Without immediate action, humanity may face a further escalation of resistance to fungal diseases, a group of scientists from around the world has warned. The commentary – published in The Lancet this week — was coordinated by scientists from the University of Manchester, the Westerdijk Institute and the University of Amsterdam. According to the scientists, most of the fungal pathogens identified by the World Health Organization – accounting for approximately 3.8 million deaths per year – are already resistant or rapidly acquiring resistance to antifungal drugs.
The authors argue that the current narrow focus on bacteria will not fully combat antimicrobial resistance (AMR). They demand that the United Nations meeting on antimicrobial resistance (AMR) in September also include the resistance that has developed in many fungal pathogens.
Devastating health consequences
Resistance is now the rule rather than the exception for the four currently available antifungal classes, making it difficult – if not impossible – to treat many invasive fungal infections. Fungicide-resistant infections include Aspergillus, Candida, Nakaseomyces glabratus and Trichophyton indotineae, all of which can have devastating health consequences in the elderly or those with weakened immune systems.
Dr. Norman van Rhijn from the University of Manchester coordinated the commentary with Professor Ferry Hagen from the University of Amsterdam and the Westerdijk Institute in the Netherlands.
Dr. van Rhijn said: “Most people agree that drug-resistant bacterial infections represent a significant part of the AMR problem. However, many drug resistance problems in recent decades have also resulted from invasive fungal diseases that are largely recognized by scientists, governments, physicians and pharmaceutical companies. companies are not considering the threat of fungal pathogens and resistance to mold, even though it is a growing global problem.”
Unlike bacteria, the close similarities between fungal and human cells make it difficult to find treatments that selectively inhibit fungi with minimal toxicity to patients, experts say.
Back to square one
Professor Ferry Hagen added: “Despite the enormous difficulties in their development, several promising new agents, including entirely new classes of molecules, have entered clinical trials in recent years. But even before they reach the market after years of development, fungicides with similar mechanisms of action These measures have been developed by the agrochemical industry and result in cross-resistance. That brings us back to square one. It is true that many essential crops are affected by fungi, so antifungal protection is needed for food security. But the question is at what price?”
The scientists recommend:
- Global agreement to restrict the use of certain classes of antifungal molecules for specific applications.
- Collaborate on solutions and regulations that guarantee food security and universal health for animals, plants and people.
- Add priority to AMR in fungal infections at the UN meeting in September.
