or iatrogenic (organ transplants and malignancy treatments) brought about a significant increase in the incidence of fungal infections. Moreover, the etiology, commonly opportunistic fungi that rarely caused infections before, became important and often lethal pathogens. Thus, it became necessary to treat various new fungi, sometimes with different susceptibility profiles. This led to an insurgence of new antimycotic compounds for systemic administration, by improving drugs from existing molecule groups, such as the azoles, and introducing the triazoles, or by discovering new groups, such as the echinocandins. Hence, the drive behind the development of antimycotic drugs was at that stage a necessity to treat new pathogens and not aimed to overcome resistance problems, which are aroused in fungal infections later. In addition, since amphotericin B was still the reference to which other drugs were compared due to its broad spectrum, efforts were made to mitigate its significant toxicity by incorporating it into a variety of molecules. Thus, while the number of new antibacterial drug groups dwindled, that of their antimycotic counterpart flourished.
Since there is now a larger variety of antimycotic drugs, each having its own spectrum of activity, susceptibility testing has become necessary. This was emphasized by the fact that innate resistance was reported for some fungi in regard to certain drugs (i.e., resistance of Candida glabrata to fluconazole) and acquired resistance was becoming a problem as well. Seemingly, the use of azoles in agriculture may prove to be one of the driving forces behind this phenomenon. As a result, susceptibility testing was standardized, first for yeasts, for which the inoculum is easier to quantify, and subsequently for molds. While the predictive value of these tests has been improving continuously, further progress is necessary before they can be universally adopted.
This Special Issue of the Journal of Fungi is aimed at presenting the state-of-the-art for the above-mentioned topics.
Prof. Esther Segal
Prof. Daniel Elad
Manuscript Submission Information
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- Fungal infections
- Antimycotic therapy
- Antifungal drug susceptibility testing
- Antifungal drug resistance