SpringerLink
Log in

Emerging Challenges in Diagnosis and Treatment of Invasive Fungal Infections: Addressing the Impact of COVID-19 and New Pathogens

  • Published:
Current Fungal Infection Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Invasive fungal infections (IFIs) pose significant challenges in healthcare settings, affecting a wide range of patient populations and often resulting in high morbidity and mortality rates. This narrative review is aimed at exploring the current state of knowledge on the diagnosis and treatment of IFIs, focusing on the recent developments, advancements, and obstacles in managing these life-threatening infections. The objective of this study involved conducting a comprehensive literature search, followed by a rigorous selection process to identify relevant studies. Subsequently, a critical analysis of the literature was undertaken, and the obtained information was carefully synthesized to achieve the research aim.

Recent Findings

Recent advances in diagnosis and treatment have greatly improved our ability to detect and manage of IFIs. The non-culture-based techniques have increased the accuracy and speed of fungal detection, while new antifungal drugs and immunotherapies have shown promising results in the treatment of IFIs. The principles of prophylactic and antifungal therapy are currently affected by new challenges in the epidemiology of IFIs, the emergence of the multidrug-resistant fungal pathogen (Candida auris), and the increasing rate of antifungal resistance.

Summary

Most promising prospects for improving the management of IFIs consist of new diagnostic techniques and novel therapeutic options. The use of non-culture-based techniques including antigen assays can speed up diagnosis and enable the timely beginning of antifungal therapy. However, the diagnosis of IFIs remains challenging due to the heterogeneity of characteristics among different fungal pathogens and the limitations of techniques.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price includes VAT (Germany)

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Data Availability

This declaration is not applicable.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Firacative C. Invasive fungal disease in humans: are we aware of the real impact? Mem Inst Oswaldo Cruz. 2020; https://doi.org/10.1590/0074-02760200430.

  2. Correction to Molecular epidemiology of clinical filamentous fungi in Qatar beyond Aspergillus and Fusarium with notes on the rare species. Med Mycol. 2022; https://doi.org/10.1093/MMY/MYAD006.

  3. WHO fungal priority pathogens list to guide research, development and public health action.

  4. Baddley JW, Thompson GR, Chen SCA, White PL, Johnson MD, Nguyen MH, et al. Coronavirus disease 2019–associated invasive fungal infection. Open Forum Infect Dis. 2021; https://doi.org/10.1093/OFID/OFAB510.

  5. Koukaki E, Rovina N, Tzannis K, Sotiropoulou Z, Loverdos K, Koutsoukou A, et al. Fungal infections in the ICU during the COVID-19 Era: descriptive and comparative analysis of 178 patients. J Fungi. 2022; https://doi.org/10.3390/JOF8080881.

  6. Kundu R, Singla N. COVID-19 and plethora of fungal infections. Curr Fungal Infect Rep. 2022; https://doi.org/10.1007/S12281-022-00432-2/METRICS.

  7. Bretagne S, Sitbon K, Desnos-Ollivier M, Garcia-Hermoso D, Letscher-Bru V, Cassaing S, et al. Active surveillance program to increase awareness on invasive fungal diseases: the French RESSIF network (2012 to 2018). MBio. 2022; https://doi.org/10.1128/MBIO.00920-22/SUPPL_FILE/MBIO.00920-22-SF001.TIF.

  8. Bassetti M, Azoulay E, Kullberg BJ, Ruhnke M, Shoham S, Vazquez J, et al. EORTC/MSGERC definitions of invasive fungal diseases: summary of activities of the Intensive Care Unit Working Group. Clin Infect Dis. 2021; https://doi.org/10.1093/CID/CIAA1751.

  9. Srinivas S, Kumari P, Gupta D. Utility of panfungal PCR in the diagnosis of invasive fungal infections in febrile neutropenia. J Fam Med Prim Care. 2021; https://doi.org/10.4103/JFMPC.JFMPC_2325_20.

