Advertisement

Candida: Friend and Foe of Humans

  • Priyanka Bhakt
  • Anamika Battu
  • Rupinder KaurEmail author
Chapter

Abstract

Opportunistic fungal infections pose a serious public health challenge. Candida species are the most common cause of hospital-acquired bloodstream fungal infections and are associated with a mortality rate of about 40%. Majority of these infections are caused by the yeast Candida albicans, which lives in the mouth, intestines, and urinary and reproductive tracts in healthy individuals but causes various infections in patients with weakened immune systems. C. albicans, which is multimorphic in nature, has no known terrestrial life cycle. The spectrum of diseases caused by C. albicans includes superficial infections of the skin (thrush), vagina (yeast infections), mouth (oral thrush), and life-threatening bloodstream infections (candidemia). Candidemia, which is diagnosed by fungal culture of the blood, usually results in the multiple organ failure and patient death. Candida infections commonly arise from the microflora of the patient but can spread in health-care settings due to contaminated beds, medical equipment, surfaces, and hands of health-care workers. Recent global surveillance programs have revealed significant contribution of four other species of Candida, C. glabrata, C. tropicalis, C. parapsilosis, and C. krusei, to bloodstream Candida infections. We will discuss salient features and prevalence of Candida species, the spectrum of diseases caused, and their prevention, diagnosis, and treatment in this chapter.

Keywords

Antifungals Candida albicans Fungal infections Oral and vaginal thrush Sepsis 

Notes

Acknowledgments

We thank Reshma Chowdary Alokam for the help with confocal imaging. Research in RK laboratory is supported by the Wellcome Trust/DBT India Alliance Senior Fellowship [IA/S/15/1/501831] to RK, and grants from the Department of Biotechnology, Government of India [BT/PR7388/MED/29/650/2012 and BT/PR7123/BRB/10/1149/2012] to RK. PB is a recipient of Junior and Senior Fellowship sponsored by the University Grants Commission, New Delhi, India. AB is a recipient of Junior Fellowship sponsored by the Department of Biotechnology, Government of India.

