The people most vulnerable to these infections are immunocompromised patients such as diabetics, those with an organ or tissue transplant, people taking immunosuppressive medications, and anyone receiving chemotherapy. Candida auris is opportunistic, particularly in hospital settings, and can make its way into the body through invasive catheters, ventilators, or surgical treatments.
Since deadly fungal infections have risen steadily over the past 50 years, with global death rates similar to those of some of the worst diseases, why haven’t scientists developed effective treatments to reduce risks for immunocompromised individuals?
Antifungals
There are hundreds of different antibiotics used to treat bacterial infections, and antivirals have been increasingly effective in fighting off viruses, shortening symptoms, and boosting the immune system. But developing medications to treat fungal infections can be complicated because fungi have the same type of cells as humans, so a substance created to kill fungi may mistakenly target human cells. Many antifungals are highly potent, so if they attack human cells, they can cause kidney or liver damage, particularly after prolonged use.- Medication misuse: Skipping doses, stopping therapy too soon, or using a prescribed dose that is too low can enhance the ability of the fungus to resist fungal medications.
- Fungicides: Many fungicidal drugs are used to protect crops, exposing fungi to more fungicides, inevitably creating resistance. People who work closely with or ingest fungicide-treated crops may become more susceptible to antifungal resistance.
- Transmitted resistance: One person can transmit drug-resistant fungus to another, even if they’ve never used an antifungal drug.
- Prolonged treatment: Some fungal infections require prolonged treatment. The longer the fungus is exposed to an antifungal drug, the more likely it will develop resistance to the drug.
- Misidentification of fungus: When a fungus is misdiagnosed and treated with the wrong antifungal, the infecting fungus can become stronger.
- Spontaneous resistance: The fungus stops responding to a previously effective antifungal medication for no known reason.
Immunotherapy
Immunotherapy has been used for many years to battle cancer successfully by training the immune system to find and destroy cancer cells.Zeeshan Afzal, a veterinarian with a background in clinical science and extensive experience with fungal disease, told The Epoch Times, “One example of immunologic therapy for invasive fungal infections is monoclonal antibodies designed to target and neutralize fungal cells specifically.”
Vaccines
There are more than 25 vaccines for fungal infection available worldwide, but none can protect vulnerable, immunocompromised patients from fungal infections.Karen Norris, who holds a doctorate in biomedical sciences and microbiology and is a member of the University of Georgia Center for Vaccines and Immunology, is working to find a vaccine to protect against the fungal pathogens responsible for more than 80 percent of fatal fungal infections.
Economic Challenges
Fungal infections cost the health care system millions of dollars each year. According to research published in Open Forum Infectious Diseases, in 2018, there were 666,235 fungal infections diagnosed in the United States. The estimated hospitalization costs directly associated were $6.7 billion, with a total cost of $37.7 billion for all visits at which any fungal infections were diagnosed.Yet there is little talk among the media or government officials about solving this overwhelming problem in the United States and worldwide.
In Conclusion
Invasive and often deadly fungal infections continue to plague the immunocompromised across the globe. The science exists to develop better antifungal drugs, immunologic therapies, and effective vaccines. Unfortunately, antifungal drugs are expensive to develop, and patients take them for a short period of time, which means the return on investment for pharmaceutical companies is relatively poor—if it exists at all.And there is also a pattern drug companies have seen play out after developing new antibiotics for drug-resistant bacterial infections. Often, doctors are reluctant to prescribe new antibiotics for fear of the side effects and contributing to further drug resistance, so they continue to prescribe the old drugs.
The most compelling reason for the private sector to increase funding for these therapies is the millions of lives they could save.