Diagnosis and treatment of invasive Candida infections – a review article

Marta Dąbrowska, Monika Sienkiewicz, Paweł Kwiatkowski, Michał Dąbrowski

Abstract


Candida albicans is the most common cause of fungal infections worldwide. Invasive candidiasis comprises candidemia and deep-seated candidiasis. Most yeast invasive infections are endogenous with a high mortality. Pathogenesis of candidiasis depends on avoiding host immune responses, as well as the virulence factors of the fungus enabling colonization and invasion of tissues. Adequate source control and antifungal therapy administered within a short time is critical to get a better prognosis. The emergence of drug resistance and the side effects of currently available antifungals are becoming the major problem in the management of Candida spp. infection.


Keywords


Candida spp., candidemia, invasive candidiasis, treatment, recommendation

Full Text:

PDF

References


Andes D.R., Safdar N., Baddley J.W., Playford G., Reboli A.C., Rex J.H., Sobel J.D., Pappas P.G., Kullberg B.J.; Mycoses Study Group. 2012. Mycoses Study Group. Impact of treatment strategy on outcomes in patients with candidemia and other forms of invasive candidiasis: a patient-level quantitative review of randomized trials. Clin. Infect. Dis. 54(8): 1110–1122.

Arendrup M.C., Dzajic E., Jensen R.H., Johansen H.K., Kjaeldgaard P., Knudsen J.D., Kristensen L., Leitz C., Lemming L.E., Nielsen L., Olesen B., Rosenvinge F.S., Røder B.L., Schønheyder H.C. 2013. Epidemiological changes with potential implication for antifungal prescription recommendations for fungaemia: data from a nationwide fungaemia surveillance programme. Clin. Microbiol. Infect. 19: E343–353. doi: 10.1111/1469-0691.12212.

Barchiesi F., Arzeni D., Caselli F., Scalise G. 2000. Primary resistance to flucytosine among clinical isolates of Candida spp. J. Antimicrob. Chemother. 45: 408–409.

Barchiesi F., Orsetti E., Gesuita R., Skrami E., Manso E. Candidemia Study Group. 2016. Epidemiology, clinical characteristics, and outcome of candidemia in a tertiary referral center in Italy from 2010 to 2014. Infection 44: 205–213.

Bassetti M., Marchetti M., Chakrabarti A., Colizza S., Garnacho-Montero J., Kett D.H., Munoz P., Cristini F., Andoniadou A., Viale P., Rocca G.D., Roilides E., Sganga G., Walsh T.J., Tascini C., Tumbarello M., Menichetti F., Righi E., Eckmann C., Viscoli C., Shorr A.F., Leroy O., Petrikos G., De Rosa F.G. 2013. A research agenda on the management of intra-abdominal candidiasis: results from a consensus of multinational experts. Intensive Care Med. 39(12): 2092–2106.

Berdal J.E., Haagensen R., Ranheim T., Bjørnholt J.V. 2014. Nosocomial Candidemia; Risk Factors and Prognosis Revisited; 11 Years Experience from a Norwegian Secondary Hospital. PLoS One. 9(7): e103916.

Block A.A., Thursky K.A., Worth L.J., Slavin M.A. 2009. Thrombolytic therapy for management of complicated catheter-related Candida albicans thrombophlebitis. Intern. Med. J. 39: 61–63.

Boogaerts M., Winston D.J., Bow E.J., Garber G., Reboli A.C., Schwarer A.P., Novitzky N., Boehme A., Chwetzoff E., De Beule K. Itraconazole Neutropenia Study. 2001. Intravenous and oral itraconazole versus intravenous amphotericin B deoxycholate as empirical antifungal therapy for persistent fever in neutropenic patients with cancer who are receiving broad-spectrum antibacterial therapy: a randomized, controlled trial. Ann. Intern. Med. 135: 412–422.

Cabrera A.G., Khan M.S., Morales D.L., Chen D.W., Moffett B.S., Price J.F., Dreyer W.J., Denfield S.W., Jeewa A., Fraser C.D. Jr, Vallejo J.G. 2013. Infectious complications and outcomes in children supported with left ventricular assist devices. J. Heart Lung Transplant. 32: 518–524.

