'Silent pandemic' of deadly fungal infections is spreading globally
The global health community is currently grappling with an antibiotic resistance crisis, which contributes to nearly five million deaths annually. However, bacteria are not the only mutating pathogens posing a threat. According to researchers, fungal infections are also evolving beyond our medical capabilities, leading to a "silent pandemic" that requires urgent attention. This warning comes from molecular biologist Norman van Rhijn from the University of Manchester in the UK and his international team of scientists.
Fungal infections: An overlooked threat
Van Rhijn and his team have expressed concern that the issue of fungal pathogens and antifungal resistance is being overlooked in global discussions. They argue that this growing problem should be a central part of the debate on antimicrobial resistance. The United Nations is set to host a meeting on this topic in New York City this September, where resistant bacteria, fungi, viruses, or parasites will be discussed.
Call for action against rising fungal infections
The team of scientists is urging governments, researchers, and the pharmaceutical industry to broaden their focus beyond bacteria. In a correspondence for The Lancet, they highlight that many initiatives aimed at combating antimicrobial resistance often neglect fungal infections. They warn that without immediate action, these infections could become even more lethal. Currently, certain aggressive fungal infections affect 6.5 million people annually and are responsible for 3.8 million deaths each year.
Disproportionate focus on bacteria over fungi
"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," write van Rhijn. In 2022, World Health Organization (WHO) published its first-ever Fungal Priority Pathogen List to systematically prioritize fungal pathogens. The most dangerous ones include Aspergillus fumigatus from mold that infects respiratory system, Candida causing yeast infections, Nakaseomyces glabratus affecting urogenital tract or bloodstream, and Trichophyton indotineae infecting skin, hair, and nails.
Challenges in developing antifungal medicines
Fungi are complex organisms, most similar to animals in their structure. This complexity makes it difficult and costly for scientists to create medicines, that can eliminate fungal cells without harming other vital 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," warn the authors of the correspondence.
Agrochemical industry's role in antifungal resistance
The development of new antifungals is being accelerated by the agrochemical industry. However, this can lead to cross-resistance for critical priority pathogens. "Even before [these drugs] reach the market after years of development and clinical trials, fungicides with similar modes of action are developed by the agrochemical industry resulting in cross-resistance for critical priority pathogens," explain the researchers. They highlight the need for a balance between food security and treating resistant fungal pathogens.
