Case Western Reserve University researchers report rise in global fungal drug-resistant infections
Researchers issue call to action to address and prevent growing problem
CASE WESTERN RESERVE UNIVERSITY
CLEVELAND—A global wave of infections caused by fungi growing drug-resistant has the medical community issuing precautions on how to protect yourself.
Skin contact with microorganisms found in soil or on hard surfaces, such as common shower facilities, or exposure to infected pets, can result in fungal infections known as dermatomycoses. Rashes, itching, burning and skin irritation are among the symptoms.
Epidemiological data published in Microbial Cell indicates that a rise in severe fungal infections has resulted in over 150 million cases annually and almost 1.7 million fatalities globally.
In a recent study published in Pathogens and Immunity, Thomas McCormick and Mahmoud Ghannoum, professors of dermatology at the Case Western Reserve University School of Medicine and affiliated with University Hospitals Cleveland Medical Center, explain how rising antifungal resistance is worsening the problem of invasive fungal infections.
“This is not just an issue that affects individual patients,” McCormick said. “The World Health Organization has recognized it as a widespread threat that has the potential to impact entire healthcare systems if left unchecked.”
Based on their findings, the researchers issued precautions and a “call to action” for the medical community to help protect people from multidrug-resistant fungi—starting with awareness and education.
“Healthcare providers must prioritize the use of diagnostic tests when faced with an unknown fungal infection,” Ghannoum said. “Early detection can make all the difference in improving patient outcomes.”
Patients treated with medications to protect the immune system after cancer and transplant procedures are more vulnerable to fungal infections—making them especially more vulnerable to infections from drug-resistant fungi, the researchers said.
The emergence of multidrug-resistant fungal species, such as Candida auris and Trichophyton indotineae, is especially troubling and requires urgent attention, they reported.
In a study recently published in Emerging Infectious Diseases, Ghannoum’s research team and the Centers for Disease Control and Prevention (CDC), detailed a case that demonstrated Trichophyton indotineae, in addition to becoming drug-resistant, was also sexually transmissible.
To address the growing health concern, McCormick and Ghannoum suggest several measures:
- Increased awareness and education: Raising awareness in the general healthcare setting to obtain a more accurate understanding of the rise of antifungal-resistant infections.
- Diagnostic Testing: Routine use of diagnostic tests can guide appropriate treatment strategies.
- Antifungal Susceptibility Testing (AST): Improving insurance reimbursement rates for AST and increasing the number of qualified laboratories with the capacity to perform these tests.
- Call to Action: Addressing the emerging challenge of antifungal resistance involves concerted efforts from healthcare professionals, researchers, policymakers and the pharmaceutical industry to develop and implement strategies for managing and preventing antifungal resistance.
“The ultimate goal of these measures,” Ghannoum said, “is to improve the quality of patient care by ensuring effective treatment and preventing further escalation of the problem.”
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About Case Western Reserve University
Case Western Reserve University is one of the country's leading private research institutions. Located in Cleveland, we offer a unique combination of forward-thinking educational opportunities in an inspiring cultural setting. Our leading-edge faculty engage in teaching and research in a collaborative, hands-on environment. Our nationally recognized programs include arts and sciences, dental medicine, engineering, law, management, medicine, nursing, and social work. About 6,200 undergraduate and 6,100 graduate students comprise our student body. Visit case.edu to see how Case Western Reserve thinks beyond the possible.
About University Hospitals / Cleveland, Ohio
Founded in 1866, University Hospitals serves the needs of patients through an integrated network of 21 hospitals (including five joint ventures), more than 50 health centers and outpatient facilities, and over 200 physician offices in 16 counties throughout northern Ohio. The system’s flagship quaternary care, academic medical center, University Hospitals Cleveland Medical Center, is affiliated with Case Western Reserve University School of Medicine, Northeast Ohio Medical University, Oxford University, the Technion Israel Institute of Technology and National Taiwan University College of Medicine. The main campus also includes the UH Rainbow Babies & Children's Hospital, ranked among the top children’s hospitals in the nation; UH MacDonald Women's Hospital, Ohio's only hospital for women; and UH Seidman Cancer Center, part of the NCI-designated Case Comprehensive Cancer Center. UH is home to some of the most prestigious clinical and research programs in the nation, with more than 3,000 active clinical trials and research studies underway. UH Cleveland Medical Center is perennially among the highest performers in national ranking surveys, including “America’s Best Hospitals” from U.S. News & World Report. UH is also home to 19 Clinical Care Delivery and Research Institutes. UH is one of the largest employers in Northeast Ohio with more than 30,000 employees. Follow UH on LinkedIn, Facebook and Twitter. For more information, visit UHhospitals.org.