Candel F.J., Pazos Pacheco C., Ruiz-Camps I., Maseda E., Sánchez-Benito M.R., Montero A., Puig M., Gilsanz F., Aguilar J., Matesanz M. 2017. Update on management of invasive candidiasis. Rev. Esp. Quimioter. 30(6): 397–406.

Card L, Lofland D. 2012. Candidal endocarditis presenting with bilateral lower limb ischemia. Clin. Lab. Sci. 25: 130–134.

Chen T.L., Chen H.P., Fung C.P., Lin M.Y., Yu K.W., Liu C.Y. 2004. Clinical characteristics, treatment and prognostic factors of candidal meningitis in a teaching hospital in Taiwan. Scand. J. Infect. Dis. 36: 124–130.

Clancy C.J., Nguyen M.H. 2013. Finding the “missing 50%” of invasive candidiasis: How nonculture diagnostics will improve understanding of disease spectrum and transform patient care. Clin. Infect. Dis. 56: 1284–1292.

Clinical Alert to U.S. Healthcare Facilities – June 2016 – Fungal Diseases | CDC. www.cdc. gov. Retrieved 2017-04-06.

De Castro N., Mazoyer E., Porcher R., Raffoux E., Suarez F., Ribaud P., Lortholary O., Molina J.M. 2012. Hepatosplenic candidiasis in the era of new antifungal drugs: a study in Paris 2000–2007. Clin. Microbiol. Infect. 18: E185–187.

Diekema D., Arbefeville S., Boyken L., Kroeger J., Pfaller M. 2012. The changing epidemiology of health care-associated candidemia over three decades. Diagn. Microbiol. Infect. Dis. 73: 45–48.

Durand M.L. 2017. Bacterial and Fungal Endophthalmitis. Clin. Microbiol. Rev. 30(3): 597–613.

Dzierżanowska D. 2006. Leki przeciwgrzybicze stosowane w leczeniu grzybic układowych. In: Zakażenia grzybicze – wybrane zagadnienia. a-Medica Press, Bielsko-Biała: 92–125.

Eileen P., Scully L.R., Baden J., Katz T. 2008. Fungal brain infections. Current Opinion in Neurology 21: 347–352.

Espinel-Ingroff A., Arendrup M., Cantón E., Cordoba S., Dannaoui E., García-Rodríguez J., Gonzalez G.M., Guarro J., Las-Flord C., Lackhard S.L., Martin-Mazuelos E., Meis J.F., Ostrovsky-Zeichner L., Pelaez T., St-Germain G., Turnidge J. 2016. Multicenter study of method-dependent epidemiological cutoff values for detection of resistance in Candida spp. and Aspergillus spp. to Amphotericin B and Echinocandins for the Etest agar diffusion method. Antimicrob Agents Chemother. 61(1): e01792-16.

Fennelly A.M., Slenker A.K., Murphy L.C., Moussouttas M., DeSimone J.A. 2013. Candida cerebral abscesses: a case report and review of the literature. Med. Mycol. 51: 779–784.

Fisher J.F., Kavanagh K., Sobel J.D., Kauffman C.A., Newman C.A. 2011.Candida urinary tract infection: pathogenesis. Clin. Infect. Dis. 52 (Suppl. 6): S437–351.

Gamaletsou M.N., Kontoyiannis D.P., Sipsas N.V., Moriyama B., Alexander E., Roilides E., Brause B., Walsh T.J. 2012. Candida osteomyelitis: analysis of 207 pediatric and adult cases (1970–2011). Clin. Infect. Dis. 55: 1338–1351.

Garczewska B., Kamińska W., Dzierżanowska D. 2008. Phenotype and genotype characterization of Candida albicans strains isolated from patients hospitalized at the Children’s Memorial Health Institute. Med. Dośw. Mikrobiol. 60: 231–241.

Gedik H., Simsek F., Kanturk A., Yildirmak T., Arica D., Aydin D., Demirel N., Yokuş O. 2014. Bloodstream infections in patients with hematological malignancies: which is more fatal – cancer or resistant pathogens? Ther. Clin. Risk Manag. 10: 743–752.

