Diagnosis and Treatment of Invasive Candidiasis

Abstract

Candida species, belonging to commensal microbial communities in humans, cause opportunistic infections in individuals with impaired immunity. Pathogens encountered in more than 90% cases of invasive candidiasis include C. albicans, C. glabrata, C. krusei, C. tropicalis, and C. parapsilosis. The most frequently diagnosed invasive infection is candidemia. About 50% of candidemia cases result in deep-seated infection due to hematogenous spread. The sensitivity of blood cultures in autopsy-proven invasive candidiasis ranges from 21% to 71%. Non-cultural methods (beta-D-glucan, T2Candida assays), especially beta-D-glucan in combination with procalcitonin, appear promising in the exclusion of invasive candidiasis with high sensitivity (98%) and negative predictive value (95%). There is currently a clear deficiency in approved sensitive and precise diagnostic techniques. Omics technologies seem promising, though require further development and study. Therapeutic options for invasive candidiasis are generally limited to four classes of systemic antifungals (polyenes, antimetabolite 5-fluorocytosine, azoles, echinocandins) with the two latter being highly effective and well-tolerated and hence the most widely used. Principles and methods of treatment are discussed in this review. The emergence of pan-drug-resistant C. auris strains indicates an insufficient choice of available medications. Further surveillance, alongside the development of diagnostic and therapeutic methods, is essential.

Quantitatively detecting Candida albicans enolase1 with a one-step double monoclonal antibody sandwich ELISA assay

“…Since IC is subtle and indistinguishable from the bacterial infections, it presents a major challenge in clinical diagnosis. However, in recent years, researchers have investigated a combination of various culture and non-culture techniques, as well as tested the combined use of different non-culture techniques, for enhancing the diagnostic efficiency ( Posteraro et al, 2011 ; Barantsevich and Barantsevich, 2022 ; Fisher et al, 2022 ). At the same time, novel diagnostic technologies are constantly being developed and clinically tested.…”

Biocontrol of Candida albicans by Antagonistic Microorganisms and Bioactive Compounds

“…However no identified compounds are currently used as a drug against C. albicans . There are still four types of antifungal agents for C. albicans infection: polyene, triazole, 5-fluorocytosine, and echinocandin antifungal drugs [ 13 ]. Through the study of these active compounds, it is expected to obtain new drugs for the treatment and prevention of C. albicans infection, thereby maintaining human health.…”

“…Since then, many antifungal agents have been developed [ 11 , 12 ]. There are four types of antifungal agents for C. albicans infection [ 13 ]. The most commonly used antifungal drugs and the mechanism of action include:(1) The widest range and most effective is polyene (Amphotericin B), which can kill most fungi.…”

Evaluation of Physically and/or Chemically Modified Chitosan Hydrogels for Proficient Release of Insoluble Nystatin in Simulated Fluids

“…The prevalence of fungal invasive infections is continuously increasing as a result of the growing number of immunocompromised patients, having an estimated attributable global mortality higher than 1.5 million deaths every year [ 1 , 2 , 3 ]. Superficial mycotic infections caused by Candida species often affect the mucocutaneous tissues (oral or vulvovaginal mucosa) [ 4 , 5 ].…”