  10. Lass-Flörl C, Samardzic E, Knoll M. Serology anno 2021—fungal infections: from invasive to chronic. Clin Microbiol Infect. 2021; https://doi.org/10.1016/j.cmi.2021.02.005.

  11. Eigl S, Hoenigl M, Spiess B, Heldt S, Prattes J, Neumeister P, et al. Galactomannan testing and Aspergillus PCR in same-day bronchoalveolar lavage and blood samples for diagnosis of invasive aspergillosis. Med Mycol. 2017; https://doi.org/10.1093/MMY/MYW102.

  12. Teh BW, Yeoh DK, Haeusler GM, Yannakou CK, Fleming S, Lindsay J, et al. Consensus guidelines for antifungal prophylaxis in haematological malignancy and haemopoietic stem cell transplantation, 2021. Intern Med J. 2021; https://doi.org/10.1111/IMJ.15588.

  13. Cornely OA, Lass-Flörl C, Lagrou K, Arsic-Arsenijevic V, Hoenigl M. Improving outcome of fungal diseases - guiding experts and patients towards excellence. Mycoses. 2017; https://doi.org/10.1111/MYC.12628.

  14. Cuervo G, Garcia-Vidal C, Puig-Asensio M, Merino P, Vena A, Martín-Peña A, et al. Usefulness of guideline recommendations for prognosis in patients with candidemia. Med Mycol. 2019; https://doi.org/10.1093/MMY/MYY118.

  15. Liu F, Zhong L, Zhou F, Zheng C, Zhang K, Cai J, et al. Clinical features, strain distribution, antifungal resistance and prognosis of patients with non -albicans candidemia: a retrospective observational study. Infect Drug Resist. 2021; https://doi.org/10.2147/IDR.S323583.

  16. Díez A, Carrano G, Bregón-Villahoz M, Cuétara MS, García-Ruiz JC, Fernandez-de-Larrinoa I, et al. Biomarkers for the diagnosis of invasive candidiasis in immunocompetent and immunocompromised patients. Diagn Microbiol Infect Dis. 2021; https://doi.org/10.1016/J.DIAGMICROBIO.2021.115509.

  17. Du H, Bing J, Hu T, Ennis CL, Nobile CJ, Huang G. Candida auris: epidemiology, biology, antifungal resistance, and virulence. PLoS Pathog. 2020; https://doi.org/10.1371/JOURNAL.PPAT.1008921.

  18. Lewis White P, Dhillon R, Cordey A, Hughes H, Faggian F, Soni S, et al. A national strategy to diagnose coronavirus disease 2019-associated invasive fungal disease in the intensive care unit. Clin Infect Dis. 2021; https://doi.org/10.1093/CID/CIAA1298.

  19. Garcia-Vidal C, Sanjuan G, Moreno-García E, Puerta-Alcalde P, Garcia-Pouton N, Chumbita M, et al. Incidence of co-infections and superinfections in hospitalized patients with COVID-19: a retrospective cohort study. Clin Microbiol Infect. 2021; https://doi.org/10.1016/J.CMI.2020.07.041.

  20. Villanueva-Lozano H, Treviño-Rangel R de J, González GM, Ramírez-Elizondo MT, Lara-Medrano R, Aleman-Bocanegra MC, et al. Outbreak of Candida auris infection in a COVID-19 hospital in Mexico. Clin Microbiol Infect. 2021; https://doi.org/10.1016/J.CMI.2020.12.030

  21. Kosmidis C, Denning DW. The clinical spectrum of pulmonary aspergillosis. Thorax. 2015; https://doi.org/10.1136/THORAXJNL-2014-206291.

  22. Chakrabarti A, Chatterjee SS, Das A, Shivaprakash MR. Invasive aspergillosis in develo** countries. Med Mycol. 2011; https://doi.org/10.3109/13693786.2010.505206.

