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成人念珠菌血症和侵袭性念珠菌病综合综述:聚焦新兴多重耐药真菌

A Comprehensive Review of Candidemia and Invasive Candidiasis in Adults: Focus on the Emerging Multidrug-Resistant Fungus .

作者信息

Mallick Deobrat Chandra, Kaushik Nayanjyoti, Goyal Lokesh, Mallick Lipika, Singh Prabhat

机构信息

Christus Spohn Hospital Shoreline, 600 Elizabeth St, Corpus Christi, TX 78404, USA.

CHI Health Nebraska Heart Institute, 7440 S 91st, Lincon, NE 68526, USA.

出版信息

Diseases. 2025 Mar 24;13(4):93. doi: 10.3390/diseases13040093.

Abstract

Candidemia and invasive candidiasis represent critical healthcare-associated fungal infections that pose substantial challenges to medical systems worldwide. These conditions arise when fungi from the Candida genus infiltrate the bloodstream or deeper tissues, leading to a range of clinical manifestations. Among the various species, continues to hold its position as the most frequently encountered causative agent, largely due to its prevalence and adaptability within human hosts. However, it is far from the only significant player; other Candida species, such as , , and the particularly concerning , contribute significantly to the disease burden and exhibit varying dominance depending on geographic regions. The clinical presentation of these infections can differ widely, spanning from subtle, almost imperceptible symptoms in some patients to severe, life-threatening fulminant sepsis in others, often accompanied by alarmingly high mortality rates that underscore the urgency of effective management strategies. Several well-established risk factors predispose individuals to developing invasive candidiasis and candidemia. Breaches in the body's natural barriers-such as the skin (cutaneous) or the gastrointestinal (GI) tract-provide entry points for these opportunistic pathogens. Additionally, deficiencies in the host's immune responses, whether due to medical treatments, underlying diseases, or genetic predispositions, heighten vulnerability to infection. Among the diverse Candida species, has emerged as an especially troubling entity in recent years. This multidrug-resistant species is notorious for its resistance to standard antifungal therapies, which complicates treatment efforts and contributes to elevated morbidity and mortality rates. Its rapid global spread has positioned it as a formidable public health threat, prompting heightened surveillance and research into its behavior and control.

摘要

念珠菌血症和侵袭性念珠菌病是与医疗保健相关的严重真菌感染,给全球医疗系统带来了巨大挑战。当念珠菌属真菌侵入血液或更深层组织时,就会引发这些病症,导致一系列临床表现。在各种念珠菌物种中,[具体物种1]由于其在人类宿主中的普遍存在和适应性,仍然是最常遇到的致病因子。然而,它远不是唯一的重要病原体;其他念珠菌物种,如[具体物种2]、[具体物种3],尤其是令人担忧的[具体物种4],对疾病负担有重大贡献,并且根据地理区域表现出不同程度的优势。这些感染的临床表现差异很大,从一些患者轻微、几乎难以察觉的症状到另一些患者严重、危及生命的暴发性败血症,通常伴随着惊人的高死亡率,这凸显了有效管理策略的紧迫性。有几个已确定的风险因素使个体易患侵袭性念珠菌病和念珠菌血症。身体天然屏障的破坏,如皮肤(皮肤)或胃肠道(GI),为这些机会性病原体提供了入口。此外,宿主免疫反应的缺陷,无论是由于医疗治疗、基础疾病还是遗传易感性,都会增加感染的易感性。在各种念珠菌物种中,[具体物种4]近年来已成为一个特别麻烦的病原体。这种多重耐药物种因其对标准抗真菌治疗的耐药性而臭名昭著,这使治疗工作复杂化,并导致发病率和死亡率升高。它在全球的迅速传播使其成为一个巨大的公共卫生威胁,促使加强对其行为和控制的监测和研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8948/12026337/ff0644aca209/diseases-13-00093-g001.jpg

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