The Challenge of Invasive Fungal Infection

Abstract

Systemic fungal infections cause almost 25% of the infection-related deaths in leukaemic patients. Particularly those with prolonged neutropenia are at risk but mycoses also feature in critically ill intensive care patients and in individuals who are treated for solid tumours and AIDS, or who received an organ transplant. The spread of AIDS and the more aggressive cytotoxic chemotherapy in combination with an improved management of haemorrhages and bacterial infections in leukaemic and other cancer patients facilitated the occurrence of these invasive fungal infections. These life-threatening complications remain both difficult to diagnose and to treat and therefore carry a poor prognosis. For many years, the only realistic option to treat systemic infections was amphotericin B, whose administration was known to be associated with numerous adverse effects. Now less toxic formulations of amphotericin have become available for clinical use, as well as several new triazoles that appear to provide an effective and less toxic alternative for the treatment of certain fungal infections.

Modes of Action of the New Arylguanidine Abafungin beyond Interference with Ergosterol Biosynthesis and in vitro Activity against Medically Important Fungi

“…In the past decades, fungal infections have increased, especially in immuno-compromised patients [1][2][3][4] . The currently used antifungal drugs belong to ten different major groups of substances [5] .…”

Synergism of CAY-1 with Amphotericin B and Itraconazole

“…In addition, antifungal drugs can cause toxic or adverse drug reactions. For example, the polyene antifungal, amphotericin B (AB), has a broad range of activity but is limited in its use due to numerous adverse effects [3] . Saponins have surface-active properties which cause pores to form in microbial membranes leading to lysis, a mode of action which differs from those of AB or itraconazole (IT), an azole antifungal drug.…”

Disruption in Candida albicans of the TPS2 gene encoding trehalose-6-phosphate phosphatase affects cell integrity and decreases infectivity The EMBL accession number for the sequence reported in this paper is AJ242990.

“…Systemic infections by the yeast Candida albicans rank among the leading causes of death by microbial infections (de Pauw & Meunier, 1999 ;Edwards, 1991 ;Verduyn Lunel et al, 1999). Effective drugs are available for the treatment of candidiasis (Herbrecht et al, 1999 ;Martin, 1999), but the increasing prevalence of resistant strains indicates an urgent need for new antifungal agents (Monk & Perlin, 1994).…”