FAILSAFE Fungal Antimicrobial Resistance Innovations for Low & Middle Income Countries: Solutions & Access For Everyone
FAILSAFE Fungal Antimicrobial Resistance Innovations for Low & Middle Income Countries: Solutions & Access For Everyone
Lead applicant
Dr Caroline Maluleka – Wits Health Consortium Ltd
Co-applicants
Nelesh Govender – University of the Witwatersrand and Mycology Division Head, WHC
Rachel Wake – St George’s University of London
Tihana Bicanic – St George’s University of London
Geographical focus – Southern Africa
Research Theme – Innovative platforms
Lay summary
Candida is a type of fungus that is usually found on the skin and in the digestive system of healthy people – this is known as colonisation. But in people with risk factors such as critical illness, cancer, long-term use of antibiotics, or intravenous catheters, Candida can invade other body sites and cause serious infections. Several Candida species are a big problem in intensive care units (ICU) because they can cause life-threatening bloodstream infections. To treat these Candida bloodstream infections, doctors use antifungal medications. However, some Candida species are resistant to these medicines, which makes the treatment of the infection ineffective and can lead to death. In healthcare settings, patients can get an antifungal-resistant Candida infection by being exposed to other patients with Candida infections in the hospital or from the hospital environment.
Previous exposure to antifungals, whether for treatment or prevention of an infection, can change the types of Candida that colonise the body, favouring species that are naturally resistant to antifungals or causing a usually-sensitive species to mutate and become antifungal-resistant. This increases the risk of later invasive infections when these resistant Candida overgrow and invade sterile body parts. This study aims to investigate the relationship between prior antifungal exposure and the acquisition of antifungal-resistant Candida in ICU patients at two teaching hospitals in South Africa and Mozambique.
Patients who have been exposed to antifungal medicines and those who have not will be included in the study, and samples will be collected from multiple parts of the body over time to see how antifungal exposure affects the acquisition or development of antifungal-resistance in Candida. At the same time, the amount of antifungals used in the ICUs and the way they are prescribed to patients will be evaluated to explore the relationship between antifungal use and resistant Candida infections and identify specific challenges in current treatment practices. This research will shed light on the burden and causes of Candida resistance in low- and middle-income countries (LMIC), and will support ongoing efforts to monitor and improve the use of antifungals, ultimately improving outcomes of people with Candida infections.