Jackie Rocheleau
Better treatment for Candida auris, Aspergillus and other dangerous fungal pathogens is slow to come, even as rates of drug resistance rise. New therapies are in the pipeline, and hospital practices can help.
As rates of antibiotic resistance grow alarmingly among disease-causing bacteria, dangerous fungi also are evolving stronger defenses, with a lot less fanfare.
Every year, infections of molds and yeasts such as Aspergillus and Candida kill more than 1.5 million people globally, more than malaria and on a par with rates for tuberculosis. And new drug-resistant strains are emerging, such as Candida auris, first detected in Japan in 2009 and since then reported on every continent except Antarctica. Between September 1, 2020, and August 31, 2021, the number of reported C. auris cases in the United States has soared to over 1,100 in 21 states, up from 63 cases in four states from 2013 to 2016.
With Covid-19 cases stressing health care systems, changes in hospital infection control have given drug-resistant fungi a leg up, too. In 2019, the Centers for Disease Control and Prevention listed C. auris as an urgent threat; it was the first time the agency had done so for a pathogenic fungus. In December 2020, the CDC reported increased spread of C. auris during the pandemic.
Put simply, “fungal infections are a massive public health problem,” says Johanna Rhodes, a genomic epidemiologist of fungal infections at Imperial College London. There are few drugs to fight them, and the pipeline for development of new ones has been frustratingly slow.
Today, though, a few novel antifungals are moving through clinical trials and researchers are developing new approaches to drug discovery that may ultimately strengthen the antifungal arsenal.
