Candida parapsilosis: epidemiology, pathogenicity, clinical manifestations, and antimicrobial susceptibility.

Early reports associated Candida parapsilosis with endocarditis in intravenous narcotic addicts. More recently, this species has emerged as an important nosocomial pathogen, with clinical manifestations including fungemia, endocarditis, endophthalmitis, septic arthritis, and peritonitis, all of which usually occur in association with invasive procedures or prosthetic devices. Outbreaks of C. parapsilosis infections have been caused by contamination of hyperalimentation solutions, intravascular pressure monitoring devices, and ophthalmic irrigating solution. Experimental studies have generally shown that C. parapsilosis is less virulent than Candida albicans or Candida tropicalis. However, characteristics of C. parapsilosis that may relate to its increasing occurrence in nosocomial settings include frequent colonization of the skin, particularly the subungual space, and an ability to proliferate in glucose-containing solutions, with a resultant increase in adherence to synthetic materials. Recently developed molecular techniques may facilitate the continued exploration of the epidemiology and pathogenesis of C. parapsilosis infections.