H irano R., Sakamoto Y., Kudo K., Ohnishi M. 2015. Retrospective analysis of mortality and Candida isolates of 75 patients with candidemia: a single hospital experience. Infect. Drug Resist. 8: 199–205.

H ot A., Maunoury C., Poiree S., Lanternier F., Viard J.P., Loulergue P., Coignard H., Bougnoux M.E., Suarez F., Rubio M.T., Mahlaoui N., Dupont B., Lecuit M., Faraggi M., Lortholary O. 2011. Diagnostic contribution of positron emission tomography with [18F] fluorodeoxyglucose for invasive fungal infections. Clin. Microbiol. Infect. 17: 409–417.

https://www.mp.pl/interna/chapter/B16.II.18.12.

Kaldau N.C., Brorson S., Jensen P.E., Schultz C., Arpi M. 2012. Bilateral polymicrobial osteomyelitis with Candida tropicalis and Candida krusei: a case report and an updated literature review. Int. J. Infect. Dis. 16: 16–22.

Kauffman C.A., Fisher J.F., Sobel J.D., Newman C.A. 2011. Candida urinary tract infections – diagnosis. Clin. Infect. Dis. 52 (Suppl. 6): S452–456.

Kauffman C.A., Vazquez J.A., Sobel J.D., Gallis H.A., McKinsey D.S., Karchmer A.W., Sugar A.M., Sharkey P.K., Wise G.J., Mangi R., Mosher A., Lee J.Y., Dismukes W.E. 2000. Prospective multicenter surveillance study of funguria in hospitalized patients. The National Institute for Allergy and Infectious Diseases (NIAID) Mycoses Study Group. Clin. Infect. Dis. 30: 14–18.

Kollef M., Micek S., Hampton N., Doherty J.A., Kumar A. 2012. Septic shock attributed to Candida infection: importance of empiric therapy and source control. Clin. Infect. Dis. 54: 1739–1746.

Krishnasamy P.V., Liby C. 3rd. 2010. Emphysematous pyelonephritis caused by Candida tropicalis. Am. J. Med. 123: e7–8.

Kullberg B.J., Arendrup M.C. 2015. Invasive candidiasis. The New England Journal of Medicine 373 (15): 1445–1456. doi: 10.1056/NEJMra1315399. ISSN 1533-4406.

Kullberg B.J., Sobel J.D., Ruhnke M., Pappas P.G., Viscoli C., Rex J.H., Cleary J.D., Rubinstein E., Church L.W., Brown J.M., Schlamm H.T., Oborska I.T., Hilton F., Hodges M.R. 2005. Voriconazole versus a regimen of amphotericin B followed by fluconazole for candidaemia in non-neutropenic patients: a randomised non-inferiority trial. Lancet 366: 1435–1442.

Lingappan A., Wykoff C.C., Albini T.A., Miller D., Pathengay A., Davis J.L., Flynn H.W. Jr. 2012. Endogenous fungal endophthalmitis: causative organisms, management strategies, and visual acuity outcomes. Am. J. Ophthalmol. 153: 162–166.

Lim C.S.Y., Rosli R., Seow H.F., Chong P.P. 2012. Candida and invasive candidiasis: back to basis. Eur. J. Clin. Microbiol. Infect. Dis. 31: 21–31.

Magill S.S., Edwards J.R., Bamberg W., Beldavs Z.G., Dumyati G., Kainer M.A., Lynfield R., Maloney M., McAllister-Hollod L., Nadle J., Ray S.M., Thompson D.L., Wilson L.E., Fridkin S.K. Emerging Infections Program Health Care-Associated Infections and Antimicrobial Use Prevalence Survey Team. 2014. Multistate point-prevalence survey of health care-associated infections. N. Engl. J. Med. 27; 370(13): 1198–1208.

Marchetti O., Bille J., Fluckiger U., Eggimann P., Ruef C., Garbino J., Calandra T., Glauser M.P., Täuber M.G., Pittet D. Fungal Infection Network of Switzerland. 2004. Fungal Infection Network of Switzerland. Epidemiology of candidaemia in Swiss tertiary care hospitals: secular trends 1991–2000. Clin. Infect. Dis.

Martino R., Viscoli C. 2005. Empirical antifungal therapy in patients with neutropenia and persistent or recurrent fever of unknown origin. B. J. Haematol. 132: 138–154.

