Purpose of Review
For this review, we use a One Health approach to examine two globally emerging public health threats related to antifungal drug resistance: triazole-resistant
Aspergillus fumigatus
infections, which can cause a life-threatening illness in immunocompromised hosts, and antifungal-resistant dermatophytosis, which is an aggressive skin infection caused by dermatophyte molds. We describe the state of current scientific knowledge and outline necessary public health actions to address each issue.
Recent Findings
Recent evidence has identified the agricultural use of triazole fungicides as an important driver of triazole-resistant
A. fumigatus
infections. Antifungal-resistant dermatophyte infections are likely driven by the inappropriate use of antifungal drugs and antibacterial and corticosteroid creams.
Summary
This review highlights the need for a One Health approach to address emerging antifungal resistant infections, emphasizing judicious antifungal use to preserve available treatments; strengthened laboratory capacity to identify antifungal resistance; and improved human, animal, and environmental surveillance to detect emerging resistance, monitor trends, and evaluate the effectiveness of efforts to decrease spread.