. Scientific Frontline: The increase of fungal infection

Monday, January 30, 2023

The increase of fungal infection

A strain of Candida auris cultured in a petri dish at a CDC laboratory.
Photo Credit: Shawn Lockhart / Centers for Disease Control / Public Domain

Late last year the WHO published a report highlighting the first-ever list of fungal "priority pathogens" – a catalogue of the 19 fungi that represent the greatest threat to public health. The premise behind the publication is both because fungi are a significant and increasing threat to public health and because there is little global R&D into fungi or their treatment.

According to Professor Ana Traven, from the Biomedicine Discovery Institute, fungi can range from the benign (skin and nail infections and vaginal thrush) to the deadly (Candida, Aspergillus), “and they have been largely ignored because deadly fungal infections predominantly target people who are immunosuppressed, they are generally not transmitted in human-to-human contact.”

Then in 2016 a Candida auris infection closed down an ICU in the UK after three deaths, and C. auris was transmitted between patients, something that is rarely seen in fungal infection. C. auris infections didn’t even exist before 2009 in humans, and it is now one of four of the WHO’s “critical priority” pathogens. Professor Traven and her colleague, Dr Claudia Simm have set up the only comprehensive research program in Australia working on C. auris, and are one of only a handful of Australian research teams working on fungal infections at all. “There are fewer scientists working in this space, not because it is not important, it is just not high profile enough,” she said. Less than 5% of NHMRC funding devoted to infectious diseases is given to researchers in the fungal space.  “And when you go to an infectious diseases conference only one in twenty presentations will be on fungal infections,” Dr Simm added. “Which is madness, because fungal pathogens are responsible for at least 13 million infections and 1.5 million deaths globally per year.”

Traditionally fungal infections have targeted severely ill patients and those with reduced function of the immune system. Populations at greatest risk of invasive fungal infections include those with cancer, HIV/AIDS, organ transplants, chronic respiratory disease, patients in intensive care wards.

Now, however, climate change could be broadening the repertoire of these infections, according to Traven. “Normally the body temperature of humans is too high for fungi to grow. But it has been proposed that, as the ambient temperature globally increases, the capacity for fungi to survive at higher temperatures increases” she said.

“Now these infections are breaking down mammal’s body temperature defenses.”

In April last year Traven and Simm published, in a journal published by the American Society for Microbiology, one of the first papers out of Australia on a potential new therapeutic approach for the drug-resistant Candida auris.

“Fungal infections are not going away. We are seeing new serious fungal pathogens emerging and the number of individuals susceptible to these infections is increasing, as we saw for example with mucormycosis (called “black fungus” in the media) in COVID-19 patients last year. There really must be more funding into how these fungi operate and how we can treat them,” Traven said. “Maybe now that the WHO has shone a spotlight on them, there can be action.”

Published in journalAmerican Society for Microbiology

Source/CreditMonash University

Reference Number: mcb013023_01

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