Fungal Infections Are Becoming Increasingly Difficult to Treat

Fungal infections are becoming increasingly difficult to treat due to growing resistance to existing medications, as highlighted by recent research published in The Lancet Microbe. The study examines infections caused by the widespread fungus Aspergillus fumigatus, which lives in soil and decaying organic matter.

While inhalation of Aspergillus spores usually poses no risk, individuals who are immunocompromised or have pre-existing lung conditions are at significant risk. The World Health Organization lists Aspergillus as one of its top priority fungi, with mortality rates for individuals suffering from drug-resistant infections ranging from 47% to 88%.

The study found a troubling increase in the fungus’s resistance to antifungal medications, especially azoles—key drugs used for treatment. Complicating matters, patients often harbor multiple strains of the fungus, sometimes with varying resistance profiles.

Jochem Buil, a microbiologist involved in the study, analyzed over 12,600 samples of Aspergillus fumigatus taken from Dutch hospitals over three decades. Approximately 2,000 of these samples showed mutations that lead to resistance against azole antifungals.

Among patients with invasive infections, nearly 86% were found to be infected with multiple strains, making treatment even more complex. The challenges involved in diagnosing and treating these infections are exacerbated by a limited number of antifungal drug classes.

Unlike antibiotics, which have many variations, there are only three major classes of antifungal medications available. Increasing resistance, particularly in agricultural settings due to the use of fungicides, continues to undermine treatment efficacy.

While the individual risk for getting azole-resistant Aspergillus is relatively low—mostly affecting immunocompromised individuals—experts warn about a concerning trend in drug-resistant fungal infections. Overall, the situation regarding antifungal resistance is deteriorating, posing a growing threat to public health.