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Invasive Candidiasis
Published in Firza Alexander Gronthoud, Practical Clinical Microbiology and Infectious Diseases, 2020
Candida auris is an emerging multidrug-resistant pathogen of increasing concern. It is almost always resistant to fluconazole and can display reduced susceptibility to all antifungal classes. Empirical treatment consists of an echinocandin.
Diagnostic Approach to Rash and Fever in the Critical Care Unit
Published in Cheston B. Cunha, Burke A. Cunha, Infectious Diseases and Antimicrobial Stewardship in Critical Care Medicine, 2020
Lee S. Engel, Charles V. Sanders, Fred A. Lopez
Candida auris, first reported in 2009, is one of the most serious emerging pathogens associated with infections of critically ill patients [280,287]. Candida auris is frequently resistant to fluconazole and has demonstrated an ability to develop resistance to multiple other commonly used antifungals, including echinocandins and polyenes [288,289]. Risk factors for Candid auris do not differ from other systemic Candida infections, but the incidence appears to be significantly higher in patients with primary or acquired altered immune response [290]. Furthermore, the mortality rates associated with outbreaks in the intensive care setting approach 20% [291]. The CDC has identified Candida auris as a nationally notifiable condition, and cases should be reported to state or local health departments [292].
Invasive candidiasis
Published in Mahmoud A. Ghannoum, John R. Perfect, Antifungal Therapy, 2019
Richard R. Watkins, Tracy Lemonovich
Most IC infections are caused by one of five Candida spp. (albicans, parapsilosis, tropicalis, glabrata, and krusei), with C. albicans accounting for approximately 38%–70% of infections based on geographic area [11]. However, recent reports have noted an increasing trend in the isolation of non-albicans spp. in some clinical settings [1,12–14]. Furthermore, each of the non-albicans Candida spp. has been associated with a specific patient population and risk factors (Table 16.1). Candida auris is an emerging strain associated with high mortality and is often multidrug-resistant. Transmission of C. auris has likely occurred in health care facilities in the United Sates (US), highlighting the need for infection control measures to contain this pathogen [15].
An overview of micafungin as a treatment option for invasive candidiasis in pediatric patients younger than 4 months old
Published in Expert Opinion on Pharmacotherapy, 2022
Matteo Bassetti, Daniele Roberto Giacobbe, Antonio Vena, Susanna Esposito
Invasive candidiasis is an important cause of morbidity and mortality in pediatric patients younger than 4 months old, especially in pre-term infants. Although limited due to the peculiarity of the evaluated population, the available data related to micafungin efficacy and safety supports its use for the treatment of pediatric patients younger than 4 months old with invasive candidiasis. Nonetheless, further study to optimize its use remains mandatory, especially for pediatric patients younger than 4 months old with hematogenous Candida meningoencephalitis or meningitis that could require micafungin treatment when other options are unavailable or contraindicated. The recent worrisome worldwide diffusion of Candida auris, more frequently resistant to polyenes than to echinocandins and showing high rates of resistance to azoles, could render micafungin even more crucial for guaranteeing an efficacious antifungal treatment for invasive candidiasis in pediatric patients younger than 4 months old.
Detection and treatment of Candida auris in an outbreak situation: risk factors for developing colonization and candidemia by this new species in critically ill patients
Published in Expert Review of Anti-infective Therapy, 2019
Alba Ruiz-Gaitán, Héctor Martínez, Ana María Moret, Eva Calabuig, María Tasias, Ana Alastruey-Izquierdo, Óscar Zaragoza, Joan Mollar, Juan Frasquet, Miguel Salavert-Lletí, Paula Ramírez, José Luis López-Hontangas, Javier Pemán
The emerging and multidrug-resistant fungal pathogen Candida auris has been related to health-care-associated outbreaks in several countries from five continents, often in intensive care units (ICU) [1–7]. The capacity of C. auris to originate hospital outbreaks is related to: (i) the difficulties to be quickly identified in the laboratories (since it is frequently misidentified with other related species by phenotypic and biochemical methods), (ii) its ability to persist in the hospital environment and medical equipment surfaces, (iii) its capability to form biofilms and to be transmitted person-to-person through direct contact, (iv) its resistance to antifungal agents, (v) its virulence mechanisms and capacity of evading the immune response or avoiding the attack of neutrophils, and (vi) also by its resistance to disinfectant products habitually used in daily practice [8–12].
Antifungal resistance in superficial mycoses
Published in Journal of Dermatological Treatment, 2022
Aditya K. Gupta, Maanasa Venkataraman
Recent reports from the Centers for Disease Control and Prevention (CDC) highlighted the emergence of multidrug-resistant Candida and Aspergillus species (80). Acquired resistance to azoles and echinocandins separately and together was reported in Candida glabrata (81). Candida auris, an emerging pathogen known to cause severe invasive bloodstream infections with high mortality in over 20 countries, has been reported to express multi-drug resistance against several classes of antifungal agents (58). Treatment with triazoles, such as ravuconazole was shown to be effective in vitro against C. auris, suggestive of an alternative treatment for drug-resistant candidiasis (82).