Tuesday, July 16, 2024

WHO Develops Priority List of Emerging Fungal Pathogens Amid Rising Threats

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With the escalating global health threat posed by fungal infections, the World Health Organization (WHO) has initiated a critical process to establish a priority list of fungal pathogens. This initiative is aimed at addressing the increasing mortality and complications associated with these infections. A recent systematic review focused on the epidemiology and impact of infections caused by Fusarium spp., Scedosporium spp., and Lomentospora prolificans reveals significant insights into their threat level and resistance patterns.

Rising Mortality and Antifungal Resistance

The review, which analyzed studies from PubMed and Web of Sciences databases published between January 1, 2011, and February 23, 2021, indicates alarmingly high mortality rates for invasive infections caused by these pathogens. Specifically, mortality rates ranged from 42.9% to 66.7% for invasive fusariosis, 42.4% to 46.9% for scedosporiosis, and 50% to 71.4% for lomentosporiosis. The high mortality rates underscore the urgent need for improved treatment strategies and global surveillance.

Antifungal susceptibility tests revealed high minimum inhibitory concentrations (MIC) for commonly used antifungal agents, suggesting limited effectiveness of current treatments. The median/mode MIC for itraconazole and isavuconazole were found to be ≥16 mg/l for all three pathogens. This resistance to antifungal agents poses a significant barrier to effective treatment, highlighting the necessity for new therapeutic options and improved access to treatment.

Emerging Threats and Incidence Trends

The data revealed that these fungal pathogens are emerging threats, with invasive fusariosis cases rising from 0.08 to 0.22 per 100,000 admissions between the periods of 2000-2009 and 2010-2015. Furthermore, Scedosporium spp. and L. prolificans infections in lung transplant recipients were only documented from 2014 onwards. Such trends emphasize the changing landscape of fungal infections and the need for heightened vigilance and monitoring.

The review calls for comprehensive global surveillance to better understand the antifungal susceptibility, risk factors, sequelae, and outcomes associated with these infections. This information is vital for developing effective prevention and treatment strategies and ensuring market access to necessary antifungal medications.

Key Takeaways for Healthcare Professionals

– High mortality rates for Fusarium spp., Scedosporium spp., and L. prolificans infections necessitate urgent attention.
– Current antifungal agents show limited effectiveness due to high MIC values.
– Rising incidence rates of these infections highlight the need for enhanced surveillance and research.
– Access to effective antifungal treatments is critical in managing the threat posed by these pathogens.

In conclusion, the systematic review underscores the urgent need for global health initiatives to address the rising threat of fungal infections. The WHO’s development of a priority list of fungal pathogens is a crucial step in this direction, aiming to improve treatment outcomes and ensure better access to necessary medications.

Original Article: Med Mycol. 2024 Jun 27;62(6):myad128. doi: 10.1093/mmy/myad128.

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