Medical mycological iceberg: recent trends in the epidemiology of mycoses

Abstract

Infectious diseases caused by fungi (mycoses) are one of the significant problems of modern medicine Worldwide, more than 300 million people suffer from severe and chronic mycoses, 25 million patients are at risk of disability or death. Due to changes in treatment strategies and the wider use of antifungal prevention in recent years, the epidemiology of fungal infections has changed and has become particularly relevant due to a significant increase in cases of invasive mycoses. Deep, visceral mycoses, sometimes associated with HIV infection, oncohematological pathology, organ transplantation, nursing of newborns, have become more frequent, while the role of fungi that were previously considered apatogenic increases. In the context of the COVID-19 pandemic, risk factors for these infections continue to increase, and therefore it is likely that the incidence of fungal infections, including those associated as nosocomial, will increase in the coming years. The increasing role of fungi in the etiology of hospital infections, the introduction into clinical practice of a significant number of new drugs was inevitably accompanied by the formation of resistance of fungi to antimycotics. According to literature data, the rate of emergence of pathogenic fungi resistant to a limited number of widely used antifungal agents is unprecedented. Thus, in modern conditions associated with the increase in resistance of pathogenic fungi, the key measures should be aimed at developing optimal strategies for containing resistance to antifungal drugs. Key words: mycoses, fungal infections, antimycotics, resistance, risk factors, pandemic, COVID-19