  23. Bongomin F, Gago S, Oladele RO, Denning DW. Global and multi-national prevalence of fungal diseases-estimate precision. J Fungi (Basel, Switzerland). 2017; https://doi.org/10.3390/JOF3040057.

  24. Rutsaert L, Steinfort N, Van Hunsel T, Bomans P, Naesens R, Mertes H, et al. COVID-19-associated invasive pulmonary aspergillosis. Ann Intensive Care. 2020; https://doi.org/10.1186/S13613-020-00686-4.

  25. Alanio A, Dellière S, Fodil S, Bretagne S, Mégarbane B. Prevalence of putative invasive pulmonary aspergillosis in critically ill patients with COVID-19. Lancet Respir Med. 2020; https://doi.org/10.1016/S2213-2600(20)30237-X.

  26. Prakash H, Chakrabarti A. Global epidemiology of mucormycosis. J Fungi (Basel, Switzerland). 2019; https://doi.org/10.3390/JOF5010026.

  27. Dallalzadeh LO, Ozzello DJ, Liu CY, Kikkawa DO, Korn BS. Secondary infection with rhino-orbital cerebral mucormycosis associated with COVID-19. Orbit. 2022; https://doi.org/10.1080/01676830.2021.1903044.

  28. Hussain S, Riad A, Singh A, Klugarová J, Antony B, Banna H, et al. Global prevalence of COVID-19-associated mucormycosis (CAM): living systematic review and meta-analysis. J Fungi. 2021; https://doi.org/10.3390/JOF7110985/S1.

  29. Rajasingham R, Smith RM, Park BJ, Jarvis JN, Govender NP, Chiller TM, et al. Global burden of disease of HIV-associated cryptococcal meningitis: an updated analysis. Lancet Infect Dis. 2017; https://doi.org/10.1016/S1473-3099(17)30243-8.

  30. Boutati EI, Anaissie EJ. Fusarium, a significant emerging pathogen in patients with hematologic malignancy: ten years’ experience at a cancer center and implications for management. Blood. 1997;

  31. Liu CJ, Lee TF, Ruan SY, Yu CJ, Chien JY, Hsueh PR. Clinical characteristics, treatment outcomes, and prognostic factors of Pneumocystis pneumonia in non-HIV-infected patients. Infect Drug Resist. 2019; https://doi.org/10.2147/IDR.S199761.

  32. Gold JAW, Jackson BR, Benedict K. Possible diagnostic delays and missed prevention opportunities in Pneumocystis pneumonia patients without HIV: analysis of commercial insurance claims data—United States, 2011–2015. Open Forum Infect Dis. 2020; https://doi.org/10.1093/OFID/OFAA255.

  33. Alanio A, Dellière S, Voicu S, Bretagne S, Mégarbane B. The presence of Pneumocystis jirovecii in critically ill patients with COVID-19. J Infect. 2021; https://doi.org/10.1016/J.JINF.2020.10.034.

  34. Sasani E, Bahrami F, Salehi M, Aala F, Bakhtiari R, Abdollahi A, et al. Pneumocystis pneumonia in COVID-19 patients: a comprehensive review. Heliyon. 2023; https://doi.org/10.1016/J.HELIYON.2023.E13618.

  35. Peter Donnelly J, Chen SC, Kauffman CA, Steinbach WJ, Baddley JW, Verweij PE, et al. Revision and update of the consensus definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer and the Mycoses Study Group Education and Research Consortium. Clin Infect Dis. 2020; https://doi.org/10.1093/CID/CIZ1008.

  36. Dyal J, Akampurira A, Rhein J, Morawski BM, Kiggundu R, Nabeta HW, et al. Reproducibility of CSF quantitative culture methods for estimating the rate of clearance in cryptococcal meningitis. Med Mycol. 2016; https://doi.org/10.1093/MMY/MYV104.

