Silent rise of invasive fungal infections and battle ahead

WEB DESK: Medical advancements have undoubtedly saved countless lives, but they have also given rise to a lesser-known issue: the increasing prevalence of invasive fungal infections. Here’s what you should know.

While common fungal infections like athlete’s foot and yeast infections are widely recognised, a more menacing problem lurks beneath the surface – invasive fungal infections. Unlike their well-known counterparts, these invasive fungi can infiltrate the lungs or spread to vital organs through the bloodstream.

Recent years have witnessed a surge in these infections, and they can be life-threatening, particularly for those with weakened immune systems. Surprisingly, these infections have largely remained under the radar of public awareness until just last year when the World Health Organisation (WHO) compiled its inaugural list of health-threatening fungi.

This limited awareness has not only led to misdiagnoses but has also hindered the development of effective treatments. It has also made it challenging for WHO to precisely quantify the disease’s global burden.

Experts suggest that invasive fungal infections claim as many as 1.5 million lives annually, a statistic on par with the annual death toll attributed to tuberculosis.

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But how does one contract an invasive fungal infection?

The answer lies in the air we breathe. Fungal spores are ubiquitous, originating from sources as diverse as compost bins, moldy bread on kitchen counters, and flower bulbs in gardens.

Typically, for the vast majority of healthy individuals, these spores pose no threat as their immune systems effectively combat them. However, for immunocompromised individuals, such as heavy smokers or recent organ transplant recipients, inhaling these spores can lead to complications.

So, why the increase in invasive fungal infections?

This rise can be primarily attributed to the growing number of life-saving medical procedures. With more people undergoing surgeries and treatments, their susceptibility to invasive fungal infections has increased. Additionally, antifungal resistance is becoming a pressing issue.

What is antifungal resistance, and why is it problematic?

Antifungal resistance bears similarities to antibiotic resistance. Some fungi have developed resistance to the medications (antifungals) used to treat them. Some are intrinsically resistant to specific classes of antifungals, while others develop resistance because they receive suboptimal doses that do not eliminate them but allow them to become resistant.

How are antifungals used in agriculture?

Antifungals are applied to flower bulbs and food crops to prevent fungal growth. Before flower bulbs are sold, they undergo a process called “bulb dipping,” where they are immersed in a bath of azoles, the same antifungal agents used to treat invasive fungal infections.

The issue arises when consumers plant these treated bulbs in their gardens, as the azoles leach into the soil. This creates high azole concentrations near the bulb, gradually decreasing with distance. The fungi in the soil adapt to these azole levels and become resistant.

The most common invasive fungal infections are caused by Candida and Aspergillus fungi. Aspergillus primarily targets the lungs, while Candida can spread through the bloodstream, causing infections in various organs, including the eyes, bones, liver, or spleen. This typically occurs from the gastrointestinal tract, where fungi naturally coexist with bacteria.