Skip to main content

Advertisement

Log in

Epidemiological Attributes of Candida Species in Tropical Regions

  • Tropical Mycoses (L Martinez, Section Editor)
  • Published:
Current Tropical Medicine Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Global burden associated with the growing incidence of fungal infections poses as a serious threat especially in developing countries. Several local surveillance programs have already been established to follow the epidemiological characteristics of Candida infections; however, these programs often only focused on broadly researched regions, like Europe, North America, and certain Asian countries. Therefore, the need to evaluate epidemiological data is high in less studied regions, for example in the tropical climate zone countries, especially since the number of fungal infections is generally described to be higher in these locations.

Recent Findings

C. albicans is still the most often isolated pathogenic species, in the Candida genus; however, the importance of other NAC (non-albicans Candida species) is increasing. Distributions of frequently isolated Candida species known to differ according to climate zones. For instance, Northern Europe and the USA generally report C. glabrata as the most prominent NAC species, while C. tropicalis-associated infections are more common in tropical regions.

Summary

Current epidemiological data from tropic regions highlights the importance to study Candida-associated fungal infections in these locations, since besides the most common pathogens, emerging species like C. auris appearing to become more frequently isolated.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Bongomin F, Gago S, Oladele RO, Denning DW. Global and multi-national prevalence of fungal diseases—estimate precision. J Fungi. 2017;3.

  2. Global tuberculosis report 2019. Geneva: World Health Organization; 2019. Licence: CC BY-NC-SA 3.0 IGO.

  3. World malaria report 2019. Geneva: World Health Organization; 2019. Licence: CC BY-NC-SA 3.0 IGO.

  4. Lamoth F, Lockhart SR, Berkow EL, Calandra T. Changes in the epidemiological landscape of invasive candidiasis. J Antimicrob Chemother. 2018;73:i4–13.

    Article  CAS  PubMed  Google Scholar 

  5. Kaur H, Chakrabarti A. Strategies to reduce mortality in adult and neonatal candidemia in developing countries. J Fungi. 2017;3.

  6. Pfaller MA, Diekema DJ. Epidemiology of invasive candidiasis: a persistent public health problem. Clin Microbiol Rev. 2007;20:133–63.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. del Rocio Reyes-Montes M, Duarte-Escalante E, Martínez-Herrera E, Acosta-Altamirano G, Frías-De León MG. Current status of the etiology of candidiasis in Mexico. Rev Iberoam Micol [Internet]. Asociación Española de Micología; 2017;34:203–210. Available from: https://doi.org/10.1016/j.riam.2017.05.001.

  8. Özenci V, Klingspor L, Ullberg M, Chryssanthou E, Denning DW, Kondori N. Estimated burden of fungal infections in Sweden. Mycoses. 2019;62:1043–8.

    Article  PubMed  Google Scholar 

  9. Giacobbe DR, Maraolo AE, Simeon V, Magnè F, Pace MC, Gentile I, et al. Changes in the relative prevalence of candidaemia due to non-albicans Candida species in adult in-patients: a systematic review, meta-analysis and meta-regression. Mycoses. 2020;63:334–42.

    Article  PubMed  Google Scholar 

  10. Megri Y, Arastehfar A, Boekhout T, Daneshnia F, Hörtnagl C, Sartori B, et al. Candida tropicalis is the most prevalent yeast species causing candidemia in Algeria: the urgent need for antifungal stewardship and infection control measures. Antimicrob Resist Infect Control. 2020;9:1–10.

    Article  Google Scholar 

  11. Aldardeer NF, Albar H, Al-Attas M, Eldali A, Qutub M, Hassanien A, et al. Antifungal resistance in patients with Candidaemia: a retrospective cohort study. BMC Infect Dis. 2020;20:1–7.

    Article  Google Scholar 

  12. Van Schalkwyk E, Mpembe RS, Thomas J, Shuping L, Ismail H, Lowman W, et al. Epidemiologic shift in Candidemia driven by Candida auris, South Africa, 2016-2017. Emerg Infect Dis. 2019;25:1698–707.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Kabir MA, Ahmad Z. Candida infections and their prevention. ISRN Prev Med. 2013;2013:1–13.