  37. Cornely OA, Alastruey-Izquierdo A, Arenz D, Chen SCA, Dannaoui E, Hochhegger B, et al. Global guideline for the diagnosis and management of mucormycosis: an initiative of the European Confederation of Medical Mycology in cooperation with the Mycoses Study Group Education and Research Consortium. Lancet Infect Dis. 2019; https://doi.org/10.1016/S1473-3099(19)30312-3.

  38. Neofytos D, Horn D, Anaissie E, Steinbach W, Olyaei A, Fishman J, et al. Epidemiology and outcome of invasive fungal infection in adult hematopoietic stem cell transplant recipients: analysis of Multicenter Prospective Antifungal Therapy (PATH) Alliance registry. Clin Infect Dis. 2009; https://doi.org/10.1086/595846.

  39. Clancy CJ, Nguyen MH. Finding the “missing 50%” of invasive candidiasis: how nonculture diagnostics will improve understanding of disease spectrum and transform patient care. Clin Infect Dis. 2013; https://doi.org/10.1093/CID/CIT006.

  40. Kontoyiannis DP, Sumoza D, Tarrand J, Bodey GP, Storey R, Raad II. Significance of aspergillemia in patients with cancer: a 10-year study. Clin Infect Dis. 2000; https://doi.org/10.1086/313918.

  41. Nucci M, Marr KA, Vehreschild MJGT, de Souza CA, Velasco E, Cappellano P, et al. Improvement in the outcome of invasive fusariosis in the last decade. Clin Microbiol Infect. 2014;

  42. Lackner M, Caramalho R, Lass-Flörl C. Laboratory diagnosis of mucormycosis: current status and future perspectives. Future Microbiol. 2014; https://doi.org/10.2217/FMB.14.23.

  43. Lass-Flörl C. How to make a fast diagnosis in invasive aspergillosis. Med Mycol. 2019; https://doi.org/10.1093/MMY/MYY103.

  44. Boulware DR, Rolfes MA, Rajasingham R, von Hohenberg M, Qin Z, Taseera K, et al. Multisite validation of cryptococcal antigen lateral flow assay and quantification by laser thermal contrast. Emerg Infect Dis. 2014; https://doi.org/10.3201/EID2001.130906.

  45. Bateman M, Oladele R, Kolls JK. Diagnosing Pneumocystis jirovecii pneumonia: a review of current methods and novel approaches. Med Mycol. 2020; https://doi.org/10.1093/MMY/MYAA024.

  46. Procop GW, Haddad S, Quinn J, Wilson ML, Henshaw NG, Reller LB, et al. Detection of Pneumocystis jiroveci in respiratory specimens by four staining methods. J Clin Microbiol. 2004; https://doi.org/10.1128/JCM.42.7.3333-3335.2004.

  47. Lau A, Chen S, Sorrell T, Carter D, Malik R, Martin P, et al. Development and clinical application of a panfungal PCR assay to detect and identify fungal DNA in tissue specimens. J Clin Microbiol. 2007; https://doi.org/10.1128/JCM.01862-06.

  48. León C, Ruiz-Santana S, Saavedra P, Castro C, Loza A, Zakariya I, et al. Contribution of Candida biomarkers and DNA detection for the diagnosis of invasive candidiasis in ICU patients with severe abdominal conditions. Crit Care. 2016; https://doi.org/10.1186/S13054-016-1324-3.

  49. Mikulska M, Calandra T, Sanguinetti M, Poulain D, Viscoli C. The use of mannan antigen and anti-mannan antibodies in the diagnosis of invasive candidiasis: recommendations from the Third European Conference on Infections in Leukemia. Crit Care. 2010; https://doi.org/10.1186/CC9365.

  50. Cummings JR, Jamison GR, Boudreaux JW, Howles MJ, Walsh TJ, Hayden RT. Cross-reactivity of non-Aspergillus fungal species in the Aspergillus galactomannan enzyme immunoassay. Diagn Microbiol Infect Dis. 2007; https://doi.org/10.1016/J.DIAGMICROBIO.2007.04.022.

