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Excerpt
Candida spp. are the predominant fungi implicated in infections in immunocompromised patients with Aspergillus spp. and Cryptococcus neoformans occurring less frequently. Fungi such as Hisoplasma capsulatum, Coccidiodes immitos, and Blastomyces dermatitidis cause infections in immunocompetent and immunocompromised individuals. There are increasing reports of other fungi, once thought to be nonpathogenic, that can cause infections such as Trichosporon beigelii, Fusarium spp., Zygomycetes including Cunninghamella, and dematiaceous molds.
New antifungal agents have begun to appear commensurate with the increased rate of fungal infections. Amphotericin B is still the gold standard by which other drugs are measured for their antifungal activity. The azole family, e.g. fluconazole and itraconazole, has found a place in therapy and prophylaxis. New agents such as voriconazole and terbinafine show promise.
Coinciding with these issues is the recognizable need for antifungal susceptibility testing to identify innately resistant organisms and the emergence of resistance during therapy.1 Additionally, there is a need to develop a correlation between the in vitro susceptibility data and the clinical outcome, and possible synergy with combination therapy.