    Article  Google Scholar 

  14. Kullberg BJ, Arendrup MC. Invasive candidiasis. Campion EW, editor. N Engl J Med [Internet]. 2015;373:1445–1456. Available from: https://doi.org/10.1056/NEJMra1315399

  15. Pappas PG, Lionakis MS, Arendrup MC, Ostrosky-Zeichner L, Kullberg BJ. Invasive candidiasis. Nat Rev Dis Prim [Internet]. Macmillan Publishers Limited; 2018;4:18026. Available from: https://doi.org/10.1038/nrdp.2018.26.

  16. Bhattacharya S, Sae-Tia S, Fries BC. Candidiasis and mechanisms of antifungal resistance. Antibiotics [Internet]. 2020;9:312 Available from: https://www.mdpi.com/2079-6382/9/6/312.

    Article  CAS  Google Scholar 

  17. Plantinga TS, Johnson MD, Scott WK, Joosten LAB, Van Der Meer JWM, Perfect JR, et al. Human genetic susceptibility to Candida infections. Med Mycol. 2012;87:785–94.

    Article  Google Scholar 

  18. Trofa D, Gácser A, Nosanchuk JD. Candida parapsilosis, an emerging fungal pathogen. Clin Microbiol Rev [Internet]. American Society for Microbiology; 2008 [cited 2018 Apr 8];21:606–625. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18854483.

  19. Zaoutis TE, Heydon K, Localio R, Walsh TJ, Feudtner C. Outcomes attributable to neonatal candidiasis. Clin Infect Dis. 2007;44:1187–93.

    Article  PubMed  Google Scholar 

  20. Stoll BJ, Hansen NI, Adams-Chapman I, Fanaroff AA, Hintz SR, Vohr B, et al. Neurodevelopmental and growth impairment among extremely low-birth-weight infants with neonatal infection. J Am Med Assoc. 2004;292:2357–65.

    Article  CAS  Google Scholar 

  21. Pammi M, Holland L, Butler G, Gacser A, Bliss JM. Candida parapsilosis is a significant neonatal pathogen. Pediatr Infect Dis J. 2013;32:e206–16.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Lerma A, Cantero E, Soriano M, Orden B, Muñez E, Ramos-Martinez A. Clinical presentation of candidaemia in elderly patients: experience in a single institution. Rev Esp Quimioter [Internet]. 2017;30:207–12 Available from: http://www.ncbi.nlm.nih.gov/pubmed/28361527.

    CAS  Google Scholar 

  23. Bal AM, Palchaudhuri M. Candidaemia in the elderly: epidemiology, management and adherence to the European Confederation of Medical Mycology quality indicators. Mycoses. 2020:0–2.

  24. Papp C, Bohner F, Kocsis K, Varga M, Szekeres A, Bodai L, et al. Triazole evolution of Candida parapsilosis results in cross-resistance to other antifungal drugs, influences stress responses, and alters virulence in an antifungal drug-dependent manner. Mitchell AP, editor. mSphere [Internet]. 2020;5:1–15. Available from: https://msphere.asm.org/content/5/5/e00821-20.

  25. Rodrigues CF, Silva S, Henriques M. Candida glabrata: a review of its features and resistance. Eur J Clin Microbiol Infect Dis. 2014;33:673–88.

    Article  CAS  PubMed  Google Scholar 

  26. Pfaller MA, Diekema DJ, Turnidge JD, Castanheira M, Jones RN. Twenty years of the SENTRY antifungal surveillance program: results for Candida species from 1997–2016. Open Forum Infect Dis [Internet]. 2019;6:S79–94 Available from: https://www.jmilabs.com/data/posters/ECCMID2018-SENTRY20-Candida.pdf.

    Article  Google Scholar 

  27. Turner SA, Butler G. The Candida pathogenic species complex. Cold Spring Harb Perspect Med [Internet] 2014;4:a019778–a019778. Available from: https://doi.org/10.1101/cshperspect.a019778.

  28. Silva S, Negri M, Henriques M, Oliveira R, Williams DW, Azeredo J. Candida glabrata, Candida parapsilosis and Candida tropicalis: biology, epidemiology, pathogenicity and antifungal resistance. FEMS Microbiol Rev. 2012;36:288–305.