  51. Nucci F, Nouér SA, Capone D, Nucci M. Invasive mould disease in haematologic patients: comparison between fusariosis and aspergillosis. Clin Microbiol Infect. 2018; https://doi.org/10.1016/J.CMI.2018.05.006.

  52. Vidal JE, Boulware DR. Lateral flow assay for cryptococcal antigen: an important advance to improve the continuum of HIV care and reduce cryptococcal meningitis-related mortality. Rev Inst Med Trop Sao Paulo. 2015; https://doi.org/10.1590/S0036-46652015000700008.

  53. Giacobbe DR, Mikulska M, Tumbarello M, Furfaro E, Spadaro M, Losito AR, et al. Combined use of serum (1,3)-β-D-glucan and procalcitonin for the early differential diagnosis between candidaemia and bacteraemia in intensive care units. Crit Care. 2017; https://doi.org/10.1186/S13054-017-1763-5.

  54. Ferreras-Antolin L, Borman A, Diederichs A, Warris A, Lehrnbecher T. Serum beta-D-glucan in the diagnosis of invasive fungal disease in neonates, children and adolescents: a critical analysis of current data. J Fungi. 2022; https://doi.org/10.3390/JOF8121262/S1.

  55. Friedrich R, Rappold E, Bogdan C, Held J. Comparative analysis of the Wako β-glucan test and the Fungitell assay for diagnosis of candidemia and Pneumocystis jirovecii pneumonia. J Clin Microbiol. 2018; https://doi.org/10.1128/JCM.00464-18.

  56. Del Corpo O, Butler-Laporte G, Sheppard DC, Cheng MP, McDonald EG, Lee TC. Diagnostic accuracy of serum (1-3)-β-D-glucan for Pneumocystis jirovecii pneumonia: a systematic review and meta-analysis. Clin Microbiol Infect. 2020; https://doi.org/10.1016/j.cmi.2020.05.024.

  57. Parra-Sánchez M, Zakariya-Yousef Breval I, Castro Méndez C, García-Rey S, Loza Vazquez A, Úbeda Iglesias A, et al. Candida albicans germ-tube antibody: evaluation of a new automatic assay for diagnosing invasive candidiasis in ICU patients. Mycopathologia. 2017; https://doi.org/10.1007/S11046-017-0125-9.

  58. Burnham-Marusich AR, Hubbard B, Kvam AJ, Gates-Hollingsworth M, Green HR, Soukup E, et al. Conservation of mannan synthesis in fungi of the Zygomycota and Ascomycota reveals a broad diagnostic target. mSphere. 2018; https://doi.org/10.1128/mSphere.00094-18.

  59. Avni T, Leibovici L, Paul M. PCR Diagnosis of invasive candidiasis: systematic review and meta-analysis. J Clin Microbiol. 2011; https://doi.org/10.1128/JCM.01602-10.

  60. Pelzer BW, Seufert R, Koldehoff M, Liebregts T, Schmidt D, Buer J, et al. Performance of the AsperGenius® PCR assay for detecting azole resistant Aspergillus fumigatus in BAL fluids from allogeneic HSCT recipients: A prospective cohort study from Essen, West Germany. Med Mycol. 2020; https://doi.org/10.1093/MMY/MYZ050.

  61. Cruciani M, Mengoli C, Barnes R, Donnelly JP, Loeffler J, Jones BL, et al. Polymerase chain reaction blood tests for the diagnosis of invasive aspergillosis in immunocompromised people. Cochrane database Syst Rev. 2019; https://doi.org/10.1002/14651858.CD009551.PUB4.

  62. Egger M, Jenks JD, Hoenigl M, Prattes J. Blood Aspergillus PCR: the good, the bad, and the ugly. J Fungi (Basel, Switzerland). 2020; https://doi.org/10.3390/JOF6010018.

