A 2020 study called fungal infections a "silent crisis" that was already causing about 1.7 million deaths every year. Drug-resistant fungal infections, particularly those caused by the extremely virulent pathogen called Candida auris, were called a "global threat" that was getting worse. An updated report published in The Lancet Infectious Diseases in 2024 highlighted the growing number of fungal infections that were creating fatal problems for people affected by other diseases such as chronic obstructive pulmonary disease and lung cancer, which were killing over 2 million people annually. This study also highlighted invasive fungal infections, which were estimated to cause about 6.5 million infections every year; of these, about 2.5 million infections were the direct cause of mortality.
Fungal microbes are everywhere, and while many fungal infections are acquired in healthcare settings, fungal spores can even move through places like soil and the air, making them very difficult to avoid entirely. Pets can also spread fungal infections, and changes in the climate are bringing new fungal infections to new areas. There are also emerging threats, including Candida auris and Trichophyton indotineae. Trichophyton indotineae is a drug-resistant fungal infection that was recently found to be transmissible through sexual contact. Experts have written that the epidemiology of fungal infections is "constantly evolving."
"This is not just an issue that affects individual patients," noted Case Western Reserve University Professor Thomas McCormick. "The World Health Organization has recognized it as a widespread threat that has the potential to impact entire health care systems if left unchecked."
McCormick and Case Western Professor Mahmoud Ghannoum are calling for action in a new report published in Pathogens and Immunity. They are encouraging clinicians and healthcare providers to increase their vigilance for fungal infections, and spread awareness about these diseases.
"Healthcare providers must prioritize the use of diagnostic tests when faced with an unknown fungal infection," noted Ghannoum. "Early detection can make all the difference in improving patient outcomes."
The scientists also noted that patients who are immunocompromised, particularly after procedures related to transplants or cancer treatment, are especially susceptible to these illnesses. Medications could help protect these patients from severe outcomes.
The study authors also stressed the need for improving insurance reimbursement approvals for antifungal susceptibility testing, and finding or creating more labs that are qualified to make the assessments. Policymakers and industry professionals can also help raise awareness, increase funding, and prioritize fungal research.
"The ultimate goal of these measures is to improve the quality of patient care by ensuring effective treatment and preventing further escalation of the problem," Ghannoum said.
One major challenge in the development of novel medications for fungal infections is that fungal cells are eukaryotic, like human cells. Scientists have to create drugs that are somehow specific to fungi, and won[t harm human cells too much. Bacterial cells are prokaryotic, and viruses are not like cells at all, so the medications for those illnesses won't work on fungi either.
Sources: Case Western Reserve University, Pathogens and Immunity
