Candida spp
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Candida spp.: An Overview of Prevalence, Pathogenicity, and Treatment
Prevalence of Candida spp. in Nosocomial Infections
Candida species are a leading cause of nosocomial bloodstream infections, contributing significantly to morbidity and mortality worldwide. Candidemia, an infection of the bloodstream by Candida spp., is particularly prevalent in hospital settings. Studies have shown that Candida albicans is the most frequently isolated species in these infections, especially in North and Central Europe and the USA1 2. However, non-albicans species such as Candida glabrata, Candida parapsilosis, and Candida tropicalis are more common in South America, Asia, and South Europe1.
Candida spp. in Endodontic and Oral Infections
Candida species are also implicated in endodontic infections, although their role as primary pathogens in these infections remains debatable. A systematic review found that Candida spp. are present in approximately 8.20% of root canal infections, with Candida albicans being the most frequently isolated species3. Additionally, Candida spp. are less frequent in the oral cavities of breastfed infants compared to bottle-fed infants, indicating a potential protective effect of breastfeeding against oral Candida colonization7.
Antifungal Susceptibility and Resistance
The treatment of Candida infections is complicated by varying antifungal susceptibilities among different species. Candida albicans generally shows good susceptibility to common antifungals, but resistance is emerging in non-albicans species. For instance, Candida glabrata and Candida auris have shown significant multidrug resistance, posing a challenge for clinical management2 6. Echinocandins, such as caspofungin, generally exhibit good activity against most Candida spp., although resistance in Candida glabrata is notable2.
Natural Compounds as Potential Treatments
Recent studies have explored the antifungal activity of natural compounds against Candida spp. Cinnamaldehyde and eugenol, components of essential oils, have shown promising in vitro results against various Candida strains, including Candida albicans and Candida glabrata. These compounds demonstrated significant fungistatic and fungicidal activities, making them potential candidates for treating candidiasis4.
Virulence Factors and Pathogenicity
Candida spp. possess several virulence factors that enhance their pathogenicity. These include secreted enzymes like phospholipases and proteinases, as well as the ability to form biofilms and hyphae. These factors facilitate tissue invasion, immune evasion, and persistence in the host5 9 10. Understanding these virulence mechanisms is crucial for developing targeted therapies and improving patient outcomes.
Conclusion
Candida spp. are significant pathogens in both nosocomial and community settings, with varying prevalence and antifungal resistance patterns across different regions. While Candida albicans remains the most common species, the rise of non-albicans Candida spp. and their associated drug resistance highlight the need for ongoing surveillance and novel treatment strategies. Natural compounds like cinnamaldehyde and eugenol offer promising alternatives, and further research into the virulence factors of Candida spp. may pave the way for more effective therapies.
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Most relevant research papers on this topic
Relative frequency of albicans and the various non-albicans Candida spp among candidemia isolates from inpatients in various parts of the world: a systematic review.
Geographical variation in candidemia cases is evident, with C. albicans being the predominant species in North and Central Europe and the USA, and non-albicans species more common in South America, Asia, and South Europe.
Systematic Review
Rigorous Journal
Highly CitedNosocomial bloodstream infections due to Candida spp. in the USA: species distribution, clinical features and antifungal susceptibilities.
Candida albicans is the most prevalent species in US hospitals, with non-albicans species increasing in prevalence, and antifungal susceptibilities vary among different species.
Observational StudyHighly CitedPrevalence of Candida Species in Endodontic Infections: Systematic Review and Meta‐analysis
Candida spp. occurs in a small proportion of root canal infections, with Candida albicans being the most frequently isolated species.
Meta-AnalysisAntifungal Activity of Natural Compounds vs. Candida spp.: A Mixture of Cinnamaldehyde and Eugenol Shows Promising In Vitro Results
Cinnamaldehyde and eugenol show promising in vitro results in inhibiting Candida spp. infections, making them ideal candidates for treating fungal infections.
In Vitro StudySevere Candida spp. infections: new insights into natural immunity.
Dectin-1 deficiency may lead to weakened defense against Candida infections, offering potential for new immunotherapy approaches.
Emerging multidrug-resistant Candida species
Multidrug-resistant Candida species, particularly C. auris and C. glabrata, are a growing global health concern, with horizontal transmission being a major issue.
Literature ReviewHighly CitedCandida spp. occurrence in oral cavities of breastfeeding infants and in their mothers' mouths and breasts.
Candida species are less frequent in oral cavities of predominantly breastfed infants and their mothers' mouths and breasts compared to bottlefed infants and non-lactating women.
Observational StudyPrevalence, virulence factors and antifungal susceptibility of Candida spp. isolated from bloodstream infections in a tertiary care hospital in Brazil
Candida spp. infection in a Brazilian hospital is prevalent, with C. albicans being the predominant species and a single C. albicans isolate resistant to fluconazole and voriconazole, potentially due to previous exposure to antifungals.
Observational StudyHighly CitedMetabolic profiling of Candida clinical isolates of different species and infection sources
Metabolic profiling of Candida clinical isolates can help understand their virulence and pathogenicity, aiding in diagnosis and understanding their pathogenic properties.
Rigorous Journal