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Candida parapsilosis: epidemiology, pathogenicity, clinical manifestations, and antimicrobial susceptibility
1Department of Medical Education and Research, Greenville Hospital System, South Carolina 29605.
Abstract:
Early reports associated Candida parapsilosis with endocarditis in intravenous narcotic addicts. More recently, this species has emerged as an important nosocomial pathogen, with clinical manifestations including fungemia, endocarditis, endophthalmitis, septic arthritis, and peritonitis, all of which usually occur in association with invasive procedures or prosthetic devices. Outbreaks of C. parapsilosis infections have been caused by contamination of hyperalimentation solutions, intravascular pressure monitoring devices, and ophthalmic irrigating solution. Experimental studies have generally shown that C. parapsilosis is less virulent than Candida albicans or Candida tropicalis. However, characteristics of C. parapsilosis that may relate to its increasing occurrence in nosocomial settings include frequent colonization of the skin, particularly the subungual space, and an ability to proliferate in glucose-containing solutions, with a resultant increase in adherence to synthetic materials. Recently developed molecular techniques may facilitate the continued exploration of the epidemiology and pathogenesis of C. parapsilosis infections.
Insights
Candida parapsilosis, a yeast, is increasingly causing hospital-acquired infections, particularly in patients with invasive devices. Its ability to colonize skin and grow in glucose solutions contributes to its rise as a nosocomial pathogen.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Hospital Epidemiology
Background:
- Candida parapsilosis was initially linked to endocarditis in intravenous drug users.
- It has since emerged as a significant nosocomial pathogen, causing various infections like fungemia and endocarditis.
- These infections are often associated with invasive procedures and prosthetic devices.
Purpose of the Study:
- To review the clinical significance and epidemiology of Candida parapsilosis.
- To highlight factors contributing to its increasing prevalence in healthcare settings.
- To discuss its pathogenesis and potential for molecular investigation.
Main Methods:
- Literature review of early reports and recent studies on Candida parapsilosis.
- Analysis of clinical manifestations and outbreak sources.
- Discussion of experimental findings on virulence and adherence properties.
Main Results:
- Candida parapsilosis causes fungemia, endocarditis, and other infections in hospitalized patients.
- Outbreaks are linked to contaminated medical supplies and devices.
- The yeast exhibits frequent skin colonization and thrives in glucose-rich solutions, enhancing adherence to materials.
Conclusions:
- Candida parapsilosis is an emerging nosocomial pathogen with specific characteristics favoring its spread in hospitals.
- Understanding its epidemiology and pathogenesis is crucial for infection control.
- Molecular techniques offer promise for further research into this opportunistic fungus.