Persister cells in human fungal pathogens

Microbicidal persistence refers to the phenomenon whereby a subpopulation of microbial cells enters a dormant state to evade drug killing. This phenomenon is associated with antibiotic treatment failure in bacterial infections, and thus, the characteristics and mechanisms of bacterial persistence have been extensively studied. Despite significant evolutionary divergence, microbicidal persistence has also been observed in fungi. Notably, recent studies have demonstrated that fungal persistence can occur within the host and significantly impair the efficacy of fungicidal drugs. Given the extremely limited range of first-line fungicidal agents currently in use, improving our understanding of the shared and unique mechanisms of antifungal persistence in various fungal pathogens is of great clinical importance. This review summarizes recent advances in the study of antifungal persistence, covering conceptual definitions, measurement methods, and molecular mechanisms. It also discusses future research directions in this field.