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Fungal infections are the next chapter in reporting on superbugs 2022

a medical illustration of candida sp fungal organism. (Photo courtesy of the CDC Public Health Image Library)

Reporters wishing to write about the next chapter in antimicrobial resistance should get up to speed on fungal infections.

“The future is going to be a fungal problem,” said Tom Chiller, MD, MPHTM, chief of CDC’s mycotic disease branch, during the “Antimicrobial Resistance During and After COVID-19” panel at Health Journalism 2022 in Austin.

Fungi are spore-producing organisms such as yeast, molds and mushrooms. About 100 of them are known to cause disease in humans. According to the CDC, cases of deadly antimicrobial resistant fungal infections have been on the rise in nursing homes and hospitals already pre-pandemic during the past two years.

Excessive use of antibiotics in the hospital, especially during the first year of the pandemic when there were few options for treating patients, as well as the use of steroids to treat lung inflammation caused by COVID-19, both led to high fatalities. Contributed to the increase in resistant fungal infections with rate.

Chiller said “Covid… started an unfortunate perfect storm” that enabled greater and widespread transmission of fungal infections in hospitals.

In 2017, according to the most recent data from the CDC, 75,000 people were hospitalized for fungal infections in the US, but this is unlikely. According to the CDC, these infections often go undiagnosed and there is no national public health surveillance of common fungal infections. Globally, about 13.5 million serious fungal infections — and 1.6 million deaths — are reported annually to public health officials, according to the nonprofit Global Action for Fungal Infections.

During the past two years, CDC has documented an increasing number of illnesses linked to COVID-19 cases, caused by three obstructive fungal infections: pulmonary aspergillosis (infection caused by fungi). aspergillus), mucormycosis (often referred to by the misnomer black fungus due to its presence) and candida aurisAn emerging and serious yeast infection found in long-term care facilities.

“We didn’t know what was happening to these pathogens,” Chiller said because antibiotic resistance screening became a low priority during the COVID-19 surges. When screening resumed, a “significant amount” of resistant fungal infections were found “in places where there was none before and it was certainly dangerous for us.”

Patients at greatest risk of acquiring a resistant pathogen include those with chronic conditions or compromised immune systems. Yet in many health care settings, providers are not screening for fungal infection because it has not been a traditional source of resistant infection, he said.

Bacterial resistance to drugs has existed since antimicrobials came into widespread medical use in the 1940s. Pathogens naturally evolve to resist drugs. But the scientific and economic challenges of developing new antimicrobials have led to a steep decline in the availability of new classes of antibiotics, even as antimicrobial resistance has spread. In the 1950s, pharmaceutical companies introduced at least nine new types of antibiotics. Since 1984, there is no new registered class of antibiotics. The proliferation of resistant pathogens as well as the paucity of new drugs are posing new threats. As of 2019, at least 2.8 million people in the US contracted an antimicrobial-resistant pathogen, and at least 35,000 have died.

To combat resistant microbes, researchers are looking for alternatives other than antibiotics. One strategy is to use bacteriophages – viruses that specifically kill bacteria. To help a patient, researchers engineer a phage to target a specific bacteria in the body. This has proven successful in many patients.

Panelist Sabrina Green, director of research at Baylor College of Medicine at the BCM Taylor Service Center, told AHCJ members that her nonprofit, located within Baylor, has developed phage treatments for nearly a dozen patients with resistant infections who have no choice. was not.

In one case, Green’s team developed a bacteriophage to treat a 56-year-old male liver transplant patient who had developed chronic prostate and urinary tract infections due to resistant e coli And his illness went away.

“We’re trying to reach everyone,” Green said. “Journalists, regulatory agencies, physicians, pharmacists, so they know we exist, and we can help more people.”

Other panelists included Morgan Scott, a professor of epidemiology in the Department of Veterinary Pathology at Texas A&M, who discussed how antibiotic resistance is spreading through overuse in food animal farming, and the Austin del Seton Medical Center in Infection Prevention. Ram Thiagarajan, MD, of the University of Texas. Who talked about antibiotic stewardship in hospitals.

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