The Dual Pathogen <i>Fusarium</i>: Diseases, Incidence, Azole Resistance, and Biofilms

The increasing resistance of <i>Fusarium</i> species to nearly all first-line antifungal agents in clinical settings has led to its designation as a ‘high-priority’ human pathogen. As a dual pathogen, <i>Fusarium</i> spp. threaten both human health and crop production, impact...

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Bibliographic Details
Main Authors: Dongmei Li, Kincer Amburgey-Crovetti, Emilie Applebach, Tomoko Y. Steen, Richard Calderone
Format: Article
Language:English
Published: MDPI AG 2025-04-01
Series:Journal of Fungi
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Online Access:https://www.mdpi.com/2309-608X/11/4/294
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Summary:The increasing resistance of <i>Fusarium</i> species to nearly all first-line antifungal agents in clinical settings has led to its designation as a ‘high-priority’ human pathogen. As a dual pathogen, <i>Fusarium</i> spp. threaten both human health and crop production, impacting food security. Our recent drug profiling of clinical <i>Fusarium</i> isolates reveals resistance to several front-line antifungals, with notable cross-azole resistance observed in both clinical and plant-associated strains. While the overuse of agricultural azoles has been implicated in the selection of azole-resistant fungi such as <i>Aspergillus</i>, a similar mechanism has been assumed for <i>Fusarium</i> in clinical settings. However, direct genetic evidence supporting this hypothesis remains limited. In this review, part of our Special Interest (SI) series, we discuss the spectrum of human diseases caused by <i>Fusarium</i>. While incidence data are better established for human keratitis and onychomycosis, invasive fusariosis remains globally underreported. We propose reasons for this distinct clinical spectrum bias and explore the potential genetic basis of azole resistance.
ISSN:2309-608X