Fungal infections, often underestimated on a global scale, are emerging as a serious public health concern, driven by increasing mortality rates and a growing resistance to treatments.
This ominous scenario is under the microscope at the Pasteur Institute's National Reference Centre for Invasive Mycoses and Antifungals in Paris, where researchers meticulously scrutinise around 800 samples annually.
Dr Fanny Lanternier, an infectious disease specialist at Necker Hospital and the head of the Reference Centre at the Pasteur Institute, told RTBF that "visible or invisible, fungi are everywhere."
Mycologists speculate that the Earth might harbour up to a staggering one million fungal species. These organisms propagate through the dispersion of microscopic spores, prevalent in the air and soil, and potentially inhaled or ingested with food. Certain types of yeast also form part of the human microbiota, dwelling on the skin and within the digestive tract.
While some common fungal infections, such as oral thrush, vaginal infections, or skin and scalp mycoses, are generally mild and easily treatable, the picture changes dramatically for individuals with compromised immune systems.
Immune system weakening
In these cases, the spores that may be harmless to healthy individuals can lead to severe infections. "They will affect particularly fragile patients, who have, for example, cancer, HIV infection, have been transplanted, or have undergone major surgery," Lanternier told RTBF.
In recent years, the prevalence of fungal infections has surged in tandem with the increased use of immune-weakening treatments to combat other diseases, she added.
The gravity of the situation prompted the World Health Organisation (WHO) to publish a priority list of 19 fungi for in-depth study last year, acknowledging their status as a "major threat to public health."
Among the species posing significant challenges, according to the WHO, are Cryptococcus neoformans (potentially leading to meningitis), Candida auris (responsible for infections in various organs, especially the brain), and Aspergillus fumigatus (known for causing lung diseases). Mortality rates associated with these infections can reach an alarming 60% in some cases.
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Candida auris, in particular, has garnered considerable attention. The US Centres for Disease Control and Prevention (CDC) issued a warning this spring regarding the increasing incidence of Candida auris, a globally emerging yeast strain that has progressively infiltrated healthcare facilities across the United States. Despite mounting concerns, fungal infections remain largely overlooked and underfunded, according to the WHO.
Compounding the problem is the rising resistance of fungal pathogens to treatments, mirroring the trends observed with antibiotic-resistant bacteria. Unfortunately, some fungi, like Aspergillus, are developing resistance to antifungal agents, rendering the treatment of contaminated patients more challenging. This resistance phenomenon has been particularly evident in the Netherlands, where extensive use of antifungals in tulip fields has heightened concerns.
