The Environmental-Clinical Nexus: How Agricultural Fungicide Use is Driving the Antifungal Resistance Crisis and the Race for Novel Solutions
DOI:
https://doi.org/10.65459/pmhj.000000001Keywords:
Antifungal resistance, Priority, diagnosis, Marine compounds, NanotechnologyAbstract
Background: Fungal pathogens are an increasing global health threat, especially for immunocompromised individuals. The rise of antifungal resistance, driven by factors such as overuse of agricultural pesticides, challenges effective treatment. In response, the WHO published its first Fungal Priority Pathogens List (FPPL) in 2022, guiding research and public health efforts. Objectives: This review synthesizes current knowledge on the WHO priority fungal pathogens, explores factors driving antifungal resistance, and highlights emerging diagnostic and therapeutic strategies, such as marine natural products and nanotechnology, to combat these infections. Methods: A narrative literature review was conducted using databases like PubMed, Scopus, and Web of Science, along with official WHO reports. The search focused on publications from 2008 to 2024 using keywords such as "antifungal resistance," "WHO fungal priority list," "marine natural products," and "nanotechnology antifungals." Results: The review presents details on the 19 pathogens listed on the WHO FPPL, categorized into three priority tiers: critical, high, and medium. Emphasis is placed on the top five threats: Cryptococcus spp., Aspergillus spp., Candida spp., Fusarium spp., and Mucorales. Promising strategies include marine natural products as sources of new compounds, nano-enabled technologies for better drug delivery, and the importance of rapid, accurate diagnostics. Conclusion: Fungal pathogens remain a serious threat, worsened by increasing drug resistance. A comprehensive approach combining improved diagnostics, antimicrobial stewardship, and the development of innovative treatments from marine metabolites and nanotechnology is essential for better patient outcomes.
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