References

  1. Achkar JM, Fries BC (2010) Candida infections of the genitourinary tract. Clin Microbiol Rev 23:253–273CrossRefGoogle Scholar
  2. Brown GD, Denning DW, Gow NA, Levitz SM, Netea MG, White TC (2012) Hidden killers: human fungal infections. Sci Transl Med 4:165rv13CrossRefGoogle Scholar
  3. Cassone A (2015) Vulvovaginal Candida albicans infections: pathogenesis, immunity and vaccine prospects. Br J Obstet Gynaecol 122:785–794CrossRefGoogle Scholar
  4. Chakrabarti A, Sood P, Rudramurthy SM, Chen S, Kaur H, Capoor M et al (2015) Incidence, characteristics and outcome of ICU-acquired candidemia in India. Intensive Care Med 41:285–295CrossRefGoogle Scholar
  5. Choi JH, Lee CG, Lim YJ, Kang HW, Lim CY, Choi JS (2013) Prevalence and risk factors of esophageal candidiasis in healthy individuals: a single center experience in Korea. Yonsei Med J 54:160–165CrossRefGoogle Scholar
  6. Chowdhary A, Sharma C, Meis JF (2017) Candida auris: a rapidly emerging cause of hospital-acquired multidrug-resistant fungal infections globally. PLoS Pathog 13:e1006290CrossRefGoogle Scholar
  7. Delaloye J, Calandra T (2014) Invasive candidiasis as a cause of sepsis in the critically ill patient. Virulence 5:161–169CrossRefGoogle Scholar
  8. Duina AA, Miller ME, Keeney JB (2014) Budding yeast for budding geneticists: a primer on the Saccharomyces cerevisiae model system. Genetics 197:33–48CrossRefGoogle Scholar
  9. Falagas ME, Roussos N, Vardakas KZ (2010) 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. Int J Infect Dis 14:e954–e966CrossRefGoogle Scholar
  10. Fisher JF, Sobel JD, Kauffman CA, Newman CA (2011) Candida urinary tract infections–treatment. Clin Infect Dis 52(Suppl. 6):S457–S466CrossRefGoogle Scholar
  11. Gabaldón T, Naranjo-Ortíz MA, Marcet-Houben M (2016) Evolutionary genomics of yeast pathogens in the Saccharomycotina. FEMS Yeast Res 16. pii: fow064Google Scholar
  12. Ghannoum MA, Rice LB (1999) Antifungal agents: mode of action, mechanisms of resistance, and correlation of these mechanisms with bacterial resistance. Clin Microbiol Rev 12:501–517CrossRefGoogle Scholar
  13. Goldman M, Cloud GA, Wade KD, Reboli AC, Fichtenbaum CJ, Hafner R et al (2005) A randomized study of the use of fluconazole in continuous versus episodic therapy in patients with advanced HIV infection and a history of oropharyngeal candidiasis: AIDS Clinical Trials Group Study 323/Mycoses Study Group Study 40. Clin Infect Dis 41:1473–1480CrossRefGoogle Scholar
  14. Hawksworth DL, Lücking R (2017) Fungal diversity revisited: 2.2 to 3.8 million species. Microbiol Spectr 5(4):1-17 (FUNK-0052–2016)Google Scholar
  15. Huffnagle GB, Noverr MC (2013) The emerging world of the fungal microbiome. Trends Microbiol 21:334–341CrossRefGoogle Scholar
  16. Kaur H, Chakrabarti A (2017) Strategies to reduce mortality in adult and neonatal candidemia in developing countries. J Fungi 3:41CrossRefGoogle Scholar
  17. Kliemann DA, Pasqualotto AC, Falavigna M, Giaretta T, Severo LC (2008) Candida esophagitis: species distribution and risk factors for infection. Rev Inst Med Trop Sao Paulo 50:261–263CrossRefGoogle Scholar
  18. Kumar V, Cheng SC, Johnson MD, Smeekens SP, Wojtowicz A, Giamarellos-Bourboulis E et al (2014) Immunochip SNP array identifies novel genetic variants conferring susceptibility to candidaemia. Nat Commun 5:4675CrossRefGoogle Scholar
  19. Lewis RE (2011) Current concepts in antifungal pharmacology. Mayo Clin Proc 86:805–817CrossRefGoogle Scholar
  20. Marie C, White TC (2009) Genetic basis of antifungal drug resistance. Curr Fungal Infect Rep 3:163–169CrossRefGoogle Scholar
  21. Mery A, Sendid B, François N, Cornu M, Poissy J, Guerardel Y et al (2016) Application of mass spectrometry technology to early diagnosis of invasive fungal infections. J Clin Microbiol 54:2786–2797CrossRefGoogle Scholar
  22. Mesa-Arango AC, Trevijano-Contador N, Román E, Sánchez-Fresneda R, Casas C, Herrero E et al (2014) The production of reactive oxygen species is a universal action mechanism of Amphotericin B against pathogenic yeasts and contributes to the fungicidal effect of this drug. Antimicrob Agents Chemother 58:6627–6638CrossRefGoogle Scholar
  23. Moran G, Coleman D, Sullivan D (2012) An introduction to the medically important Candida species. In: Calderone RA, Clancy CJ (eds) Candida and candidiasis. ASM Press, Washington, DC, pp 11–25Google Scholar
