Invasive fungal infections are a growing threat to public health. Each year, these pathogens cause approximately 1.5 million deaths worldwide, as many as tuberculosis and more than malaria, and cases are increasing worldwide due to multiple factors. A major one stems from the progress of modern medicine and our increased access to therapies and treatments that damage the immune system, such as chemotherapy or transplants, since this type of infection mainly affects patients in this risk group. Climate change and the coronavirus pandemic are also associated with an increase in incidence.
These conclusions are part of the list that the World Health Organization (WHO) has drawn up with 19 fungal pathogens that “represent the greatest threat to public health,” and some of which have developed resistance to drugs. It is the same step the agency took in 2017 with superbugs, whose multidrug resistance to antibiotics alerted the authorities and led the WHO to release its Bacterial Priority Pathogens List. Estimates currently place the number of deaths caused by these microorganisms at 1.27 million.
“And now we see that the same thing is happening with fungi,” says Ana Alastruey-Izquierdo, 41, a researcher at Spain’s National Center for Microbiology at the Carlos III Health Institute in Madrid. “Furthermore, with fungi there is the problem that there are not so many diagnostic tools and there are very few antifungal compounds available. So if resistance increases very quickly, we find ourselves with a serious problem on our hands, and that is why it was the right time to do it [issue the WHO alert].”
Alastruey-Izquierdo led the group of technical experts for the WHO report, which included contributions from 400 people and reviewed 6,000 documents. The authors underscored the knowledge gap surrounding fungal infections, the lack of diagnostic methods and the low investment allocated to this type of infection, less than 1.5% of all funds for infectious disease research.
The video above explains which are the fungal pathogens of greatest concern for public health.
List of priority fungal pathogens
- Critical priority group: Cryptococcus neoformans, Candida auris, Aspergillus fumigatus and Candida albicans.
- High priority group: Nakaseomyces glabrata, Histoplasma spp., Eumycetoma causative agents, Mucorales, Fusarium spp., Candida tropicalis and Candida parapsilosis.
- Medium priority group: Scedosporium spp., Lomentospora prolificans, Coccidioides spp., Pichia kudriavzeveii (Candida krusei), Cryptococcus gattii, Talaromyces marneffei, Pneumocystis jirovecii and Paracoccidioides spp.