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WHO releases first-ever list of fungal infection, flags global health threat


The World Health Organisation (WHO) has published a report highlighting the first-ever list of fungal “priority pathogens” – a catalogue of the 19 fungi that represent the greatest threat to public health. The WHO fungal priority pathogens list (FPPL) is the first global effort to systematically prioritize fungal pathogens, considering the unmet research and development (R&D) needs and the perceived public health importance. This report is based on research led by the University of Sydney in Australia.

Emerging evidence indicates that the incidence and geographic range of fungal diseases are both expanding worldwide due to global warming and the increase of international travel and trade. During the COVID-19 pandemic, the reported incidence of invasive fungal infections increased significantly among hospitalized patients. As the fungi that cause common infections (such as candida oral and vaginal thrush) become increasingly resistant to treatment, risks for the development of more invasive forms of infections in the general population are also growing.

“Emerging from the shadows of the bacterial antimicrobial resistance pandemic, fungal infections are growing, and are ever more resistant to treatments, becoming a public health concern worldwide” said Dr Hanan Balkhy, WHO Assistant Director-General, Antimicrobial Resistance (AMR).

Three priority categories

The WHO FPPL list is divided into three categories: critical, high and medium priority.

1) The critical group includes Candida auris, which is highly drug resistant and has caused a number of outbreaks in hospitals worldwide, as well as Cryptococcus neoformans, Aspergillus fumigatus, and Candida albicans.

2) The high group includes a number of other fungi from the Candida family as well as others such as Mucorales, a group containing the fungi that causes mucormycosis or “black fungus”, an infection which rose rapidly in seriously ill people – particularly in India – during COVID-19.

3) The medium group lists a number of other fungi, including Coccidioides spp and Cryptococcus gattii.

Fungal infection treatment

Fungal pathogens are a major threat to public health as they are becoming increasingly common and resistant to treatment with only four classes of antifungal medicines currently available, and few candidates in the clinical pipeline, WHO said. 

“We need more data and evidence on fungal infections and antifungal resistance to inform and improve response to these priority fungal pathogens” said Dr Haileyesus Getahun, WHO Director, AMR Global Coordination Department.

Fungal infection: Who are at greater risk?

The invasive forms of these fungal infections often affect severely ill patients and those with significant underlying immune system related conditions. Populations at greatest risk of invasive fungal infections include those with cancer, HIV/AIDS, organ transplants, chronic respiratory disease, and post-primary tuberculosis infection.

 

 

 

 

 

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