A team of researchers have found that fungal infections are adapting to new medicines and causing a “silent pandemic” that needs to be addressed urgently.
“The threat of fungal pathogens and antifungal resistance, even though it is a growing global issue, is being left out of the debate,” explains molecular biologist Norman van Rhijn from the University of Manchester in the UK.
The United Nations is hosting a meeting this month in New York City on antimicrobial resistance, which includes discussions on resistant bacteria, fungi, viruses, or parasites.
Ahead of this event, van Rhijn and an international team of scientists are urging governments, the research community, and the pharmaceutical industry to “look beyond just bacteria.” Fungal infections, they write in a correspondence for The Lancet, are left out of too many initiatives to tackle antimicrobial resistance.
According to the researchers, without urgent attention and action, some particularly nasty fungal infections, which already infect 6.5 million a year and claim 3.8 million lives annually, could become even more dangerous.
“The disproportionate focus on bacteria is concerning because many drug resistance problems over the past decades were the result of invasive fungal diseases, which are largely under-recognized by the community and governments alike,” write van Rhijn and his colleagues, who hail from institutions in China, the Netherlands, Austria, Australia, Spain, the UK, Brazil, the US, India, Türkiye, and Uganda.
In 2022, the World Health Organization published the Fungal Priority Pathogen List – “the first global effort to systematically prioritize fungal pathogens”.
According to the list, pathogens considered most dangerous to human health included Aspergillus fumigatus, which comes from mold and infects the respiratory system; Candida, which can cause a yeast infection; Nakaseomyces glabratus, which can infect the urogenital tract or bloodstream; and Trichophyton indotineae, which can infect the skin, hair, and nails.
It is noteworthy that older people or those who are immunocompromised are the most at risk. According to a report by Science Alert, compared to bacteria or viruses, fungi are more complicated organisms, most similar to animals in their structure. Consequently, it is more expensive and difficult for scientists to develop medicine that kills the cells of fungi without damaging other important cells in the body.
“To treat deep or invasive fungal infections, only four systemic antifungal classes are available and resistance is now the rule rather than the exception for those currently available classes,” write the authors of the correspondence.
The UN’s meeting this September “must serve as a starting point” for an orchestrated and diverse approach to antimicrobial resistance, the researchers conclude, as quoted by Science Alert.