Candidemia and Invasive Candidiasis

McCarty, Todd P; White, Cameron; Pappas, Peter G.

doi:10.1016/j.idc.2021.03.007

Cited by 150 publications

(118 citation statements)

References 151 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Pathogenic adaptations by Candida manifest as local mucosal infections or systemic infections, occasionally resulting in infections spreading to major organs [13,14]. It ranks fourth as a causal factor among healthcare-associated infections and second among healthcare-related bloodstream infections in the United States [15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

Fungal Colonization and Infections—Interactions with Other Human Diseases

2022

View full text Add to dashboard Cite

Candida albicans is a commensal fungus that asymptomatically colonizes the skin and mucosa of 60% of healthy individuals. Breaches in the cutaneous and mucosal barriers trigger candidiasis that ranges from asymptomatic candidemia and mucosal infections to fulminant sepsis with 70% mortality rates. Fungi influence at least several diseases, in part by mechanisms such as the production of pro-carcinogenic agents, molecular mimicking, and triggering of the inflammation cascade. These processes impact the interactions among human pathogenic and resident fungi, the bacteriome in various organs/tissues, and the host immune system, dictating the outcomes of invasive infections, metabolic diseases, and cancer. Although mechanistic investigations are at stages of infancy, recent studies have advanced our understanding of host–fungal interactions, their role in immune homeostasis, and their associated pathologies. This review summarizes the role of C. albicans and other opportunistic fungi, specifically their association with various diseases, providing a glimpse at the recent developments and our current knowledge in the context of inflammatory-bowel disease (IBD), cancers, and COVID-19. Two of the most common human diseases where fungal interactions have been previously well-studied are cancer and IBD. Here we also discuss the emerging role of fungi in the ongoing and evolving pandemic of COVID-19, as it is relevant to current health affairs.

show abstract

Section: Introductionmentioning

confidence: 99%

Fungal Colonization and Infections—Interactions with Other Human Diseases

2022

View full text Add to dashboard Cite

show abstract

“…Candida spp. can cause invasive and opportunistic fungal diseases associated with variable mortality in immunocompromised patients as well as those with cancer and under hematopoietic cell transplantation [1]. Candida albicans is considered to be the most common species isolated from blood cultures, however, fungal infections caused by non-albicans Candida species are on the rise [2].…”

Section: Introductionmentioning

confidence: 99%

Participation of the ABC Transporter CDR1 in Azole Resistance of Candida lusitaniae

Borgeat

Brandalise

Grenouillet

et al. 2021

JoF

View full text Add to dashboard Cite

Candida lusitaniae is an opportunistic pathogen in humans that causes infrequent but difficult-to-treat diseases. Antifungal drugs are used in the clinic to treat C. lusitaniae infections, however, this fungus can rapidly acquire antifungal resistance to all known antifungal drugs (multidrug resistance). C. lusitaniae acquires azole resistance by gain-of-function (GOF) mutations in the transcriptional regulator MRR1. MRR1 controls the expression of a major facilitator transporter (MFS7) that is important for fluconazole resistance. Here, we addressed the role of the ATP Binding Cassette (ABC) transporter CDR1 as additional mediator of azole resistance in C. lusitaniae. CDR1 expression in isolates with GOF MRR1 mutations was higher compared to wild types, which suggests that CDR1 is an additional (direct or indirect) target of MRR1. CDR1 deletion in the azole-resistant isolate P3 (V688G GOF) revealed that MICs of long-tailed azoles, itraconazole and posaconazole, were decreased compared to P3, which is consistent with the role of this ABC transporter in the efflux of these azoles. Fluconazole MIC was only decreased when CDR1 was deleted in the background of an mfs7Δ mutant from P3, which underpins the dominant role of MFS7 in the resistance of the short-tailed azole fluconazole. With R6G efflux readout as Cdr1 efflux capacity, our data showed that R6G efflux was increased in P3 compared to an azole-susceptible wild type parent, and diminished to background levels in mutant strains lacking CDR1. Milbemycin oxim A3, a known inhibitor of fungal ABC transporters, mimicked efflux phenotypes of cdr1Δ mutants. We therefore provided evidence that CDR1 is an additional mediator of azole resistance in C. lusitaniae, and that CDR1 regulation is dependent on MRR1 and associated GOF mutations.

show abstract

“…In our study, patients in critical care units were more likely to culture C. auris from blood cultures compared to other species. 11 The remainder of species causing candidemia in our study were isolated more commonly in non-critical care units. The predominance of non-albicans species in clinical departments other than the medical department is also noteworthy.…”

Section: Discussionmentioning

confidence: 92%

Incidence of candidemia and prevalence of azole-resistant candidemia at a tertiary South African hospital – A retrospective laboratory analysis 2016–2020

Chibabhai

2022

Southern African Journal of Infectious Diseases

View full text Add to dashboard Cite

Coupled with the limited number of antifungal classes for management of fungal infections is the limited access to available antifungal agents in many countries worldwide. 2 This is becoming increasingly important with the changing epidemiology of candidemia, with species distribution Background: Candidemia is associated with high morbidity and mortality. The epidemiology of candidemia has changed globally over the past 20 years. South African surveillance demonstrated a shift in epidemiology from Candida albicans to non-albicans species including Candida parapsilosis and Candida auris. Hospital-level candidemia incidence from South Africa has not been reported previously. Methods:We performed a retrospective laboratory-based analysis of blood cultures with confirmed causative agents of candidemia. Ward type, department, gender and admission to critical care units were captured. Data were analysed in Microsoft Excel, Statistical Package for the Social Sciences (SPSS) and Epitools. Results:The incidence of candidemia during the study period was 2.87 per 1000 admissions. The total proportion of non-albicans species causing candidemia was 425/618 (69.7%). Overall, 65.4% of candidemia cases occurred in non-critical care units. There was a significant increase in the proportion of C. auris isolates between 2016 and 2020 (p < 0.001). Isolation of C. auris was associated with admission to critical care units (p < 0.001, odds ration [OR] 3.856, 95% confidence interval [CI]: 2.360-6.300). The proportion of azole-resistant candidemia cases increased from 21/53 (39.6%) in 2016 to 41/59 (69.5%) in 2020 (p = 0.002). Conclusion:The incidence of candidemia remained stable over the five-year study period. However, the proportion of C. auris isolates increased significantly during the study period as did the overall proportion of azole-resistant candidemia. Antifungal stewardship and continued hospital-level surveillance are imperative.

show abstract

Candidemia and Invasive Candidiasis

Cited by 150 publications

References 151 publications

Fungal Colonization and Infections—Interactions with Other Human Diseases

Fungal Colonization and Infections—Interactions with Other Human Diseases

Participation of the ABC Transporter CDR1 in Azole Resistance of Candida lusitaniae

Incidence of candidemia and prevalence of azole-resistant candidemia at a tertiary South African hospital – A retrospective laboratory analysis 2016–2020

Contact Info

Product

Resources

About