  63. Moura S, Cerqueira L, Almeida A. Invasive pulmonary aspergillosis: current diagnostic methodologies and a new molecular approach. Eur J Clin Microbiol Infect Dis. 2018; https://doi.org/10.1007/S10096-018-3251-5.

  64. Ponnaiyan D, Anitha CM, Prakash PSG, Subramanian S, Rughwani RR, Kumar G, et al. Mucormycosis diagnosis revisited: current and emerging diagnostic methodologies for the invasive fungal infection (Review). Exp Ther Med. 2023; https://doi.org/10.3892/ETM.2022.11746.

  65. Guegan H, Iriart X, Bougnoux ME, Berry A, Robert-Gangneux F, Gangneux JP. Evaluation of MucorGenius® mucorales PCR assay for the diagnosis of pulmonary mucormycosis. J Infect. 2020; https://doi.org/10.1016/J.JINF.2020.05.051.

  66. Dantas KC, de Freitas-Xavier RS, SCF SL, Júnior AM, da Silva MV, Criado PR, et al. Comparative analysis of diagnostic methods for the detection of Cryptococcus neoformans meningitis. PLoS Negl Trop Dis. 2023; https://doi.org/10.1371/JOURNAL.PNTD.0011140.

  67. **ng XW, Zhang JT, Ma YB, Zheng N, Yang F, Yu SY. Apparent performance of metagenomic next-generation sequencing in the diagnosis of cryptococcal meningitis: a descriptive study. J Med Microbiol. 2019; https://doi.org/10.1099/JMM.0.000994.

  68. Moreno A, Epstein D, Budvytiene I, Banaei N. Accuracy of Pneumocystis jirovecii plasma cell-free DNA PCR for noninvasive diagnosis of Pneumocystis pneumonia. J Clin Microbiol. 2022; https://doi.org/10.1128/JCM.00101-22.

  69. Morjaria S, Frame J, Franco-Garcia A, Geyer A, Kamboj M, Esther BN. Clinical performance of (1,3) beta-D glucan for the diagnosis of Pneumocystis pneumonia (PCP) in cancer patients tested with PCP polymerase chain reaction. Clin Infect Dis. 2019; https://doi.org/10.1093/CID/CIY1072.

  70. Krifors A, Ullberg M, Castegren M, Petersson J, Sparrelid E, Hammarström H, et al. T2Candida assay in the diagnosis of intraabdominal candidiasis: a prospective multicenter study. J Fungi. 2022; https://doi.org/10.3390/JOF8010086.

  71. Fisher MC, Denning DW. The WHO fungal priority pathogens list as a game-changer. Nat Rev Microbiol. 2023; https://doi.org/10.1038/s41579-023-00861-x.

  72. Livengood SJ, Drew RH, Perfect JR. Combination therapy for invasive fungal infections. Curr Fungal Infect Rep. 2020; https://doi.org/10.1007/S12281-020-00369-4/TABLES/1.

  73. Cavassin FB, Baú-Carneiro JL, Vilas-Boas RR, Queiroz-Telles F. Sixty years of amphotericin B: an overview of the main antifungal agent used to treat invasive fungal infections. Infect Dis Ther. 2021; https://doi.org/10.1007/S40121-020-00382-7.

  74. Zhao T, Xu X, Wu Y, Zhang W, Zeng Q, Lu Y, et al. Comparison of amphotericin B deoxycholate in combination with either flucytosine or fluconazole, and voriconazole plus flucytosine for the treatment of HIV-associated cryptococcal meningitis: a prospective multicenter study in China. BMC Infect Dis. 2022; https://doi.org/10.1186/S12879-022-07665-Z.

  75. Fioriti S, Brescini L, Pallotta F, Canovari B, Morroni G, Barchiesi F. Antifungal combinations against Candida species: from bench to bedside. J Fungi (Basel, Switzerland). 2022; https://doi.org/10.3390/JOF8101077.

