Medical Mycology: Antifungal Resistance, Diagnosis, and Infection Control

A special issue of Journal of Fungi (ISSN 2309-608X).

Deadline for manuscript submissions: 28 February 2026 | Viewed by 4057

Special Issue Editors


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Guest Editor
Laboratory for Research and Diagnosis in Tropical Diseases, Federal University of Pernambuco (UFPE), Recife 50740-570, Pernambuco, Brazil
Interests: clinical microbiology; medical microbiology; antimicrobial resistance; antimicrobial susceptibility testing; diagnostic microbiology; biofilm formation

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Guest Editor
Parasitology and Medical Mycology, University of Nantes, Nantes, France
Interests: Aspergillus; mycology; parasitology; Candida albicans; cell biology; aspergillosis; drug screening
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Special Issue Information

Dear Colleagues,

Fungal infections have become increasingly prominent in recent years, affecting approximately 1.7 billion people annually. Additionally, around 1.5 million invasive fungal infections (IFIs) have been reported, with high mortality rates worldwide. In October 2022, the WHO published a priority list of fungi requiring special attention in terms of research and diagnosis. This critical priority group included Candida albicans, Candida auris, Aspergillus fumigatus, and Cryptococcus neoformans. The many current concerns include resistance to antifungals due to drug or environmental pressure, in addition to the emergence of new species (C. auris) or multi-resistant clones (C. parapsilosis). It is noteworthy that neglected fungal tropical diseases (mycetoma, chromoblastomycosis, paracoccidioidomycosis, and sporotrichosis) are also considered a serious threat to global health due to the difficulty in diagnosing, treating, and controlling new cases. Early and effective diagnosis is essential for optimal management and control of all these infections. The latter also involves controlling resistance through the development of new targets and new classes of antifungal agents, or the repositioning of commercial drugs with antimycotic potential. This Special Issue seeks original research and review articles that contribute to the understanding of antifungal resistance and discuss cutting-edge strategies for the diagnosis of fungal infections. Furthermore, we propose to improve the understanding of measures that, in the translational scope, should be listed for the control and prevention of fungal infections. We invite researchers to submit both original research and review articles for this Special Issue.

Prof. Dr. Reginaldo Gonçalves de Lima-Neto
Prof. Dr. Patrice Le Pape
Guest Editors

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Keywords

  • medical mycology
  • fungal diseases
  • antifungal resistance
  • diagnosis
  • infection control

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Published Papers (2 papers)

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Review

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22 pages, 471 KB  
Review
Azole-Resistant Aspergillus fumigatus: Epidemiology, Diagnosis, and Treatment Considerations
by Anna Zubovskaia
J. Fungi 2025, 11(10), 731; https://doi.org/10.3390/jof11100731 - 10 Oct 2025
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Abstract
Invasive aspergillosis is an opportunistic infection caused by the Aspergillus species. It is a significant cause of morbidity and mortality in susceptible populations, including recipients of bone marrow and solid organ transplants. Azole antifungals have remained the first-line treatment for invasive aspergillosis for [...] Read more.
Invasive aspergillosis is an opportunistic infection caused by the Aspergillus species. It is a significant cause of morbidity and mortality in susceptible populations, including recipients of bone marrow and solid organ transplants. Azole antifungals have remained the first-line treatment for invasive aspergillosis for a long time; however, the advance of azole resistance in Aspergillus fumigatus, driven predominantly by extensive commercial and agricultural use of azole fungicides and environmental exposure of susceptible populations to the resistant strains, renders the traditional therapeutic approaches less effective and results in further increase in mortality. The epidemiology, molecular mechanisms of azole resistance, diagnostic approaches, and clinical implications of azole resistance in Aspergillus fumigatus sensu stricto will be discussed in this article (for ease of comprehension, the rest of this article will refer to A. fumigatus sensu stricto as A. fumigatus). Full article

Other

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12 pages, 714 KB  
Brief Report
Real-Life Use of Posaconazole in Clinical Practice for Onco-Hematological Children: A National Survey by AIEOP Infectious Diseases Working Group
by Lorenzo Chiusaroli, Manuela Spadea, Cecilia Liberati, Maria Grazia Petris, Antonio Grasso, Francesco Baccelli, Maria Vittoria Micheletti, Pietro Gasperini, Maria Rosaria D’Amico, Katia Perruccio, Angelica Barone, Daniela Onofrillo, Paola Muggeo, Maura Faraci, Simona Rinieri, Ilaria Liguoro, Antonella Colombini, Francesca Trevisan, Nagua Giurici, Gianluca Boscarol, Letizia Pomponia Brescia, Alessia Pancaldi, Francesca Compagno, Alessandra Biffi, Daniele Donà and Simone Cesaroadd Show full author list remove Hide full author list
J. Fungi 2025, 11(11), 797; https://doi.org/10.3390/jof11110797 - 7 Nov 2025
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Abstract
Background: Posaconazole is an antifungal medication used to treat invasive fungal infections (IFI) in pediatric onco-hematological patients. Its approval for pediatric use was recent, and limitations still apply. Despite limited data, the safety and efficacy profile appear generally favorable in children. This study [...] Read more.
Background: Posaconazole is an antifungal medication used to treat invasive fungal infections (IFI) in pediatric onco-hematological patients. Its approval for pediatric use was recent, and limitations still apply. Despite limited data, the safety and efficacy profile appear generally favorable in children. This study describes how posaconazole is used across centers affiliated with the Associazione Italiana Ematologia e Oncologia Pediatrica (AIEOP). Methods: A national survey was conducted among physicians within the AIEOP network to evaluate current use of posaconazole in pediatric cancer patients, including those undergoing hematopoietic stem cell transplantation (HSCT). A 25-item web questionnaire was developed and distributed in June 2024. Data analysis involved descriptive statistics. Results: Twenty-one of thirty-one centers (68%) responded, reporting availability of various posaconazole formulations: oral suspension (76%), delayed-release tablets (95%), and intravenous solution (14%). Posaconazole was primarily used for prophylaxis in patients with acute lymphoblastic leukemia (ALL, 38%), acute myeloid leukemia (AML, 38%), and aplastic anemia (19%). It was also used as secondary prophylaxis against previous possible or probable IFI or as salvage therapy for probable or confirmed aspergillosis or mucormycosis, often combined with other treatments. Drug plasma level monitoring was common but varied in scheduling across centers. Most centers (74%) discontinued posaconazole if adverse events suspected drug–drug interactions, such as with vincristine. Conclusions: Posaconazole is widely used in AIEOP centers, though application varies significantly. This variability emphasizes the need for prospective studies to better define indications, dosing, and monitoring protocols for pediatric use of this antifungal. Full article
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