• Guest speaker Professor Tihana Bicanic

Candida spp.

• Candidiasis is the most common human fungal infection
• Candida spp. cause both superficial infection (cutaneous, mucosal) and invasive disease (candidaemia, deep-seated)
• C. albicans is responsible for about 90% of human Candida infections and 40-50% of cases of candidaemia
• Non-albicans Candida spp. include C. glabrata, C. parapsilosis, C. tropicalis, C. krusei, C. auris, C. lusitaniae, C. guilliermondii, C. dubliniensis
• There has been a noticeable increase in non-albicans Candida spp. causing infection in recent years → C. glabrata now accounts for 28% of candidaemia in England and C. parapsilosis 12%
• Invasive candidiasis is associated with high mortality: 10-47% for candidaemia and > 50% for endocarditis

Taxonomy

Epidemiology

• Candida spp., and species previously in the genus Candida, are common commensal organisms of human skin and GI tract
• Candida spp. cause opportunistic infection in the context immunocompromise, antibiotic usage or other factors that promote Candida growth
• Invasive disease usually occurs in the context of disrupted cutaneous or GI barriers (CVC, mucositis, GI surgery)
• Whilst colonisation is generally considered a pre-requisite for Candida infection, a number of non-albicans Candida spp. have been isolated from the environment and exogenous infections may also occur - this is particularly true for C. auris (see below)
• C. albicans is the most common species to cause human disease (both superficial and invasive)
• Infections caused by non-albicans Candida spp. are rising - prevalence of these varies geographically and is likely linked to antifungal usage trends and patient risk factors
• The 4 main non-albicans pathogens are C. glabrata, C. parapsilosis, C. tropicalis and C. krusei. C dubliniensis or C lusitaniae becoming more common
• In England, C. albicans accounts for 39% of candidaemia*, C. glabrata* 28% and C. parapsilosis 12% (UKHSA 2022 data)

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European Confederation of Medical Mycology (ECMM) are currently recruiting to the Candida IV study. This multicentre study is focusing on non-albicans Candida species causing candidaemia and aims to investigate antifungal resistance and clinical outcomes of these infections.

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