    Article  CAS  PubMed  Google Scholar 

  29. Ko JH, Jung DS, Lee JY, Kim HA, Ryu SY, Jung SI, et al. Poor prognosis of Candida tropicalis among non-albicans candidemia: a retrospective multicenter cohort study, Korea. Diagn Microbiol Infect Dis [Internet]. Elsevier Inc.; 2019;95:195–200. Available from: https://doi.org/10.1016/j.diagmicrobio.2019.05.017.

  30. Jamiu AT, Albertyn J, Sebolai OM, Pohl CH. Update on Candida krusei, a potential multidrug-resistant pathogen. Med Mycol. 2020:1–17.

  31. Nucci M, Queiroz-Telles F, Alvarado-Matute T, Tiraboschi IN, Cortes J, Zurita J, et al. Epidemiology of Candidemia in Latin America: a laboratory-based survey. PLoS One. 2013;8:e59373.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Guinea J. Global trends in the distribution of Candida species causing candidemia. Clin Microbiol Infect [Internet]. European Society of Clinical Infectious Diseases; 2014;20:5–10. Available from: https://doi.org/10.1111/1469-0691.12539.

  33. Hesstvedt L, Arendrup MC, Poikonen E, Klingpor L, Friman V, Nordøy I, et al. Differences in epidemiology of candidaemia in the Nordic countries – what is to blame? Mycoses. 2017;60:11–9.

    Article  CAS  PubMed  Google Scholar 

  34. Vallabhaneni S, Cleveland AA, Farley MM, Harrison LH, Schaffner W, Beldavs ZG, et al. Epidemiology and risk factors for echinocandin nonsusceptible Candida glabrata bloodstream infections: data from a large multisite population-based Candidemia surveillance program, 2008–2014. Open Forum Infect Dis [Internet]. 2015;2:2633851. Available from: https://doi.org/10.1093/ofid/ofv163/2460544.

  35. Pfaller MA, Jones RN, Doern GV, Fluit AC, Verhoef J, Sader HS, et al. International surveillance of blood stream infections due to Candida species in the European SENTRY program: species distribution and antifungal susceptibility including the investigational triazole and echinocandin agents. Diagn Microbiol Infect Dis. 1999;35:19–25.

    Article  CAS  PubMed  Google Scholar 

  36. Garcia-Jeldes F, Mitchell R, Bharat A, Mcgeer A. Preparedness for Candida auris in Canadian Nosocomial Infection Surveillance Program (CNISP) hospitals, 2018. Infect Control Hosp Epidemiol. 2020;41:361–4.

    Article  PubMed  Google Scholar 

  37. Lin SY, Lu PL, Tan BH, Chakrabarti A, Wu UI, Yang JH, et al. The epidemiology of non-Candida yeast isolated from blood: the Asia surveillance study. Mycoses. 2019;62:112–20.

    Article  CAS  PubMed  Google Scholar 

  38. Jajoo M, Manchanda V, Chaurasia S, Jeeva Sankar M, Gautam H, Agarwal R, et al. Alarming rates of antimicrobial resistance and fungal sepsis in outborn neonates in North India. PLoS One. 2018;13:1–16.

    Article  Google Scholar 

  39. De Sousa Da Silva AMP, De Moraes-Pinto MI, Teofilo Pignati L, Barbosa Teixeira B, Cordeiro Lima AP, Costa Pimentel Germano P, et al. Candida spp bloodstream infections in a latin american pediatric oncology reference center: epidemiology and associated factors. Mycoses. 2020:1–11.

  40. Bignoumba M, Onanga R, Bivigou Mboumba B, Gafou A, Mouanga Ndzime Y, Lendamba RW, et al. Vulvovaginal candidiasis among symptomatic women of childbearing age attended at a Medical Analysis Laboratory in Franceville, Gabon. J Mycol Med [Internet]. Elsevier Masson SAS; 2019;29:317–319. Available from: https://doi.org/10.1016/j.mycmed.2019.100895.

  41. Durga CS, Gupta N, Soneja M, Bhatt M, Xess I, Jorwal P, et al. Invasive fungal infections in critically ill patients: a prospective study from a tertiary care hospital in India. Drug Discov Ther. 2018;12:363–7.

