Candida parapsilosis complex in the clinical setting

Area of Science:

• Medical Mycology
• Infectious Diseases
• Antimicrobial Resistance

Background:

• The Candida parapsilosis complex is a leading cause of candidemia and other infections, especially in preterm infants.
• This complex includes C. parapsilosis, C. orthopsilosis, and C. metapsilosis, presenting diverse clinical manifestations.
• High echinocandin MICs and emerging fluconazole resistance are significant clinical concerns.

Purpose of the Study:

• To provide an updated review of the epidemiology, diagnosis, resistance patterns, and treatment of the Candida parapsilosis complex.
• To compare the three species within the complex regarding microbiology and clinical characteristics.
• To serve as a resource for clinicians and researchers on Candida species infections.

Main Methods:

• Literature review of recent medical data on the Candida parapsilosis complex.
• Comparative analysis of clinical and microbiological features of the three sister species.
• Synthesis of current knowledge on diagnosis, resistance, and treatment options.

Main Results:

• The Candida parapsilosis complex exhibits unique resistance mechanisms, including FKS1 polymorphisms affecting echinocandin susceptibility.
• Clonal outbreaks with antifungal resistance, particularly to fluconazole, are increasingly reported.
• Clinical presentations range from colonization to severe disseminated infections, with a high burden in neonatal intensive care units.

Conclusions:

• The Candida parapsilosis complex poses a growing challenge due to antifungal resistance and its prevalence in vulnerable populations.
• Understanding species-specific characteristics is crucial for effective diagnosis and management.
• Bridging translational knowledge gaps is essential for addressing future therapeutic challenges.