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Open research questions in Antifungal resistance and susceptibility

1,154 gap statements mined from Antifungal resistance and susceptibility papers in our 7.9M-paper local library, which holds 4,149 papers on the topic — drawn mostly from each paper's own stated research gap, future-work, challenge and limitation notes, and its abstract. The ones listed below are a selection still marked open; each names the study that raised it, with a DOI link where the paper has one.

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What the literature leaves open

  • The lack of molecular identification and antifungal susceptibility testing in clinical practice can lead to misdiagnosis and ineffective treatment of Aspergillus infections. The emergence of multidrug-resistant Aspergillus species, such as A. udagawae, poses a significant challenge to the management of fungal infections.

    Fatal Fungal Peritonitis Caused by Aspergillus udagawae: An Autopsy Case Report · 2026 · DOI

  • Overcoming biofilm formation is an urgent priority in antifungal therapy. Current antifungal treatments are often ineffective against biofilm-forming Candida albicans. There is a need for novel strategies to inhibit Candida albicans biofilm formation.

    The combination of farnesol and berberine effectively inhibits Candida albicans growth and biofilm formation · 2026 · DOI

  • It highlights the need for effective diagnostic approaches for C. auris. The study also notes the importance of evaluating the analytical performance of diagnostic assays.

    Prospective surveillance of Candida auris and assessment of diagnostic approaches in a Belgian hospital · 2026 · DOI

  • It also highlights the need for improved diagnostic and therapeutic strategies. The emergence of antifungal-resistant strains is another significant gap.

    Editorial: Perspectives in fungal pathogenesis: 2025 · 2026 · DOI

  • The gap in prior work is the lack of evaluation of the antifungal efficacy of commercially available mouthwashes against Candida spp. The study aims to fill this gap by providing a comprehensive evaluation of the antifungal properties of mouthwashes.

    Repurposing Mouthwashes: Antifungal and Antibiofilm Abilities of Commercially Available Mouthwashes Against Candida spp. · 2025 · DOI

  • There is a lack of studies assessing the antifungal susceptibility of Candida spp. isolated from amniotic fluid. The current study aims to fill this gap by providing an assessment of antifungal susceptibility using an MIC-based assay. The study also aims to identify the species distribution and antifungal susceptibility patterns of Candida spp. isolated from amniotic fluid.

    Candida Susceptibility to Antifungals in Amniotic Fluid: A Preliminary Study · 2025 · DOI

  • The lack of a predictive model for assessing the risk of short-term mortality in patients with invasive fungal diseases after cardiac surgery. The need to identify independent risk factors for short-term mortality in this cohort.

    Construction of a Risk Assessment Model for Short-Term Mortality in Patients with Invasive Fungal Diseases Post-Cardiac Surgery Based on Multivariate Analysis · 2025 · DOI

  • Limited diagnostic capabilities for fungal infections. Need for effective antifungal therapy in the face of increasing resistance.

    Epidemiology of Fungal Bloodstream Infections and Antifungal Susceptibility in a Tertiary Care Hospital in Riyadh, Saudi Arabia: A Rare Candida Co-Infection Case · 2025 · DOI

  • It highlights the need to interpret GM test results cautiously, particularly in IgG-type multiple myeloma. The study also notes the limitations of the GM test in newly diagnosed patients with multiple myeloma prior to systemic chemotherapy.

    False-Positive Galactomannan Test Results in Multiple Myeloma · 2025 · DOI

  • Limited understanding of the epidemiology and risk factors of CAIFI in critically ill intubated patients. Lack of studies evaluating the impact of COVID-19 vaccination on the risk of prolonged mechanical ventilation in CAIFI patients.

    Factors Associated with Prolonged Mechanical Ventilation and 30-Day Mortality in Intubated COVID-19 Patients with Invasive Fungal Infections: A Retrospective Observational Study · 2025 · DOI

  • There is a lack of large-scale epidemiology studies on C. auris. The diagnosis of C. auris infections can be challenging, particularly when employing conventional techniques. There is a need for effective infection prevention and control measures to prevent the transmission of C. auris.

    Candida auris Outbreaks: Current Status and Future Perspectives · 2024 · DOI

  • The interactions between fungi and systemic anticancer therapy are poorly characterized. The relationship between systemic chemotherapy and the gut mycobiome is poorly understood. The impact of anticancer agents on fungal growth and the selection of resistant fungal phenotypes is not well understood.

    Complex Interrelationships Between Tumors, the Mycobiota, and Systemic Chemotherapy · 2026 · DOI

  • In particular, the contribution of macrophage-derived reactive oxygen species (ROS) to conidial clearance and control of fungal germination and hyphae remains unclear.

    Macrophage PHOX Restricts Aspergillus fumigatus Germination and Hyphal Development Through ROS-Dependent Immunity · 2026 · DOI

  • Central nervous system involvement is among the most devastating manifestations of mucormycosis, yet the mechanisms that enable Mucorales to adapt to the brain environment remain poorly understood.

