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Review
. 2022 Jun 30;11(7):877.
doi: 10.3390/antibiotics11070877.

Invasive Candidiasis: Update and Current Challenges in the Management of This Mycosis in South America

Fernando Oscar Riera  1   2 , Juan Pablo Caeiro  2   3 , Sofia Carla Angiolini  2   4   5 , Cecilia Vigezzi  2   4   5 , Emilse Rodriguez  2   4   5 , Paula Alejandra Icely  2   4   5 , Claudia Elena Sotomayor  2   4   5
Affiliations
Review

Invasive Candidiasis: Update and Current Challenges in the Management of This Mycosis in South America

Fernando Oscar Riera et al. Antibiotics (Basel). .

Abstract

Invasive candidiasis encompassing Candida bloodstream infections and deep-seated candidiasis can become a persistent health problem. These infections are caused by Candida species and have high morbidity and mortality rates. Species distribution, access to diagnosis, treatment and mortality are different around the world. The mortality rate is high in South America (30-70%), and Candida albicans is the most prevalent species in this region. However, a global epidemiological shift to non-albicans species has been observed. In this group, C. parapsilosis is the species most frequently detected, followed by C. tropicalis, and at a slower rate, C. glabrata, which has also increased, in addition to the emerging C. auris, resistance to several drugs. This article summarizes relevant aspects of candidemia pathogenesis, such as the mechanisms of fungal invasion, immune response, and the impact of genetic defects that increase host susceptibility to developing the infection. We also discuss relevant aspects of treatment and future challenges in South America.

Keywords: South America; candidemia; invasive candidiasis; risk factors; treatment.

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Conflict of interest statement

The authors do not have any conflict of interest to declare.

Figures

Figure 1
Figure 1
Epidemiology of candidemia in South America (2017–2022). Data about C. auris were recently published by the Pan American Health Organization (PAHO) [28]. Species distribution might have changed since these data were collected.
Figure 2
Figure 2
Risk Factors Predisposing to Invasive Candidiasis, categorized into four Groups: Co-Morbidities, Nosocomial Conditions, Drugs and Human Genetic Factors.
Figure 3
Figure 3
Invasive Candidiasis: Organs Susceptible of Infection by Candida spp. and Resulting Diseases. The names of diseases agree with those described by Pappas et al. [12].
Figure 4
Figure 4
Algorithm for management of Candida sepsis adapted from Keighley et al. and Thompson et al. [94,95].
See this image and copyright information in PMC

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