  76. O’Brien B, Chaturvedi S, Chaturvedi V. In vitro evaluation of antifungal drug combinations against multidrug-resistant Candida auris isolates from New York outbreak. Antimicrob Agents Chemother. 2020; https://doi.org/10.1128/AAC.02195-19.

  77. Smith C, Lee SC. Current treatments against mucormycosis and future directions. PLoS Pathog. 2022; https://doi.org/10.1371/JOURNAL.PPAT.1010858.

  78. Madhavan Y, Sai KV, Shanmugam DK, Manimaran A, Guruviah K, Mohanta YK, et al. Current treatment options for COVID-19 associated mucormycosis: present status and future perspectives. J Clin Med. 2022; https://doi.org/10.3390/JCM11133620.

  79. Nucci M, Barreiros G, Akiti T, Anaissie E, Nouér SA. Invasive fusariosis in patients with hematologic diseases. J Fungi. 2021; https://doi.org/10.3390/JOF7100815.

  80. Douglas AP, Smibert OC, Bajel A, Halliday CL, Lavee O, McMullan B, et al. Consensus guidelines for the diagnosis and management of invasive aspergillosis. Intern Med J. 2021; https://doi.org/10.1111/IMJ.15591.

  81. Perez L, Corne P, Pasquier G, Konecki C, Sadek M, Le Bihan C, et al. Population pharmacokinetics of isavuconazole in critical care patients with COVID-19-associated pulmonary aspergillosis and Monte Carlo simulations of high off-label doses. J Fungi. 2023; https://doi.org/10.3390/JOF9020211/S1.

  82. Pérez-Cantero A, López-Fernández L, Guarro J, Capilla J. Azole resistance mechanisms in Aspergillus: update and recent advances. Int J Antimicrob Agents. 2020; https://doi.org/10.1016/J.IJANTIMICAG.2019.09.011.

  83. Szymański M, Chmielewska S, Czyżewska U, Malinowska M, Tylicki A. Echinocandins – structure, mechanism of action and use in antifungal therapy. J Enzyme Inhib Med Chem. 2022;37:876–94. https://doi.org/10.1080/14756366.2022.2050224.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  84. Lamoth F. Novel therapeutic approaches to invasive candidiasis: considerations for the clinician. Infect Drug Resist. 2023; https://doi.org/10.2147/IDR.S375625.

  85. Haseeb A, Abourehab MAS, Almalki WA, Almontashri AM, Bajawi SA, Aljoaid AM, et al. Trimethoprim-sulfamethoxazole (Bactrim) dose optimization in Pneumocystis jirovecii pneumonia (PCP) management: a systematic review. Int J Environ Res Public Heal. 2022; https://doi.org/10.3390/IJERPH19052833.

  86. Coussement J, Lindsay J, Teh BW, Slavin M. Choice and duration of antifungal prophylaxis and treatment in high-risk haematology patients. Curr Opin Infect Dis. 2021; https://doi.org/10.1097/QCO.0000000000000737.

  87. Lehrnbecher T, Bochennek K, Groll AH. Mold-active antifungal prophylaxis in pediatric patients with cancer or undergoing hematopoietic cell transplantation. J Fungi. 2023;9:387. https://doi.org/10.3390/JOF9030387.

    Article  CAS  Google Scholar 

  88. Guidelines for prophylaxis against Pneumocystis carinii pneumonia for children infected with human immunodeficiency virus.

  89. Itsaradisaikul S, Pakakasama S, Boonsathorn S, Techasaensiri C, Rattanasiri S, Apiwattanakul N. Invasive fungal disease among pediatric and adolescent patients undergoing itraconazole prophylaxis after hematopoietic stem cell transplantation. Transplant Proc. 2021; https://doi.org/10.1016/j.transproceed.2021.04.010.

  90. Breitkopf R, Treml B, Senoner T, Bukumirić Z, Rajsic S. Invasive fungal breakthrough infections under targeted echinocandin prophylaxis in high-risk liver transplant recipients. J Fungi. 2023; https://doi.org/10.3390/JOF9020272/S1.

