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Invasive Candida infections: the changing epidemiology
1University of Washington, School of Medicine, and Program in Infectious Diseases, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
Oncology (Williston Park, N.Y.)
|February 3, 2005
Summary
Bloodstream infections caused by Candida are rising, with non-albicans species showing increased resistance to antifungal drugs. Careful evaluation of treatment is crucial to combat this growing challenge.
Area of Science:
- Mycology
- Infectious Diseases
- Clinical Microbiology
Background:
- Candida bloodstream infections (BSI) are a significant cause of mortality in the US.
- Candida albicans is common, but non-albicans species like Candida glabrata and Candida krusei are increasingly isolated.
- These shifts are driven by antifungal prophylaxis, changing patient populations, and therapeutic strategies.
Purpose of the Study:
- To highlight the growing prevalence of non-albicans Candida species in bloodstream infections.
- To emphasize the increasing resistance of these species to azole antifungals.
- To underscore the need for careful consideration of antifungal treatment options.
Main Methods:
- Epidemiological data review on Candida bloodstream infections.
- Analysis of antifungal resistance patterns in Candida species.
- Evaluation of factors contributing to changing Candida epidemiology.
Main Results:
- Non-albicans Candida species, particularly Candida glabrata, show increasing isolation rates.
- Candida glabrata exhibits resistance to fluconazole and emerging cross-resistance to newer azoles.
- Rising azole resistance in Candida species poses a significant clinical challenge.
Conclusions:
- The increasing prevalence of azole-resistant Candida species necessitates a re-evaluation of antifungal treatment strategies.
- Host and therapeutic risk factors for drug resistance must be carefully assessed.
- Effective management of Candida BSI requires monitoring resistance trends and optimizing therapy.