  24. Netea MG, Joosten LA, van der Meer JW, Kullberg BJ, van de Veerdonk FL (2015) Immune defence against Candida fungal infections. Nat Rev Immunol 15:630–642CrossRefGoogle Scholar
  25. Pappas PG, Kauffman CA, Andes DR, Clancy CJ, Marr KA, Ostrosky-Zeichner L et al (2016) Clinical practice guideline for the management of candidiasis: 2016 update by the Infectious Diseases Society of America. Clin Infect Dis 62:e1–e50CrossRefGoogle Scholar
  26. Perlin DS, Shor E, Zhao Y (2015) Update on antifungal drug resistance. Curr Clin Microbiol Rep 2:84–95CrossRefGoogle Scholar
  27. Pfaller MA, Diekema DJ (2007) Epidemiology of invasive candidiasis: a persistent public health problem. Clin Microbiol Rev 20:133–163CrossRefGoogle Scholar
  28. Pfaller MA, Castanheira M, Lockhart SR, Ahlquist AM, Messer SA, Jones RN (2012) Frequency of decreased susceptibility and resistance to echinocandins among fluconazole-resistant bloodstream isolates of Candida glabrata. J Clin Microbiol 50:1199–1203CrossRefGoogle Scholar
  29. Pfaller MA, Andes DR, Diekema DJ, Horn DL, Reboli AC, Rotstein C et al (2014) Epidemiology and outcomes of invasive candidiasis due to non-albicans species of Candida in 2,496 patients: data from the Prospective Antifungal Therapy (PATH) registry 2004–2008. PLoS One 9:e101510CrossRefGoogle Scholar
  30. Pfaller MA, Wolk DM, Lowery TJ (2016) T2MR and T2Candida: novel technology for the rapid diagnosis of candidemia and invasive candidiasis. Future Microbiol 11:103–117CrossRefGoogle Scholar
  31. Pianalto KM, Alspaugh AJ (2016) New horizons in antifungal therapy. J Fungi 2:26CrossRefGoogle Scholar
  32. Revankar SG, Sobel JD (2012) Mucosal candidiasis. In: Calderone RA, Clancy CJ (eds) Candida and candidiasis. ASM Press, Washington, DC, pp 419–427Google Scholar
  33. Sangeorzan JA, Bradley SF, He X, Zarins LT, Ridenour GL, Tiballi RN et al (1994) Epidemiology of oral candidiasis in HIV-infected patients: colonization, infection, treatment, and emergence of fluconazole resistance. Am J Med 97:339–346CrossRefGoogle Scholar
  34. Seed PC (2014) The human mycobiome. Cold Spring Harb Perspect Med 5:a019810CrossRefGoogle Scholar
  35. Silva S, Negri M, Henriques M, Oliveira R, Williams DW, Azeredo J (2012) Candida glabrata, Candida parapsilosis and Candida tropicalis: biology, epidemiology, pathogenicity and antifungal resistance. FEMS Microbiol Rev 36:288–305CrossRefGoogle Scholar
  36. Smeekens SP, van de Veerdonk FL, Kullberg BJ, Netea MG (2013) Genetic susceptibility to Candida infections. EMBO Mol Med 5:805–813CrossRefGoogle Scholar
  37. Sobel JD, Fisher JF, Kauffman CA, Newman CA (2011) Candida urinary tract infections – epidemiology. Clin Infect Dis 52(Suppl. 6):S433–S436CrossRefGoogle Scholar
  38. Stajich JE, Berbee ML, Blackwell M, Hibbett DS, James TY, Spatafora JW et al (2009) The fungi. Curr Biol 19:R840–R845CrossRefGoogle Scholar
  39. Takahashi Y, Nagata N, Shimbo T, Nishijima T, Watanabe K, Aoki T et al (2015) Long-term trends in esophageal candidiasis prevalence and associated risk factors with or without HIV infection: lessons from an endoscopic study of 80,219 patients. PLoS One 10:e0133589CrossRefGoogle Scholar
  40. Turner SA, Butler G (2014) The Candida pathogenic species complex. Cold Spring Harb Perspect Med 4:a019778CrossRefGoogle Scholar
  41. Vazquez JA (2010) Optimal management of oropharyngeal and esophageal candidiasis in patients living with HIV infection. HIV AIDS (Auckland, N.Z.) 2:89–101Google Scholar
  42. Williams D, Lewis M (2011) Pathogenesis and treatment of oral candidosis. J Oral Microbiol 3:5771CrossRefGoogle Scholar
  43. Wisplinghoff H, Bischoff T, Tallent SM, Seifert H, Wenzel RP, Edmond MB (2004) Nosocomial bloodstream infections in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study. Clin Infect Dis 39:309–317CrossRefGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  • Priyanka Bhakt
    • 1
    • 2
  • Anamika Battu
    • 1
    • 2
  • Rupinder Kaur
    • 1
    Email author
  1. 1.Laboratory of Fungal PathogenesisCentre for DNA Fingerprinting and DiagnosticsHyderabadIndia
  2. 2.Graduate StudiesManipal Academy of Higher EducationManipalIndia

Personalised recommendations