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January 1, 1997

Investigators Seeking New Ways to Stem Rising Tide of Resistant Fungi

JAMA. 1997;277(1):5-6. doi:10.1001/jama.1997.03540250013006

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FOR DECADES, scientists and physicians have fretted over the seemingly diabolical ability of bacteria to evolve strategies for outmaneuvering antibiotics.

Now pathogenic fungi using similar tactics are also registering on clinical radar screens. Partly a consequence of the AIDS epidemic, partly a by-product of medical advances, fungal infections have been on the rise during the past 2 decades. More recently, the emergence of fungi that are resistant to the modest arsenal of drugs used to treat them has raised the specter of the fungal equivalent of multidrug-resistant bacteria.

"While we've become accustomed to appreciating the problems of antibacterial resistance, this level of resistance [by fungi] to antifungal drugs is historically unprecedented," says Thomas J. Walsh, MD, head of the immunocompromised host division of the National Cancer Institute, Bethesda, Md.

"Just 5 to 10 years ago, textbooks said the emergence of resistance to antifungals is a rare event. Now it is