Update on Candida krusei, a potential multidrug-resistant pathogen

Area of Science:

• Mycology
• Infectious Diseases
• Antimicrobial Resistance

Background:

• Candida albicans is the primary cause of candidiasis, but non-albicans Candida (NAC) species, including Candida krusei, are emerging pathogens.
• Candida krusei is a yeast found in healthy individuals but can cause severe infections in immunocompromised patients, especially those with hematologic malignancies.
• Increased resistance of NAC species to antifungal drugs, including intrinsic resistance of C. krusei to fluconazole, drives this epidemiological shift.

Purpose of the Study:

• To review the biology, pathophysiology, and epidemiology of Candida krusei.
• To discuss the mechanisms of antifungal resistance in Candida species.
• To explore alternative therapeutic approaches for challenging fungal infections.

Main Methods:

• Literature review of current knowledge on Candida krusei.
• Analysis of epidemiological trends in candidiasis.
• Examination of molecular mechanisms of antifungal drug resistance.
• Discussion of alternative therapies.

Main Results:

• Candida krusei is an opportunistic pathogen with intrinsic and acquired resistance to common antifungal drugs.
• Mechanisms of resistance include target alteration/overexpression, reduced drug accumulation, and bypass pathways.
• The limited antifungal arsenal and drug development challenges necessitate exploration of alternative treatments.

Conclusions:

• Candida krusei represents a significant multidrug-resistant fungal threat, particularly in vulnerable populations.
• Understanding resistance mechanisms is crucial for developing effective treatment strategies.
• Alternative therapies are urgently needed to combat resistant Candida infections.