Updates in the epidemiology and management of candidemia and coinfection.

: In recent years, more and more studies have focused on the association between candidemia and infection (CDI), highlighting the risk of subsequent candidemia in patients with CDI. However, a more recent model focuses on the coinfection as a clinical entity in which candidemia could occur before or after the CDI episode. : In this review we analyzed the physiopathological mechanisms underlying the coinfection, both in case of candidemia preceding and following the CDI. We highlighted that gut alterations occurring during a CDI play a crucial role in the risk of subsequent candidemia. Moreover, we identified areas of interest about the management of coinfection and proposed answers to relevant clinical questions. : The evaluation of risk factors for candidemia in patients with CDI and the rational antibiotic use in patients with candidemia remain the most efficacious and cost-free instruments to optimally manage the coinfection. However, further studies are required to cover some unmet needs, such as the development of rapid diagnostic methods of candidemia and the use of new available drugs with minimal effect on the microbiome biodiversity in patients with CDI at high risk of fungemia.