76 | www.Ups tatePhys i c i ansSC . com | www.Hea l thL i nksUps tate. com FUNGAL PATHOGENS By the Numbers 9 BILLION - The number of annual outpatient visits due to fungal diseases in the United States. Source: World Health Organization. 4.95 MILLION - The number of worldwide deaths every year related at least in part to the presence of drug-resistant bacterial infections. Source: World Health Organization. 19 - The number of fungal pathogens selected by the World Health Organization in 2022 that present the greatest threat to public health. Source: World Health Organization. 23 - The number of states reporting the presence of candida auris, one of the WHO’s top four fungal threats. Source: Centers for Disease Control and Prevention. 75,000 - The number of annual hospitalizations in the United States due to fungal diseases. Source: Centers for Disease Control and Prevention. “Annually, over 150 million severe cases of fungal infections occur worldwide,” said researcher Didac Carmona-Gutierrez of the University of Graz in Austria, in a 2020 report for Microbial Cell, a journal concerning unicellular biology and human disease. A number of researchers who contributed to the 2022 WHO fungal report stated that “Drug-resistant bacterial infections are estimated to directly cause 1.27 million deaths and to contribute to approximately 4.95 million deaths every year, with the greatest burden in resource-limited settings.” But Dr. Paula Cannon, distinguished professor of molecular microbiology and immunology at the University of Southern California in Los Angeles, pointed out that even resource-rich nations, such as the United States and Canada, are just as vulnerable to fungal spread. “Humans are changing – and many more people are susceptible due to immune deficiencies,” Dr. Cannon said. “And we are also seeing real-time evolution, such as with the multidrug resistant candida, which can form colonies in the liver, spleen, kidney and even the brain. It has caused bad outbreaks in hospitals, and the CDC now recognizes it as a real public health threat.” As of October 2022, the Centers for Disease Control and Prevention identified that candida auris alone had spread to 23 U.S. states, including South Carolina. The question is whether future vaccines can outpace the fungal threats before the problem gets too far. “Life is a constant competition, a battle among all living things to evolve and get an advantage over an environment and exploit a potential new niche or food source,” she said. “We should not consider ourselves safe from that – to a fungus, we are not special, just yummy. So even with people working on obscure things like fungi, you never know what knowledge we will need to survive the next problem nature throws at us. So let’s keep supporting these efforts.” CANDIDA ALBICANS. This fungal pathogen is a globally distributed pathogenic yeast, and a life-threatening disease with high mortality. It can be part of the healthy human microbiome, the community of microorganisms that naturally live on our bodies and inside us. But it may also cause infections of the mucus membrane or produce invasive candidiasis. While treatment is possible, antifungal resistance remains low, and critically ill and immunocompromised patients are especially affected.
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