Montagna M.T., De Giglio O., Napoli C., Lovero G., Caggiano G., Delia M., Pastore D., Santoro N., Specchia G. 2012. Invasive fungal infections in patients with hematologic malignancies (Aurora project): lights and shadows during 18-months surveillance. Int. J. Mol. Sci. 13: 774–787.

Montravers P., Lepape A., Dubreuil L., Gauzit R., Pean Y., Benchimol D., Dupont H. 2009. Clinical and microbiological profiles of community-acquired and nosocomial intra-abdominal infections: results of the French prospective, observational EBIIA study. J. Antimicrob. Chemother. 63: 785–794.

Montravers P., Leroy O., Eckmann C. 2015. Intra-abdominal candidiasis: it’s still a long way to get unquestionable data. Intensive Care Med. 41(9): 1682–1684.

Navalkele B.D., Revankar S., Chandrasekar P. 2017. Candida auris: a worrisome, globally emerging pathogen. Expert Review of Anti-Infective Therapy 15(9), 819–827.

Neofytos D., Huprikar S., Reboli A., Schuster M., Azie N., Franks B., Horn D. 2014. Treatment and outcomes of Candida osteomyelitis: review of 53 cases from the PATH Alliance(R) registry. Eur. J. Clin. Microbiol. Infect. Dis. 33: 135–141.

Nosari A.M., Caira M., Pioltelli M.L., Fanci R., Bonini A., Cattaneo C., Castagnola C., Capalbo S.F., De Fabritiis P., Mettivier V., Morselli M., Pastore D., Aversa F., Rossi G., Pagano L. Hema e-Chart Group Hema e-Chart registry of invasive fungal infections in haematological patients. 2013. Improved outcome in recent years in mould infections., Italy. Clin. Microbiol. Infect. 19(8): 757–762.

O’Brien D., Cotter M., Lim C.H., Sattar M.T., Smyth E., Fitzpatrick F. 2011. Candida parapsilosis meningitis associated with Gliadel (BCNU) wafer implants. Br. J. Neurosurg. 25: 289–291.

Ostrosky-Zeichner L., Kullberg B.J., Bow E.J., Hadley S., León C., Nucci M., Patterson T.F., Perfect J.R. 2011. Early treatment of candidemia in adults: a review. Med. Mycol. 49: 113–120.

Pappas P.G., Kauffman C.A., Andes D.R., Clancy C.J., Marr K.A., Ostrosky-Zeichner L., Reboli A.C., Schuster M.G., Vazquez J.A., Walsh T.J., Zaoutis T.E., Sobel J.D. 2016. Executive Summary: Clinical practice guideline for the management of candidiasis: 2016 Update by the Infectious Diseases Society of America. Clin. Infect. Dis. 62(4): 409–417.

Pappas P.G. Invasive candidiasis. 2006. Infect. Dis. Clin. North Am. 20(3): 485–506. 51. Pfaller M.A., Diekema D.J., Gibbs D.L., Newell V.A., Ellis D., Tullio V., Rodloff A., Fu W., Ling T.A.; Global Antifungal Surveillance Group. 2010. Results from the ARTEMIS DISK Global Antifungal Surveillance Study, 1997 to 2007: a 10.5-year analysis of susceptibilities of Candida species to fluconazole and voriconazole as determined by CLSI standardized disk diffusion. J. Clin. Microbiol. 48: 1366–1377.

Pfaller M.A., Diekema D.J. 2007. Epidemiology of invasive candidiasis: a persistent public health problem. Clin. Microbiol. Rev. 20: 133–163.

Puig-Asensio M.1, Pemán J., Zaragoza R., Garnacho-Montero J., Martín-Mazuelos E., Cuenca-Estrella M., Almirante B. Prospective Population Study on Candidemia in Spain (CANDIPOP) Project; Hospital Infection Study Group (GEIH); Medical Mycology Study Group (GEMICOMED) of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC); Spanish Network for Research in Infectious Diseases. 2014. Impact of therapeutic strategies on the prognosis of candidemia in the ICU. Crit. Care Med. 42(6): 1423–1432.