  91. Batchelor R, Thomas C, Gardiner BJ, Lee SJ, Fleming S, Wei A, et al. When azoles cannot be used: the clinical effectiveness of intermittent liposomal amphotericin prophylaxis in hematology patients. Open Forum Infect Dis. 2021; https://doi.org/10.1093/OFID/OFAB113.

  92. Hawes AM, Permpalung N. Diagnosis and antifungal prophylaxis for COVID-19 associated pulmonary aspergillosis. Antibiot. 2022; https://doi.org/10.3390/ANTIBIOTICS11121704.

  93. Hatzl S, Reisinger AC, Posch F, Prattes J, Stradner M, Pilz S, et al. Antifungal prophylaxis for prevention of COVID-19-associated pulmonary aspergillosis in critically ill patients: an observational study. Crit Care. 2021; https://doi.org/10.1186/S13054-021-03753-9.

  94. • Massart N, Reizine F, Dupin C, Legay F, Legris E, Cady A, et al. Prevention of acquired invasive fungal infection with decontamination regimen in mechanically ventilated ICU patients: a pre/post observational study. 2023; https://doi.org/10.1080/23744235.2023.2170460. Important study is about reducing the risk of intensive care unit–acquired invasive fungal infections in mechanically ventilated patients receiving multisite disinfectants.

  95. Jacobs SE, Zagaliotis P, Walsh TJ. Novel antifungal agents in clinical trials. F1000Research. 2021; https://doi.org/10.12688/f1000research.28327.1.

  96. Gintjee TJ, Donnelley MA, Thompson Iii GR. Aspiring antifungals: review of current antifungal pipeline developments. J Fungi. 2020; https://doi.org/10.3390/JOF6010028.

  97. Shaw KJ. GR-2397: Review of the novel siderophore-like antifungal agent for the treatment of invasive aspergillosis. J Fungi. 2022; https://doi.org/10.3390/JOF8090909.

  98. Rauseo AM, Coler-Reilly A, Larson L, Spec A. Hope on the horizon: novel fungal treatments in development. Open Forum Infect Dis. 2020; https://doi.org/10.1093/OFID/OFAA016.

Download references

Funding

This study has been funded and supported by the Tehran University of Medical Sciences, Tehran, Iran (Grant no. 1400-3-422-55238).

Author information

Authors and Affiliations

  1. Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

    Ali Ahmadi, Bahareh Bashardoust, Selva Aminizadeh & Sadegh Khodavaisy

  2. Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran

    Ali Ahmadi & Bahareh Bashardoust

  3. Department of Microbiology, Shahr-e-Qods Branch, Islamic Azad University, Tehran, Iran

    Mahsa Abdorahimi

  4. Research Center for Antibiotic Stewardship and Antimicrobial Resistance, Tehran University of Medical Sciences, Tehran, Iran

    Mohammadreza Salehi & Sadegh Khodavaisy

  5. Department of Infectious Diseases and Tropical Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

    Mohammadreza Salehi

Authors
  1. Ali Ahmadi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bahareh Bashardoust
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mahsa Abdorahimi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Selva Aminizadeh
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mohammadreza Salehi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Sadegh Khodavaisy
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

A.A. and B.B. wrote the main manuscript text with support from S.KH. and M.S. M.A. prepared Table 1. S.A. contributed to the editing of the manuscript. All authors reviewed the manuscript.

Corresponding author

Correspondence to Sadegh Khodavaisy.

Ethics declarations

Conflict of Interest

The authors declare no competing interests.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ahmadi, A., Bashardoust, B., Abdorahimi, M. et al. Emerging Challenges in Diagnosis and Treatment of Invasive Fungal Infections: Addressing the Impact of COVID-19 and New Pathogens. Curr Fungal Infect Rep 17, 296–308 (2023). https://doi.org/10.1007/s12281-023-00475-z

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12281-023-00475-z

Keywords

Search

Navigation