Are we effectively treating fungal infections?

 

Invasive fungal infections – A major cause for concern?



 
  • Each year, fungal infections are responsible for around 1.4 million deaths worldwide1

  • Despite this, fungal infections are often misunderstood and receive less public awareness compared to diseases caused by bacteria, viruses and parasites

  • Individuals with impaired immune systems, such as cancer and HIV patients, or those who have undergone bone marrow or organ transplants, are most at risk of suffering from an invasive fungal infection2

  • The fungal pathogens that pose the most risk are Candida, Aspergillus, Pneumocystis and Cryptococcus spp.3

Candida

  • Candida is ranked 4th among the most common bloodstream infections4

  • Patients who develop Septicaemia caused by Candida have only a 60% chance of surviving, despite the use of antifungal medications5-11

  • Candida is becoming increasingly resistant to first-line and secondline antifungal medications.12 The few available treatment options are expensive and can be toxic to already sick patients13

Aspergillus

  • Aspergillus infections are the most common microbial infections in transplant recipients14

  • Aspergillus is associated with high morbidity and a mortality rate of 70%15
 

Resistance to antifungal medication is becoming an important clinical problem, which threatens to undo many of the health advances of the last 50 years16

 
  • In the last 20 years, there has been little change in how clinicians diagnose fungal infections

  • This has led to inappropriate prescribing of antifungal medication and increased medical costs17

  • New strategies are desperately required to better treat and diagnose life-threatening fungal infections
 

References

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  4. Wisplinghoff et al. Clin Infect Dis 2004;39: 309-17.
  5. Kollef M et al. Clin Infect Dis 2012;54: 1739-1746.
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  12. Alexander BD et al. Clin Infect Dis 2014;58(5): 754.
  13. Biggest Threats - Antibiotic/Antimicrobial Resistance - CDC. Web: https://www.cdc.gov/drugresistance/biggest_threats.html (Last accessed: March 2017).
  14. Kontoyiannis DP et al. Clin Infect Dis 2010;50: 1091-100.
  15. Falcone M et al. Med Mycol 2011;49(4): 406-413.
  16. Fairlamb AH et al. Nat Microbiol 2016;1(7): e16092.
  17. Agrawal S et al. J Antimicrob Chemother 2016;71 Suppl 2: ii37-ii42.
  18. O’Neill J. Tackling drug-resistant infections globally: Final report and recommendations. The review on antimicrobial resistance; London: HM Government and the Wellcome Trust; 2016.
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  21. Roberts RR et al. Clin Infect Dis 2009;49(8): 1175-84.
  22. Arendrup MC et al. Bone Marrow Transplant 2012;47: 1030-45.
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  30. Leeflang MM et al. Cochrane Database Syst Rev 2008;4: CD0073944.
  31. Cruciani M et al. Cochrane Database Syst Rev 2015;10: CD009551.