Rammaert B., Desjardins A., Lortholary O. 2012. New insights into hepatosplenic candidosis, a manifestation of chronic disseminated candidosis. Mycoses 55: e74–84.

Richardson M., Lass-Florl C. 2008. Changing epidemiology of systemic fungal infections. Clin. Microbiol. Infect. 14 (Suppl. 4): S5–24.

Sallam A., Taylor S.R., Khan A., McCluskey P., Lynn W.A., Manku K., Pacheco P.A., Lightman S. 2012. Factors determining visual outcome in endogenous Candida endophthalmitis. Retina 32: 1129–1134.

Satoh K., Makimura K., Hasumi Y., Nishiyama Y., Uchida K., Yamaguchi H. 2009. Candida auris sp. nov., a novel ascomycetous yeast isolated from the external ear canal of an inpatient in a Japanese hospital. Microbiol. Immunol. 53: 41–44. doi: 10.1111/j.1348-0421.2008.00083.x.

Shah C.P., McKey J., Spirn M.J., Maguire J. 2008. Ocular candidiasis: a review. Br. J. Ophthalmol. 92: 466–468.

Slavin M., van Hal S., Sorrell T.C., Lee A., Marriott D.J., Daveson K., Kennedy K., Hajkowicz K., Halliday C., Athan E., Bak N., Cheong E,. Heath C.H., Orla Morrissey C., Kidd S., Beresford R., Blyth C., Korman T.M., Owen Robinson J., Meyer W., Chen S.C.; Australia and New Zealand Mycoses Interest Group. 2015. Invasive infections due to filamentous fungi other than Aspergillus: Epidemiology and determinants of mortality. Clin. Microbiol. Infect. 21: 490 e491–10.

Sobel J.D., Fisher J.F., Kauffman C.A., Newman C.A. 2011. Candida urinary tract infections – epidemiology. Clin. Infect. Dis. 52 (Suppl. 6): S433–436.

Springer J., Chatterjee S. 2012. Candida albicans prosthetic shoulder joint infection in a patient with rheumatoid arthritis on multidrug therapy. J. Clin. Rheumatol. 18: 52–53.

Staniszewska M., Bondaryk M., Piłat J., Siennicka K., Madga U., Kurzątkowski W. 2012. Czynniki zjadliwości Candida albicans. Przegl. Epidemiol. 66: 629–633.

Tacke D., Koehler P., Cornely O.A. 2013. Fungal endocarditis. Curr. Opin. Infect. Dis. 26: 501–507.

Ueng S.W., Lee C.Y., Hu C.C., Hsieh P.H., Chang Y. 2013. What is the success of treatment of hip and knee candidal periprosthetic joint infection? Clin. Orthop. Relat. Res. 471: 3002–3009.

Walsh T.J., Teppler H., Donowitz G.R., Maertens J.A., Baden L.R., Dmoszynska A., Cornely O.A., Bourque M.R., Lupinacci R.J., Sable C.A., dePauw B.E. 2004. Caspofungin versus liposomal amphotericin B for empirical antifungal therapy in patients with persistent fever and neutropenia, N. Engl. J. Med. 351: 1391–1402.

Wisplinghoff H., Bischoff T., Tallent S.M., Seifert H., Wenzel R.P., Edmond M.B. 2004. Nosocomial bloodstream infections in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study. Clin. Infect. Dis. 39: 309–317.

Y apar N. 2014. Epidemiology and risk factors for invasive candidiasis. Therapeutics and clinical risk management. 10: 95–105. doi: 10.2147/TCRM.S40160. ISSN 1176-6336. PMC 3928396. PMID 24611015.

Y in M., Li C., Wu D., Wang H. 2016. Catheter removal does matter but should be individualized for patients with candidemia. Intern. Med. 55(15): 2133.




DOI: http://dx.doi.org/10.17951/c.2018.73.1.47-59
Date of publication: 2019-06-10 12:48:59
Date of submission: 2019-06-10 12:37:53


Statistics


Total abstract view - 2612
Downloads (from 2020-06-17) - PDF - 0

Indicators



Refbacks

  • There are currently no refbacks.


Copyright (c) 2019 Marta Dąbrowska, Monika Sienkiewicz, Paweł Kwiatkowski

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.