

Dr. Primali Jayasekera
Consultant Medical Mycologist,
Head / Department of Mycology,
Medical Research Institute,
Colombo 8
This year November 18th to 24th is declared as the “World Antimicrobial Awareness Week” which is an annual advocacy week with the theme of “Spread awareness, stop resistance”. This includes increasing awareness and development of antimicrobial resistance including its consequences and preventive strategies from stake holders to general public.
Antifungal resistance is a very important global public health issue that is discussed under antimicrobial resistance. But very little is known about. Antifungal resistance occurs when fungal genetic material changes over time and no longer respond to existing antifungal drugs resulting severe infections which are difficult to treat and increasing the risk of disease spread and death.
Main cause for development of resistant fungi are misuse and overuse of antibiotics and antifungal drugs. Also, inadequate infection prevention and control measures can promote the spread of resistant fungi.
The cost of antifungal resistance is enormous to the economy of the country as the significant percentage of country’s economy is spent on free healthcare system. In addition to death and disability, prolonged illness results in longer hospital stays, the need for more expensive diagnostics, medicines, intensive-care and financial challenges for those impacted, as most of them are already affected with some other disease which already have made them immunocompromised. The classic example is devastating impact of mucormycosis and invasive aspergillosis during the COVID-19 pandemic.
In future, the success story of modern medicine may depend on the morbidity & mortality following sepsis from multi-resistant or pan resistant fungi, namely Candida auris as very few drugs are under development & existing antifungal drugs are often associated with important negative side effects.