Tackling the emerging threat of antifungal resistance to human health

Matthew C. Fisher*, Ana Alastruey-Izquierdo, Judith Berman, Tihana Bicanic, Elaine M. Bignell, Paul Bowyer, Michael Bromley, Roger Brüggemann, Gary Garber, Oliver A. Cornely, Sarah J. Gurr, Thomas S. Harrison, Ed Kuijper, Johanna Rhodes, Donald C. Sheppard, Adilia Warris, P.L. White, Jianping Xu, Bas Zwaan, Paul E. Verweij*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

308 Citations (Scopus)


Invasive fungal infections pose an important threat to public health and are an under-recognized component of antimicrobial resistance, an emerging crisis worldwide. Across a period of profound global environmental change and expanding at-risk populations, human-infecting pathogenic fungi are evolving resistance to all licensed systemic antifungal drugs. In this Review, we highlight the main mechanisms of antifungal resistance and explore the similarities and differences between bacterial and fungal resistance to antimicrobial control. We discuss the research and innovation topics that are needed for risk reduction strategies aimed at minimizing the emergence of resistance in pathogenic fungi. These topics include links between the environment and One Health, surveillance, diagnostics, routes of transmission, novel therapeutics and methods to mitigate hotspots for fungal adaptation. We emphasize the global efforts required to steward our existing antifungal armamentarium, and to direct the research and development of future therapies and interventions.

Original languageEnglish
Pages (from-to)557-571
JournalNature Reviews Microbiology
Issue number9
Early online date29 Mar 2022
Publication statusPublished - Sept 2022


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