    Host brain infection induces RNAi epimutation in Mucor circinelloides and enhances blood-brain barrier invasion · 2026 · DOI

  • This species primes systemic Th17 immunogenicity which protects against disseminated infection, and yet the fungal determinants driving protection remain uncertain.

    Candidalysin promotes fungal-specific Th17 CD4 T cell differentiation and protective systemic immunogenicity · 2026 · DOI

  • Future research should focus on systems for automated data extraction from the EPR to allow reliable case classification with minimal workload.

    From Aspergillus fumigatus pathogen surveillance to Aspergillus disease surveillance · 2026 · DOI

  • In response to this situation, and after successive dose increases and a pharmacogenetic analysis that confirmed the patient was not a CYP2C19 or CYP2C9 rapid or ultra-rapid metaboliser, a new administration frequency of every 8 hours was proposed, with limited evidence, but which allowed achieving target concentrations and patient improvement.

    Optimisation of voriconazole treatment in paediatric patients with Aspergillus flavus fungal endocarditis: a pharmacokinetics case report · 2025 · DOI

  • The addition of fluconazole to surgical prophylaxis regimens is controversial, and there is a lack of data describing exposures achieved during MCS device insertion.

    Fluconazole exposure during mechanical circulatory support (MCS) device insertion · 2025 · DOI

  • Current prescribing information lacks guidance regarding the co-administration of isavuconazole with anticancer drugs-limited by the availability of clinical drug-drug interaction (DDI) data in the patient population.

    Comparative Analysis of Isavuconazole DDIs With Other Azole Antifungal Drugs and PBPK Model‐Informed Dosing Recommendations for Anticancer Drugs · 2025 · DOI

  • The biofilm formation was analyzed by XTT assay, which may not accurately represent biofilm formation - The characteristics of C.

    Relationship Between Virulence Factor Activities, Cytotoxicity of Candida albicans Strains Isolated from Oral Cavity, and Cytokine Production by Oral Keratinocytes Exposed to Those Strains · 2025 · DOI

  • Investigate the relationship between the pathogenicity of C.

    Relationship Between Virulence Factor Activities, Cytotoxicity of Candida albicans Strains Isolated from Oral Cavity, and Cytokine Production by Oral Keratinocytes Exposed to Those Strains · 2025 · DOI

  • Further study on the epidemiology and clinical characteristics of A. udagawae infections, - Investigation of the genetic mechanisms of antifungal resistance in A.

    Fatal Fungal Peritonitis Caused by Aspergillus udagawae: An Autopsy Case Report · 2026 · DOI

  • Further studies on antifungal susceptibility patterns, - Investigation of the link between fungal imbalance and adverse outcomes, - Research on the effectiveness of antifungal stewardship…

    Candida Susceptibility to Antifungals in Amniotic Fluid: A Preliminary Study · 2025 · DOI

  • The study was conducted in a single tertiary care hospital in Riyadh, Saudi Arabia, - The sample size was limited to 55 patients, - The study did not include central or arterial line…

    Epidemiology of Fungal Bloodstream Infections and Antifungal Susceptibility in a Tertiary Care Hospital in Riyadh, Saudi Arabia: A Rare Candida Co-Infection Case · 2025 · DOI

  • Prospective validation of the observations in an independent cohort of MM, - Investigation of the GM index values in different types of MM, - Analysis of the effects of different treatments on the GM index…

    False-Positive Galactomannan Test Results in Multiple Myeloma · 2025 · DOI

Most-cited papers in Antifungal resistance and susceptibility

Most recent work

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Open questions raised by papers listed on this page include: (1) The lack of molecular identification and antifungal susceptibility testing in clinical practice can lead to misdiagnosis and ineffective treatment of Aspergillus infections (“Fatal Fungal Peritonitis Caused by Aspergillus udagawae: An Autopsy Case Report”, 2026); (2) There is a need for novel strategies to inhibit Candida albicans biofilm formation (“The combination of farnesol and berberine effectively inhibits Candida albicans…”, 2026); (3) The impact of anticancer agents on fungal growth and the selection of resistant fungal phenotypes is not well understood (“Complex Interrelationships Between Tumors, the Mycobiota, and Systemic…”, 2026); (4) The contribution of macrophage-derived reactive oxygen species (ROS) to conidial clearance and control of fungal germination and hyphae remains unclear (“Macrophage PHOX Restricts Aspergillus fumigatus Germination and Hyphal…”, 2026); (5) Central nervous system involvement is among the most devastating manifestations of mucormycosis, yet the mechanisms that enable Mucorales to adapt to the brain environment remain poorly understood (“Host brain infection induces RNAi epimutation in Mucor circinelloides and…”, 2026). 1,154 gap statements have been mined from Antifungal resistance and susceptibility papers in our 7.9M-paper local library, which holds 4,149 papers on the topic; the gaps come from whichever of those papers state one. They are mostly the research gaps the authors state and the papers' abstracts, plus future-work, limitations and challenges passages. The ones listed below are a selection still marked open; each names the study that raised it, with a DOI link where the paper has one, so you can read the original claim in context.

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