    Article  PubMed  Google Scholar 

  42. Siciliano RF, Gualandro DM, Sejas ONE, Ignoto BG, Caramelli B, Mansur AJ, et al. Outcomes in patients with fungal endocarditis: a multicenter observational cohort study. Int J Infect Dis [Internet]; 2018;77:48–52. Available from: https://doi.org/10.1016/j.ijid.2018.09.016.

  43. Hoarau G, Picot S, Lemant J, Peytral J, Poubeau P, Zunic P, et al. Candidemia in the intensive care unit: a 12-year retrospective cohort study in Reunion Island. Med Mal Infect [Internet]. Elsevier Masson SAS; 2018;48:414–418. Available from: https://doi.org/10.1016/j.medmal.2018.04.392.

  44. Ortiz B, Pérez-Alemán E, Galo C, Fontecha G. Molecular identification of Candida species from urinary infections in Honduras. Rev Iberoam Micol [Internet]. Asociación Española de Micología; 2018;35:73–77. Available from: https://doi.org/10.1016/j.riam.2017.07.003.

  45. Camplesi Junior M, Silva HM, Arantes AM, Costa CR, Ataides FS, Silva TC, et al. Invasive fungal infection in patients with hematologic disorders in a Brazilian tertiary care hospital. Rev Soc Bras Med Trop. 2017;50:80–5.

    Article  Google Scholar 

  46. Alves PGV, Melo SGO, de Souza Bessa MA, de Oliveira Brito M, de Paula Menezes R, de Araújo LB, et al. Risk factors associated with mortality among patients who had candidemia in a university hospital. Rev Soc Bras Med Trop [Internet]. 2020;53:3–7 Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822020000100645&tlng=en.

    Google Scholar 

  47. Braga PR, Cruz IL, Ortiz I, Barreiros G, Nouér SA, Nucci M. Secular trends of candidemia at a Brazilian tertiary care teaching hospital. Braz J Infect Dis [Internet]. Elsevier Ltd; 2018;22:273–277. Available from: https://doi.org/10.1016/j.bjid.2018.07.008.

  48. Armstrong PA, Rivera SM, Escandon P, Caceres DH, Chow N, Stuckey MJ, et al. Hospital-associated multicenter outbreak of emerging fungus Candida auris, Colombia, 2016. Emerg Infect Dis [Internet]. 2019;25:1339–46 Available from: http://wwwnc.cdc.gov/eid/article/25/7/18-0491_article.htm.

    Google Scholar 

  49. Qiao GL, Ling J, Wong T, Yeung SN, Iovieno A. Candida keratitis. Cornea [Internet] 2020;39:801–805. Available from: https://doi.org/10.1097/ICO.0000000000002306.

  50. Leck AK, Thomas PA, Hagan M, Kaliamurthy J, Ackuaku E, John M, et al. Aetiology of suppurative corneal ulcers in Ghana and South India, and epidemiology of fungal keratitis. Br J Ophthalmol [Internet]. 2002;86:1211–5 Available from: www.bjophthalmol.com.

    Article  CAS  Google Scholar 

  51. Shi Y, Zhu Y, Fan S, Liu X, Liang Y, Shan Y. Molecular identification and antifungal susceptibility profile of yeast from vulvovaginal candidiasis. BMC Infect Dis. 2020;20:1–10.

    Article  CAS  Google Scholar 

  52. Bitew A, Abebaw Y. Vulvovaginal candidiasis: species distribution of Candida and their antifungal susceptibility pattern. BMC Womens Health. 2018;18:1–10.

    Article  Google Scholar 

  53. Zeng ZR, Tian G, Ding YH, Yang K, Liu JB, Deng J. Surveillance study of the prevalence, species distribution, antifungal susceptibility, risk factors and mortality of invasive candidiasis in a tertiary teaching hospital in Southwest China. BMC Infect Dis. 2019;19:1–12.

    Article  Google Scholar 

  54. • Doi AM, Pignatari ACC, Edmond MB, Marra AR, Camargo LFA, Siqueira RA, et al. Epidemiology and microbiologic characterization of nosocomial candidemia from a Brazilian national surveillance program. PLoS One. 2016;11:1–9 Broad multiregional epidemiological study from Brazil, processing candidaemia data from 16 hospitals. This study highlights the importance of non-albicans species, while it reports remarkably high mortality.

