ECDC issues risk assessment on azole resistance in Aspergillus from environmental azole fungicide.
February 28 2013
Today the European Centre for Disease Prevention and Control (ECDC) issued a risk assessment report on azole resistance in Aspergillus spp. and its possible link to environmental usage of azole fungicides. An increase of strains of Aspergillus causing serious human infection showing resistance to azole antifungals has been detected in several European countries although the number of studies is small. However, a high rate of therapy failures has been reported in patients having Aspergillus isolates resistant to triazole antifungals. The majority of resistant isolates are multi-azole-resistant and therefore, triazole drugs would be marginalised in the management of azole resistant aspergillosis. Although the environmental link of the resistance has not been fully proven, there are several findings that point at a relationship.
New Pan Asia fungal working group
February 19 2013
For the first time a pan-Asia network of fungal expertise has taken root. With nearly half the world’s population in only 3 asian countries (China, India and Indonesia) and many other populous contries, the lack of diagnostic capabilities in Asia is being addressed. The Asia Fungal Working Group (AWFG) was founded to improve the understanding and education, diagnosis and management of fungal diseases in Asia. The AWFG is now under the umbrella of ISHAM. The executive committee of AFWG consists of Professor Arunaloke Chakrabarti (Chandigarh), Professor Yee-Chun Chen (Taipei), Dr Ariya Chindamporn (Bangkok), David Ellis (Adelaide), Ruoyu Li (Beijing), Tan Ai Ling (Singapore), Zhengyin Liu (Beijing), Atul K Patel (Ahmedabad), Pei-Lun Sun (Taipei), Tan Ban Hock (Singapore), Siriorn Watcharananan (Bangkok).
LIFE advisers meet WHO’s Tuberculosis leader Mario Raviglione
January 22 2013
As Chronic Pulmonary Aspergillosis (CPA) may follow TB in about 10% of cases, discussion on establishment of coordination with the work of the WHO’s STB Department is important. Mario Raviglione, (Director), an Infectious Diseases physician originally from Italy who trained in the USA in Boston and New York in the early AIDS era, described CPA as one the ‘post-TB sequelae’ that had been neglected for too long largely due to lack of information and capacity to diagnose and treat.
In detailed discussions, which also included Dr Mukund Uplekar (Policy, Strategy & Innovations team) and Dr Salah Ottmani (Technical Support Coordination team), the need for research and standardization goals were emphasized. Raviglione articulated the value of surveillance and better estimate of the burden as well as of standardization of diagnosis and treatment management to achieve sustained healthcare benefits across different countries and societies.
The WHO Global Tuberculosis Report 2012 describes the impact of proper TB care in the past 17 years:20 million lives saved, annual number of TB cases have fallen 2.2% since 2011; and a rapid diagnostic test (GeneXpert) is now available in 67 low- and middle-income countries. The LIFE program should aspire to such uniform, effective and cost-effective approaches.
Appointment of David Warnock as LIFE advisor
January 14 2013
Fungal disease public health has been greatly strengthened by the work of Dr David Warnock, previously Chief of the Mycotic Diseases Branch at the US Centres of Disease Control. Following his retirement from CDC, Warnock has joined the LIFE Advisory team, bringing with him over 30 years of experience in fungal disease. He has published extensively on the epidemiology, laboratory diagnosis and therapy of fungal diseases. He has quietly and consistently championed the value of epidemiological data and public health tools in better understanding fungal infections, having been the architect of the TransNet study (fungal infection after transplantation) and encouraging the global estimate of cryptococcal meningitis.
Hidden Killers: Human Fungal Infections - call for action
December 28 2012
On December 20th, in the prestigious journal “Science Translation Medicine”, Gordon Brown and colleagues describe the numbers of people with various life-threatening fungal infections and the major development and research needs which are required to improve diagnosis, treatment and survival. They estimate there are over 200,000 cases of invasive aspergillosis; >400,000 cases of invasive candidiasis (Candida bloodstream infection), 1 million cases of cryptococcal meningitis and over 400,000 patients with Pneumocystis pneumonia in AIDS cases alone, worldwide. Numerous other estimates of the global frequency of fungal diseases are estimated including vaginal candidiasis, chronic and allergic aspergillosis, the endemic mycoses in N. America and other important fungal infections.
The authors point out the major advances in diagnosis and therapy, and yet there is a major gap in implementing these findings and in developing vaccines to prevent fungal infections. Immunity to fungal infections is now much better understood, and is ripe for translation into immuno-protection or immunotherapy approaches. Progressing antifungal vaccines into clinical trials is essential and will help reduce the global burden of fungal diseases. Rapid diagnostics will reduce mortality rates, yet funding is woefully inadequate for mycology compared to other pathogens. The total spent on medical mycology research was only 1.4 to 2.5% of that spent on immunology and infectious disease research by the Wellcome Trust, the U.K. Medical Research Council, and the U.S. National Institutes of Health. Much better diagnostics are required for all the serious fungal infections and because of emerging resistance - new antifungal drugs need to be developed.