Quick Facts

• Drug-resistant fungi infections are 20% more deadly than treatable fungal infections
• C. auris cases reached 6,304 in 2024, with the pathogen now identified in 60+ countries
• Only five new antifungal drug classes have been developed in the past 75 years

A team of 50 scientists from 16 organizations worldwide published an urgent call to action in Nature Medicine this week. They warn of a “silent surge” of drug-resistant fungi that threatens patients with weakened immune systems.

The researchers documented alarming statistics. Candida auris cases in the U.S. reached 6,304 in 2024 according to CDC data. The pathogen has spread to at least 60 countries globally.

“We are facing a silent surge of drug-resistant fungi—from Candida auris in ICUs to azole-resistant Aspergillus in the community—that is already costing lives,” said Paul Verweij, professor at Radboud University Medical Center who led the research.

The mortality data reveals the scope of the threat. Patients with drug-resistant fungal infections face 20% higher death rates compared to those with treatable infections. One in three patients with C. auris infections does not survive.

Limited treatment options compound the problem. Only five new classes of antifungal drugs have been developed in 75 years. The similarity between fungal and human cells makes developing safe, effective treatments extremely difficult.

“The main challenge is that fungi, if you look at the cell structure — how they are built up — it’s very similar to the human cell,” Verweij explained. “It’s quite difficult to find a drug which kills the fungus but does not harm the human cell.”

Agricultural practices accelerate resistance development. Fungicides used on crops closely resemble medical antifungals. Long-term agricultural exposure allows fungi to develop resistance, which then spreads through air to healthcare settings.

“Dual use of antifungal targets in medicine and agriculture is accelerating resistance from fields to ICUs,” said Professor Michaela Lackner from Medical University of Innsbruck.

The researchers developed a five-step global plan: awareness, surveillance, infection prevention and control, optimized use, and investments. They want fungal resistance integrated into the World Health Organization’s 2026 Global Action Plan update.

Two categories of fungal infections pose distinct threats. Severe infections target hospitalized patients with compromised immunity, affecting blood and lungs. Skin, hair and nail infections are less deadly but increasingly difficult to treat.

New resistant strains emerge regularly. Trichophyton indotineae causes skin infections that resist treatment for years. Some patients remain infected after four years of continuous treatment.

“We need more data and evidence on fungal infections and antifungal resistance to inform and improve response to these priority fungal pathogens,” said Haileyesus Getahun, WHO Director for Global Coordination on Antimicrobial Resistance.

The research highlights gaps in global surveillance. Lower-income countries lack diagnostic capabilities and infection control measures. Patients die without doctors knowing they had fungal infections or whether those infections were resistant.

The WHO created its first fungal priority pathogen list in 2022. The researchers push for concrete milestones and funding in next year’s action plan update.

Read more: Why scientists are nervous about fungi