Spiriva is a Long Acting Muscarinic Agent. Trimbow includes the LAMA, like Spiriva, and a Long acting Beta Agonist (LABA) and an Inhaled Corticosteroid (ICS). So the Trimbow is three meds in one, whereas Spiriva was just one med by itself. What you're likely reacting to is the addition of the LABA and the ICS.

There are a number of different fungal infections that can attack the lungs. If you google "fungal infections of the lungs" you'll find a number of articles that explain them. I recommend the ATS article as one of the most explanatory. There are specific high-powered antibiotics that are used to treat these conditions.

Ultibro is a combination of both a LAMA, like Spiriva, and a LABA, so it's a combination med. It should work better than spiriva by itself.

I use ultibro breezhaler instead of spriva once a rotacap

Yes I found the same issues as you, so I switched to Trinbow which seems to work a lot better. Hope this helps