JOURNAL
Pathogens and Immunity
ARTICLE TITLE
Time to Think Antifungal Resistance
Newly identified yeast could prevent fungal infections by outcompeting rivals, study suggests
ROCKEFELLER UNIVERSITY PRESS
IMAGE:
C. ALBICANS SPREADS TO THE KIDNEYS OF IMMUNOSUPPRESSED MICE (LEFT), BUT INVASIVE CANDIDIASIS IS MITIGATED BY EXPOSURE TO K. WEIZMANNII (RIGHT).
view moreCREDIT: © 2024 SEKERESOVA KRALOVA ET AL. ORIGINALLY PUBLISHED IN <EM>JOURNAL OF EXPERIMENTAL MEDICINE</EM>. HTTPS://DOI.ORG/10.1084/JEM.20231686
Researchers at the Weizmann Institute of Science in Israel have identified a yeast that could be used to prevent invasive candidiasis, a major cause of death in hospitalized and immunocompromised patients. The study, to be published March 18 in the Journal of Experimental Medicine (JEM), shows that the novel yeast lives harmlessly in the intestines of mice and humans and can displace the yeast responsible for candidiasis, Candida albicans.
Millions of microbial species live within or on the human body, many of them being harmless or even beneficial to human health. The microscopic yeast C. albicans is commonly found in the intestines and other mucosal surfaces of the body and is usually benign, though occasionally it may overgrow and cause superficial infections commonly known as thrush. Under certain circumstances, however, the yeast may penetrate the intestinal barrier and systemically infect the blood or internal organs. This dangerous condition, known as invasive candidiasis, is commonly seen in healthcare environments, particularly in immunocompromised patients, with mortality rates of up to 25%.
While studying yeast infections in laboratory mice, Steffen Jung and colleagues at the Weizmann Institute discovered that some of their mice carried a novel species of yeast that prevented the animals from being infected with C. albicans. The new species, which the researchers named Kazachstania weizmannii, is closely related to yeast associated with sourdough production and appears to live innocuously in the intestines of mice, even when the animals are immunosuppressed.
The researchers found that K. weizmannii can outcompete C. albicans for its place within the gut, reducing the population of C. albicans in mouse intestines. Moreover, while C. albicans can cross the intestinal barrier and spread to other organs in immunosuppressed mice, the presence of K. weizmannii in the animals’ drinking water significantly delayed the onset of invasive candidiasis.
Notably, Jung and colleagues also identified K. weizmannii and other, similar species in human gut samples. Their preliminary data suggest that the presence of K. weizmannii was mutually exclusive with the presence of Candida species, suggesting that the two species might also compete with each other in human intestines.
“By virtue of its ability to successfully compete with C. albicans in the murine gut, K. weizmannii lowered the C. albicans burden and mitigated candidiasis development in immunosuppressed animals,” Jung says. “This competition between Kazachstania and Candida species could have potential therapeutic value for the management of C. albicans–mediated diseases.”
Sekeresova Kralova et al. 2024. J. Exp. Med. https://rupress.org/jem/article-lookup/doi/10.1084/jem.20231686?PR
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About Journal of Experimental Medicine
Journal of Experimental Medicine (JEM) publishes peer-reviewed research on immunology, cancer biology, stem cell biology, microbial pathogenesis, vascular biology, and neurobiology. All editorial decisions on research manuscripts are made through collaborative consultation between professional scientific editors and the academic editorial board. Established in 1896, JEM is published by Rockefeller University Press, a department of The Rockefeller University in New York. For more information, visit jem.org.
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JOURNAL
Journal of Experimental Medicine
METHOD OF RESEARCH
Experimental study
SUBJECT OF RESEARCH
Animals
ARTICLE TITLE
Competitive fungal commensalism mitigates candidiasis pathology
ARTICLE PUBLICATION DATE
18-Mar-2024
COI STATEMENT
C. Donic and S. Jung reported a patent to PCT/IL2023/050470 pending (Weizmann Institute of Science). No other disclosures were reported.
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