Upsurge in Curvularia infections and global emerging antifungal drug resistance

Abstract

Background and Objective: Curvularia species not only cause disease in plants but have emerged in the last decade as a human pathogen causing mild, febrile, to life-threatening illness if not well-treated. Because of Curvularia's interlocking lifestyle on plants, animals and human and increased use of azole fungicides, there is emerging evidence of upsurge in resistance to antifungal drugs, a major public health burden. The objective of this study was to evaluate the genetic diversity of C. lunata from plant origin relative to clinical strains and to profile the current literature on the global emerging antifungal drug resistance associated with Curvularia infections. Materials and Methods: In this study, the glyceraldehyde-3-phosphate dehydrogenase (GPDH) locus was used to illustrate the genetic diversity between C. lunata of clinical and plant origin. Tajima's Χ2 test statistics was performed in MEGA6.1 phylogenetic software to investigate the diversity between sequences. Results: The results showed large genetic distance (~0.275±0.041) between lineages of C. lunata of clinical and plant origin. Even though no optimal antifungal therapy for Curvularia infections has been established for elite drugs like triazoles-itraconazole, voriconazole and posaconazole, it is cogently presented herein cases of successful site-specific treatment of infections caused by C. lunata. Conclusion: It is found that C. lunata from plant and clinical origins are genetically diverse and azole-fungicides exert selective pressure that accelerates evolution. Importantly, effective management of Curvularia infections is via combination therapy and regardless of the age and infected organ, treatment that last for at least 3 months is recommended.