    Article  Google Scholar 

  55. Vieira de Melo AP, Zuza-Alves DL, da Silva-Rocha WP, Ferreira Canário de Souza LB, Francisco EC, Salles de Azevedo Melo A, et al. Virulence factors of Candida spp. obtained from blood cultures of patients with candidemia attended at tertiary hospitals in Northeast Brazil. J Mycol Med. 2019;29:132–9.

    Article  CAS  PubMed  Google Scholar 

  56. Breda GL, Tuon FF, Meis JF, Herkert PF, Hagen F, de Oliveira LZ, et al. Breakthrough candidemia after the introduction of broad spectrum antifungal agents: a 5-year retrospective study. Med Mycol. 2018;56:406–15.

    Article  PubMed  Google Scholar 

  57. • Canela HMS, Cardoso B, Vitali LH, Coelho HC, Martinez R, de Silva Ferreira ME. Prevalence, virulence factors and antifungal susceptibility of Candida spp. isolated from bloodstream infections in a tertiary care hospital in Brazil. Mycoses. 2018;61:11–21 Study from Brazil found C. glabrata as the second most commonly isolated Candida species raising awareness to the emergence of this frequently antifungal resistant pathogen.

    Article  CAS  PubMed  Google Scholar 

  58. Berrio I, Maldonado N, De Bedout C, Arango K, Cano LE, Valencia Y, et al. Comparative study of Candida spp. isolates: identification and echinocandin susceptibility in isolates obtained from blood cultures in 15 hospitals in Medellín, Colombia. J Glob Antimicrob Resist. 2018;13:254–60.

    Article  PubMed  Google Scholar 

  59. Motoa G, Muñoz JS, Oñate J, Pallares CJ, Hernández C, Villegas MV. Epidemiología de aislamientos de Candida en unidades de cuidados intensivos en Colombia durante el período 2010–2013. Rev Iberoam Micol. 2017;34:17–22.

    Article  PubMed  Google Scholar 

  60. Kumar A, Nair R, Kumar M, Banerjee A, Chakrabarti A, Rudramurthy SM, et al. Assessment of antifungal resistance and associated molecular mechanism in Candida albicans isolates from different cohorts of patients in North Indian state of Haryana. Folia Microbiol (Praha). 2020.

  61. Gaona-Flores VA, Campos-Navarro L, Cervantes-Tovar R, Alcalá-Martínez E. The epidemiology of fungemia in an infectious diseases hospital in Mexico City: a 10-year retrospective review. Med Mycol. 2016;54:600–4.

    Article  PubMed  Google Scholar 

  62. Rodriguez L, Bustamante B, Huaroto L, Agurto C, Illescas R, Ramirez R, et al. A multi-centric study of Candida bloodstream infection in Lima-Callao, Peru: species distribution, antifungal resistance and clinical outcomes. PLoS One. 2017;12:1–12.

    Article  CAS  Google Scholar 

  63. Bac ND, Anh LT, Quang LB, Luc NK, Nga TTT, Nagi M, et al. Prevalence of Candida bloodstream isolates from patients in two hospitals in Vietnam. Iran J Microbiol. 2019;11:108–13.

    PubMed  PubMed Central  Google Scholar 

  64. Ng KP, Kuan CS, Kaur H, Na SL, Atiya N, Velayuthan RD. Candida species epidemiology 2000–2013: a laboratory-based report. Trop Med Int Health. 2015;20:1447–53.

    Article  CAS  PubMed  Google Scholar 

  65. •• Mathur P, Hasan F, Singh PK, Malhotra R, Walia K, Chowdhary A. Five-year profile of candidaemia at an Indian trauma centre: high rates of Candida auris blood stream infections. Mycoses. 2018;61:674–80 Study from India underlines the importance of correct species identification, since this study recognizes the often misidentified novel fungal pathogen, C. auris as one of the most commonly isolated species.

    Article  CAS  PubMed  Google Scholar 

  66. de Medeiros MAP, de Melo APV, de Oliveira Bento A, de Souza LBFC, de Assis Bezerra Neto F, Garcia JB-L, et al. Epidemiology and prognostic factors of nosocomial candidemia in Northeast Brazil: a six-year retrospective study. Crivellari M, editor. PLoS One [Internet]. 2019;14:e0221033. Available from: http://wwwnc.cdc.gov/eid/article/25/9/19-0520_article.htm

  67. Powell HL, Sand CA, Rennie RP. Evaluation of CHROMagar Candida for presumptive identification of clinically important Candida species. Diagn Microbiol Infect Dis. 1998;32:201–4.

