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bioRxiv · 10.64898/2026.06.04.730223

Antifungal tolerance and resistance dynamics depend on infection load, drug treatment, and host innate immunity

Galon, C. M.·Charlebois, D. A.
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Abstract

Fungi contribute substantially to the global antimicrobial resistance crisis. Tolerance is a novel form of antifungal resistance in which fungal pathogens emerge, grow slowly, and survive antifungal drug treatment. We quantitatively model the population and evolutionary dynamics of a multidrug resistant pathogen Candidozyma auris (formerly Candida auris) infecting an invertebrate host (Galleria mellonella) with an innate immune system. We find that the establishment, dominance, and co-existence of tolerant and resistant subpopulations depend on infection load, drug-treatment, and innate host immunity. This study enhances our understanding of the population and evolutionary dynamics of pathogenic infections and provides a quantitative framework to predict antimicrobial resistance.

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Galon, C. M., Charlebois, D. A.. 2026-06-09. Antifungal tolerance and resistance dynamics depend on infection load, drug treatment, and host innate immunity. https://doi.org/10.64898/2026.06.04.730223

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