Addressing the threat of candida infection: resistance and management

Oliver conds

Image credit: Cecad Cologne

Candida Species are the main cause of inpatient fungal infections and contribute significantly to morbidity and mortality. Invasive candidiasis, including candidemia, affects mostly immunocompromised or severely ill patients, but mucocutaneous candidiasis such as oral thrush and vulvaginal candidiasis may be in the otherwise healthy individual. It may occur. Mucosal cortex is not usually life-threatening, but can cause discomfort and complications, especially in patients with underlying conditions such as diabetes and immunosuppressive therapy.

New host factors and antifungal resistance promote difficult-to-treat elevations Candida infection. Pathogens such as Candida Oris Fluconazole resistance Candida Parapsilosis poses a global health risk. Recent taxonomic revisions have reclassified some Candida Species, species that lead to potential disruptions in clinical practice. Current management guidelines are limited and lack of coverage for emerging pathogens and new treatment options.

In an email interview with Oliver a Cornley's professor of translation studies at the University of Excellence, he discussed how healthcare providers can do their best. Candida Oris Fluconazole resistance Candida Parapsilosis, especially in immunodeficiency patients. He said, “HCW cannot despair patients, so we will focus on proper treatment. Candida If an invasive infection, i.e., candidemia or organ involvement, treatment must be initiated based on microscopic outcomes. It must be with echinocandin as it is most likely to attack yeast violently and quickly. As soon as the results of the susceptibility test are available, reviews should be made for your chosen treatment. ” he added.

To minimize confusion due to recent taxonomic revisions of Candida species, the microbiology lab highlighted the need for the Microbiology Lab to report both old and new names of Candida species. He said, “There is only one way. You need a report from the microbiology lab. Old and new. Candida infection is a rare disease, so the duration of such reporting should be very long. There is. At least five years.”

When managing invasive and mucocutaneous candidiasis in patients with underlying conditions such as diabetes and immunosuppressive therapy, “The important consideration is the duration of treatment, and immunosuppression means more treatment.” Patients in these groups are taking multiple medications.”

Regarding antifungal resistance, we found it to be increasing rapidly. He said, “The resistance is increasing and it's speeding up. Just a few years ago we knew azole resistance. Candida Parapsilosis only from literature. Now we all see them often. Candida Oris There is resistance towards Azole, and some clades are heading towards Echinocandin. Pan-resistant has also been discovered. Our treatment options are rapidly narrowing. Systemic infection requires new medications such as Ibrexafungerp and Fosmanogepix. ”

“Because there is a lack of reliable assays to trigger treatment, fever is too specific, and it appears that positive blood cultures will occur with the onset of invasive disease,” he said, adding that We thoroughly emphasized the critical need for reliable assays. He also said, “We often overlooked outbreaks because multiple hospitals can be involved, so we need to vigorously study outbreaks that are often overlooked. Infection control measures avoid communication. It helps to end the outbreak. However, they were not studied. The extent to which they needed. He said, “Overall, there has been little public funding in the last 25 years. That's what we are now It led to a lack of research that we are facing.”

reference

Rough OA, Sprute R, Bassetti M, ET. Al. Global Guidelines for the Diagnosis and Management of Candidiasis: ECMM's initiative in collaboration with Isham and ASM. Lancet Infect diss. February 13, 2025: S1473-3099 (24) 00749-7. doi: 10.1016/s1473-3099 (24) 00749-7. Epub before printing. PMID: 39956121