Stephanoascus ciferrii Complex: The Current State of Infections and Drug Resistance in Humans

• Published in: Journal of fungi (Basel) 2024-04, Vol.10 (4), p.294
• Main Authors: Cosio, Terenzio, Pica, Francesca, Fontana, Carla, Pistoia, Enrico Salvatore, Favaro, Marco, Valsecchi, Isabel, Zarabian, Nikkia, Campione, Elena, Botterel, Françoise, Gaziano, Roberta
• Format: Article
• Language: English
• Subjects: antifungal agents; Azoles; Candida; Candida ciferrii; Candidemia; Case reports; Clinical aspects; Drug resistance; Echinocandins; Epidemiology; Fungal infections; Fungi; immunosuppression; Laboratories; Morphology; Multidrug resistance; Pathogenicity; Pathogens; rRNA 18S; Stephanoascus ciferrii complex; Yeast
• ISSN: 2309-608X; 2309-608X
• DOI: 10.3390/jof10040294

In recent years, the incidence of fungal infections in humans has increased dramatically, accompanied by an expansion in the number of species implicated as etiological agents, especially environmental fungi never involved before in human infection. Among fungal pathogens, species are the most common opportunistic fungi that can cause local and systemic infections, especially in immunocompromised individuals. ( ) is the most common causative agent of mucosal and healthcare-associated systemic infections. However, during recent decades, there has been a worrying increase in the number of emerging multi-drug-resistant non- (NAC) species, i.e., , , , , , and . In particular, , also known as or , is a heterothallic ascomycete yeast-like fungus that has received attention in recent decades as a cause of local and systemic fungal diseases. Today, the new definition of the complex, which consists of , , and , was proposed after sequencing the 18S rRNA gene. Currently, the complex is mostly associated with non-severe ear and eye infections, although a few cases of severe candidemia have been reported in immunocompromised individuals. Low susceptibility to currently available antifungal drugs is a rising concern, especially in NAC species. In this regard, a high rate of resistance to azoles and more recently also to echinocandins has emerged in the complex. This review focuses on epidemiological, biological, and clinical aspects of the complex, including its pathogenicity and drug resistance.