The epidemiology and outcomes of invasive Candida infections among organ transplant recipients in the United States: results of the Transplant‐Associated Infection Surveillance Network (TRANSNET)

Abstract

Background: Invasive candidiasis (IC) is a common cause of mortality in solid organ

Notable Increasing Trend in Azole Non-susceptible Candida tropicalis Causing Invasive Candidiasis in China (August 2009 to July 2014): Molecular Epidemiology and Clinical Azole Consumption

“…According to data obtained in this study and from previous studies, C. tropicalis is the third commonest pathogenic Candida species in China, and its prevalence has generally been stable (15–20%; Wang et al, 2012; Liu et al, 2014; Xiao et al, 2015). In addition, some previous studies indicated that invasive infections caused by C. tropicalis have higher mortality compared to those caused by other non- tropicalis Candida species (Montagna et al, 2013; Andes et al, 2016). …”

Mechanisms involved in the triggering of neutrophil extracellular traps (NETs) by Candida glabrata during planktonic and biofilm growth

“…Neutrophils are a critical first line of defense against fungal pathogens, including Candida 2,14–18 . In response to planktonic, or non-biofilm C .…”

“…Of these, C . glabrata is frequently the most prevalent, particularly in Europe and North America 18,28 . This emerging pathogen poses obstacles to treatment, including increased intrinsic resistance to commonly used antifungals, such as azoles, and the rapid emergence of drug resistance during treatment 4,29 .…”

What is the role of empirical treatment for suspected invasive candidiasis in non-neutropenic non transplanted patients in the intensive care unit?—Empiricus strikes back!

“…(I) Gastrointestinal surgical patients and/or those admitted for necrotizing pancreatitis may constitute a higher risk group that was under-represented in that study (17,18); (II) the study excluded immuno-compromised patients including solid organ transplant or hematopoietic stem cell recipients, which is logical regarding the specificities of fungal infections among that population (19). These immuno-compromised patients are frequently hospitalized in the ICU and represent a challenge for both diagnosis and treatment of fungal infections (20)(21)(22); (III) the lack of use of selective digestive decontamination in the French ICUs may have been balanced with prior exposure to broad spectrum antibiotic therapy. However, it could also explain an incidence of invasive fungal infection lower than that observed in other countries (23); (IV) besides β-Dglucan, the evaluation or the discovery of other biomarkers is warranted to determine, more precisely, which patients would benefit from systemic antifungal therapy to prevent invasive candidiasis, a still unresolved issue (24).…”