Antifungal Resistance and Novel Mycology Diagnostics

Clinical Center

Investigators

Linked publications & trials

Abstract

Invasive and life-threatening fungal infections are currently among the most difficult diseases to manage in patients who are immunocompromised, hospitalized with severe underlying diseases (e.g., acute myelogenous leukemia), require complex surgical procedures (e.g., for trauma), and need support in intensive care units Despite the increase in fungal infections over the past decades, there are only very few classes of antifungal drugs available for therapy, which have limited efficacy, particularly in the treatment of invasive fungal infections. In addition, antifungal drug resistance of some major fungal pathogens poses ever-increasing therapeutic challenges and is associated with high mortality. We therefore aim to study the prevalence of antifungal resistance among NIH hospitalized patients and to explore efficacy of novel investigational systemic antifungal drugs against difficult to treat molds and yeasts. Moreover, diagnosis of invasive fungal diseases is challenging because current diagnostic methods lack sensitivity and specificity or take too long to yield a result to be clinically useful. Improvement of fungal diagnostics cannot rely on a single technology. Instead, it needs to be equipped with an array of diagnostic tools, including MALTI-TOF MS, fungal biomarkers, antigen and antibody tests, and nucleic acid amplification tests. Utilizing the strength of combined technologies would allow us to fulfill the gaps and optimize the test algorithms for diagnosis of emerging and rare fungal infections. Therefore, second area of my research will focus on strategies and approaches to enhance fungal identification to species level as well as fungal detection directly from clinical samples.