Current Epidemiology of Candida Infection

Area of Science:

• Infectious Diseases
• Mycology
• Healthcare Epidemiology

Background:

• Candidemia and candidiasis are leading causes of healthcare-associated infections, contributing to significant patient morbidity and mortality.
• While *Candida albicans* historically predominated, its proportion in U.S. candidemia cases has fallen below 50%.

Purpose of the Study:

• To analyze the evolving trends in species distribution and antifungal susceptibility patterns of candidemia.
• To highlight the increasing prevalence of non-*Candida albicans* species, such as *C. glabrata*, in candidemia cases.

Main Methods:

• Review of epidemiological data on candidemia and candidiasis incidence.
• Analysis of species identification and antifungal susceptibility testing results.
• Comparative assessment of trends in the United States and globally.

Main Results:

• *Candida albicans* is no longer the majority species causing candidemia in the U.S., now accounting for less than 50% of cases.
• *Candida glabrata* is increasingly prevalent, responsible for nearly 30% of U.S. cases, alongside other non-*albicans* species.
• Regional variations in predominant species exist globally; pediatric candidemia rates are declining in the U.S. without clear cause.
• Antifungal resistance remains low overall, but concerns exist regarding echinandin and multidrug resistance in *C. glabrata*.

Conclusions:

• The landscape of candidemia is dynamic, with significant shifts in causative species and ongoing concerns about antifungal resistance.
• Continuous monitoring of candidemia trends, including species prevalence and resistance patterns, is crucial for effective patient management and public health strategies.