Testing for fungus critical as new threats emerge: CDC

Two fungal infections that have not been seen before in the U.S., Trichophyton mentagrophytes type VII and Trichophyton indotineae are emerging, and the CDC's head of mycotic diseases is urging clinicians to test for them.

"We've known about those resistant strains now for a number of years," Tom Chiller, MD, told Becker's. "They've been spreading globally, but we're now just starting to see them in the U.S., and it's certainly a concern. These are hard to treat and they're very contagious, so I worry that they could replace some of the more common strains that usually cause athlete's foot, jock itch, etc., and then if so, that could become a real problem in terms of our skin health and more." 

The CDC does not have robust tracking and testing systems for the emerging fungal infections, but in 2018 it did begin tracking a different one, Candida auris

With climate change, fungi may be able to thrive in environments where previously that was not possible. And with these conditions, more fungal infections that are increasingly drug resistant are also likely, Dr. Chiller said.

"It's a pretty contagious little organism. I worry about this species becoming the predominant species for those diseases, which wouldn't be a good thing because it is much harder to treat and more aggressive," he said. "So I think now it's about identifying it as quickly and early as we can, and trying to contain and control it so it doesn't start occupying that niche that many of these fungi have been for years. The reality is it's there, and we need to pay attention to it."

Last year, Dr. Chiller encouraged clinicians to "think fungus" when diagnosing patients since new fungal threats are emerging and sometimes can be challenging to identify, so considering it as a diagnosis or possibility continues to be important.

"We're telling people to think fungus, but we're also wanting you to test for fungus if you can, because knowing that it's there is going to be the key to knowing whether you need to treat it or not," he said. "And many people are diagnosed empirically with a fungal skin infection that maybe don't have a fungal skin infection, and that's why we're encouraging testing."

Dr. Chiller said efforts are underway to help expand fungal testing options for clinicians. 

"Testing helps us preserve the antimicrobials that we need and focuses us to treat what we're diagnosing," he said.

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