Müller Valentina Laura, Kreuter Alexander, Uhrlaß Silke, Nenoff Pietro
Klinik für Dermatologie, Venerologie und Allergologie, Helios St. Johannes Klinikum Duisburg, Dieselstr. 185, 47166, Duisburg, Deutschland.
Klinik für Dermatologie, Venerologie und Allergologie, Helios St. Elisabeth Klinik Oberhausen, Universität Witten-Herdecke, Oberhausen, Deutschland.
Dermatologie (Heidelb). 2025 Jul 9. doi: 10.1007/s00105-025-05538-5.
Candida species are opportunistic yeasts that form part of the normal human microbiota. Under certain conditions, such as immunosuppression, alterations in the microbiota, or disruption of the skin barrier, these commensals may become pathogenic and lead to clinically relevant infection. Candida (C.) albicans plays a central role in skin and mucosal infections, while other species, such as Nakaseomyces (N.) glabratus (formerly known as Candida glabratus) and C. auris, are increasingly gaining clinical significance. The most common Candida infections affect the skin and mucosal membranes; however, under predisposing factors, the pathogen can enter the bloodstream, leading to septicemia with organ involvement. In this context, multidrug-resistant pathogens, particularly C. auris, pose an escalating threat to public health. Diagnosis of Candida species is generally performed using conventional microbiological techniques, including cultures and microscopy, as well as advanced molecular methods such as polymerase chain reaction (PCR) and matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS). Given the rising rates of resistance and the associated therapeutic challenges, accurate species identification and resistance profiling prior to antifungal treatment are critical. Preventive measures, especially for high-risk populations, are crucial to reduce the incidence of Candida infections. While many superficial Candida infections can be managed with hygiene practices and topical antifungal treatments, invasive candidiasis necessitates close collaboration between microbiology, pharmacology, and infectious disease specialists to ensure optimal patient care.
念珠菌属是机会性酵母菌，是人类正常微生物群的一部分。在某些情况下，如免疫抑制、微生物群改变或皮肤屏障破坏，这些共生菌可能会致病并导致临床相关感染。白色念珠菌在皮肤和黏膜感染中起核心作用，而其他菌种，如光滑念珠菌（现称为光滑纳卡酵母）和耳念珠菌，其临床意义也日益凸显。最常见的念珠菌感染影响皮肤和黏膜；然而，在易感因素作用下，病原体可进入血液，导致败血症并累及器官。在这种情况下，多重耐药病原体，尤其是耳念珠菌，对公共卫生构成了日益严重的威胁。念珠菌属的诊断通常使用传统微生物学技术，包括培养和显微镜检查，以及先进的分子方法，如聚合酶链反应（PCR）和基质辅助激光解吸电离飞行时间质谱（MALDI-TOF MS）。鉴于耐药率不断上升以及相关的治疗挑战，在抗真菌治疗前进行准确的菌种鉴定和耐药性分析至关重要。预防措施，特别是针对高危人群的措施，对于降低念珠菌感染发病率至关重要。虽然许多浅表念珠菌感染可以通过卫生措施和局部抗真菌治疗来控制，但侵袭性念珠菌病需要微生物学、药理学和传染病专家密切合作，以确保为患者提供最佳护理。
