A one health roadmap towards understanding and mitigating emerging Fungal Antimicrobial Resistance: fAMR

Abstract

The emergence of fungal antimicrobial resistance-fAMR-is having a growing impact on human and animal health, and food security. This roadmap charts inter-related actions that will enhance our ability to mitigate the risk of fAMR. As humanity's reliance on antifungal chemicals escalates, our understanding of their one-health consequences needs to scale accordingly if we are to protect our ability to manage the global spectrum of fungal disease sustainably.

Keywords: Antimicrobial resistance; Fungal infection.

Fig. 1. Potential hotspots of fAMR.

A generic systems map scoping the potential for sources of antifungal chemicals (green) to interact with ecological compartments where selection and adaptation of fungi to antifungals can occur (orange) that then lead to pathways of dispersal of viable fAMR inocula (red). The figure is generated from a kumu project where it can be dynamically browsed at https://kumu.io/mcfisher/famr-antifungal-sources-pathways-and-vectors.

Fig. 2. Key priority areas to better understand fAMR.

Priority areas where evidence and integration is needed to understand the ecological and evolutionary drivers of emerging fungal antimicrobial resistance. ‘Lady Justice’ represents the trade-offs inherent in the dual-use of antifungals with similar modes-of-action spanning clinical and environmental settings. Created under licence in BioRender. Fisher, M. (2024) BioRender.com/y84s888.