Effectiveness of front line and emerging fungal disease prevention and control interventions and opportunities to address appropriate eco-sustainable solutions

Fungal pathogens contribute to significant disease burden globally; however, the fact that fungi are eukaryotes has greatly complicated their role in fungal-mediated infections and alleviation. Antifungal drugs are often toxic to host cells and there is increasing evidence of adaptive resistance in animals and humans. Existing fungal diagnostic and treatment regimens have limitations that has contributed to the alarming high mortality rates and prolonged morbidity seen in immunocompromised cohorts caused by opportunistic invasive infections as evidenced during HIV and COVID-19 pandemics. There is a need to develop real-time monitoring and diagnostic methods for fungal pathogens and to create a greater awareness as to the contribution of fungal pathogens in disease causation. Greater information is required on the appropriate selection and dose of antifungal drugs including factors governing resistance where there is commensurate need to discover more appropriate and effective solutions. Popular azole fungal drugs are widely detected in surface water and sediment due to incomplete removal in wastewater treatment plants where they are resistant to microbial degradation and may cause toxic effects on aquatic organisms such as algae and fish. UV has limited effectiveness in destruction of anti-fungal drugs where there is increased interest in the combination approaches such as novel use of pulsed-plasma gas-discharge technologies for environmental waste management. There is growing interest in developing alternative and complementary green eco-biocides and disinfection innovation. Fungi present challenges for cleaning, disinfection and sterilization of reusable medical devices such as endoscopes where they (example, Aspergillus and Candida species) can be protected when harboured in build-up biofilm

Automated summary

Fungal pathogens are a significant global disease burden. However, their status as eukaryotes complicates their involvement in fungal-mediated infections and treatment. Antifungal drugs can be toxic to host cells, and there is increasing evidence of adaptive resistance in animals and humans. Current diagnostic and treatment methods have limitations, leading to high mortality rates and prolonged illness in immunocompromised patients. Therefore, real-time monitoring and diagnostic methods for fungal pathogens are needed, as well as increased awareness of the contribution of fungal pathogens to disease. More information is also needed on the selection and dosage of antifungal drugs, as well as factors governing resistance, to find more appropriate and effective solutions. Additionally, there is growing interest in developing alternative and complementary green biocides and disinfection innovations.