{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T18:43:50Z","timestamp":1793645030333,"version":"4.5.1"},"reference-count":251,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2020,12,8]],"date-time":"2020-12-08T00:00:00Z","timestamp":1607385600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["AI109025"],"award-info":[{"award-number":["AI109025"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>The high clinical mortality and economic burden posed by invasive fungal infections (IFIs), along with significant agricultural crop loss caused by various fungal species, has resulted in the widespread use of antifungal agents. Selective drug pressure, fungal attributes, and host- and drug-related factors have counteracted the efficacy of the limited systemic antifungal drugs and changed the epidemiological landscape of IFIs. Species belonging to Candida, Aspergillus, Cryptococcus, and Pneumocystis are among the fungal pathogens showing notable rates of antifungal resistance. Drug-resistant fungi from the environment are increasingly identified in clinical settings. Furthermore, we have a limited understanding of drug class-specific resistance mechanisms in emerging Candida species. The establishment of antifungal stewardship programs in both clinical and agricultural fields and the inclusion of species identification, antifungal susceptibility testing, and therapeutic drug monitoring practices in the clinic can minimize the emergence of drug-resistant fungi. New antifungal drugs featuring promising therapeutic profiles have great promise to treat drug-resistant fungi in the clinical setting. Mitigating antifungal tolerance, a prelude to the emergence of resistance, also requires the development of effective and fungal-specific adjuvants to be used in combination with systemic antifungals.<\/jats:p>","DOI":"10.3390\/antibiotics9120877","type":"journal-article","created":{"date-parts":[[2020,12,8]],"date-time":"2020-12-08T20:27:15Z","timestamp":1607459235000},"page":"877","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":283,"title":["Drug-Resistant Fungi: An Emerging Challenge Threatening Our Limited Antifungal Armamentarium"],"prefix":"10.3390","volume":"9","author":[{"given":"Amir","family":"Arastehfar","sequence":"first","affiliation":[{"name":"Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ 07110, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0019-1735","authenticated-orcid":false,"given":"Toni","family":"Gabald\u00f3n","sequence":"additional","affiliation":[{"name":"Life Sciences Programme, Supercomputing Center (BSC-CNS), Jordi Girona, 08034 Barcelona, Spain"},{"name":"Mechanisms of Disease Programme, Institute for Research in Biomedicine (IRB), 08024 Barcelona, Spain"},{"name":"Catalan Institution for Research and Advanced Studies. Pg. Llu\u00eds Companys 23, 08010 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4610-2996","authenticated-orcid":false,"given":"Rocio","family":"Garcia-Rubio","sequence":"additional","affiliation":[{"name":"Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ 07110, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey D.","family":"Jenks","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of California San Diego, San Diego, CA 92103, USA"},{"name":"Clinical and Translational Fungal-Working Group, University of California San Diego, La Jolla, CA 92093, USA"},{"name":"Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, La Jolla, CA 92093, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1653-2824","authenticated-orcid":false,"given":"Martin","family":"Hoenigl","sequence":"additional","affiliation":[{"name":"Clinical and Translational Fungal-Working Group, University of California San Diego, La Jolla, CA 92093, USA"},{"name":"Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, La Jolla, CA 92093, USA"},{"name":"Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helmut J. F.","family":"Salzer","sequence":"additional","affiliation":[{"name":"Department of Pulmonology, Kepler University Hospital, 4021 Linz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Macit","family":"Ilkit","sequence":"additional","affiliation":[{"name":"Division of Mycology, University of \u00c7ukurova, 01330 Adana, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2946-7785","authenticated-orcid":false,"given":"Cornelia","family":"Lass-Fl\u00f6rl","sequence":"additional","affiliation":[{"name":"Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, 6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David S.","family":"Perlin","sequence":"additional","affiliation":[{"name":"Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ 07110, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,12,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e00449-20","DOI":"10.1128\/mBio.00449-20","article-title":"Threats posed by the fungal kingdom to humans, wildlife, and agriculture","volume":"11","author":"Fisher","year":"2020","journal-title":"mBio"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.mib.2020.05.004","article-title":"Minority report: The intestinal mycobiota in systemic infections","volume":"56","author":"Rolling","year":"2020","journal-title":"Curr. 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