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Issues and Concerns in the Management of Systemic Candidiasis

  • I. W. Fong
Chapter
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Part of the Emerging Infectious Diseases of the 21st Century book series (EIDC)

Abstract

Invasive candidiasis is the most common systemic fungal infection in hospitalized patients in the developed world, associated with a mortality of up to ≥40% even in patients treated with antifungals. It is a major cause of healthcare-associated or nosocomial infection induced by several Candida species; the most common species being Candida albicans, but the prevalence of the different species varies with geographical location and type of hospital practice. In some centers and countries there has been a shift in the frequency of non-C. albicans invasive disease with increased resistance to azoles such as fluconazole, the antifungal drug of choice in many countries and healthcare centers. Also there are increased reports of resistance to the newer class of antifungals, the echinocandins, which has replaced fluconazole as first choice in many guidelines and centers. Of major concern is the emergence of the novel multidrug resistant yeast, Candida auris, in the last 10 years that has been spreading globally with inter- and intra-hospital transmission. This chapter discusses the evidence to support guidelines recommendations for an echinocandin as initial therapy for invasive candidiasis over fluconazole.

Keywords

Invasive candidiasis Candida species Candida albicans Candidemia Candida auris C. tropicalis C. glabrata Fluconazole Echinocandins Amphotericin Empiric treatment Intensive care unit 

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© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • I. W. Fong
    • 1
  1. 1.St. Michael’s HospitalUniversity of TorontoTorontoCanada

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