    Article  CAS  PubMed  Google Scholar 

  68. Forsberg K, Woodworth K, Walters M, Berkow EL, Jackson B, Chiller T, et al. Candida auris: the recent emergence of a multidrug-resistant fungal pathogen. Med Mycol [Internet]. 2018;1–12. Available from: https://doi.org/10.1093/mmy/myy054/5062854.

  69. Hata DJ, Humphries R, Lockhart SR. Candida auris: an emerging yeast pathogen posing distinct challenges for laboratory diagnostics, treatment, and infection prevention. Arch Pathol Lab Med [Internet] 2020;144:107–114. Available from: https://doi.org/10.5858/arpa.2018-0508-RA.

  70. Chowdhary A, Sharma C, Meis JF. Candida auris: a rapidly emerging cause of hospital-acquired multidrug-resistant fungal infections globally. Hogan DA, editor. PLOS Pathog [Internet]. 2017;13:e1006290. Available from: https://doi.org/10.1371/journal.ppat.1006290.

  71. Pfaller MA, Castanheira M. Nosocomial candidiasis: antifungal stewardship and the importance of rapid diagnosis. Med Mycol. 2016;54:1–22.

    PubMed  Google Scholar 

  72. Pagano L, Caira M, Candoni A, Offidani M, Fianchi L, Martino B, et al. The epidemiology of fungal infections in patients with hematologic malignancies: the SEIFEM-2004 study. Haematologica [Internet]. 2006;91:1068–75 Available from: http://www.ncbi.nlm.nih.gov/pubmed/16885047.

    Google Scholar 

  73. Cristina F, Maranhão DA, Maria D, Silva W. Mycoses in northeastern Brazil : epidemiology and prevalence of fungal species in 8 years of retrospective analysis in Alagoas. Braz J Microbiol. 2019:969–78.

  74. Heidrich D, Stopiglia CDO, Magagnin CM, Daboit TC, Vettorato G, Amaro TG, et al. Sixteen years of dermatomycosis caused by Candida spp. in the metropolitan area of Porto Alegre, Southern Brazil. Rev Inst Med Trop Sao Paulo. 2016;58.

  75. Sampaio Camargo TZ, Marra AR, Silva CV, Cardoso MFS, Martino MDV, Camargo LFA, et al. Secular trends of candidemia in a tertiary care hospital. Am J Infect Control. 2010;38:546–51.

    Article  PubMed  Google Scholar 

  76. Hoffmann-Santos HD, Paula CR, Yamamoto ACA, Tadano T, Hahn RC. Six-year trend analysis of nosocomial Candidemia and risk factors in two intensive care hospitals in Mato Grosso, Midwest Region of Brazil. Mycopathologia. 2013;176:409–15.

    Article  PubMed  Google Scholar 

  77. Tufa TB, Denning DW. The burden of fungal infections in Ethiopia. J Fungi. 2019;5:1–14.

    Article  Google Scholar 

  78. de J Treviño-Rangel R, Peña-López CD, Hernández-Rodríguez PA, Beltrán-Santiago D, González GM. Association between Candida biofilm-forming bloodstream isolates and the clinical evolution in patients with candidemia: an observational nine-year single center study in Mexico. Rev Iberoam Micol. 2018;35:11–6.

    Article  Google Scholar 

  79. Poissy J, Damonti L, Bignon A, Khanna N, Von Kietzell M, Boggian K, et al. Risk factors for candidemia: a prospective matched case-control study. Crit Care. 2020;24:1–11.

    Article  Google Scholar 

Download references

Acknowledgments

We owe gratitude to Joshua D. Nosanchuk for improving the manuscript.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Attila Gacser.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Tropical Mycoses

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bohner, F., Gacser, A. & Toth, R. Epidemiological Attributes of Candida Species in Tropical Regions. Curr Trop Med Rep 8, 59–68 (2021). https://doi.org/10.1007/s40475-021-00226-5

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40475-021-00226-5

Keywords

Navigation