Chapter 1 : : What Should Clinicians and Scientists Be Talking About?

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is often described as an ''opportunistic'' pathogen. While has clearly coevolved with humans to persist on the mucosa and skin, disseminated candidiasis has only become common within the past 50 years, when advances in medical technology rendered patients susceptible to this disease. Animal models available to date have been extremely helpful and have generated fundamental knowledge regarding pathogenesis and treatment of disseminated candidiasis. However, for development of optimal prophylactic or therapeutic strategies, it will be necessary to increasingly study the pathogenesis and immunology of infections directly in humans. The simplest conceptual means to improve morbidity and mortality from disseminated candidiasis is to create more effective antifungal therapies. Given the considerable morbidity and mortality of disseminated candidiasis even with treatment, deployment of effective prophylactic strategies is highly desirable. Simply administering into the bloodstream does not necessarily result in established infection, because the reticuloendothelial system and neutrophils in normal mammalian hosts are so efficient at cleaning the blood of fungal burden. Indeed, elegant clinical studies have confirmed the role of pattern recognition receptor polymorphisms in predisposing to mucosal candidiasis or candidal colonization. The transmission dynamics, epidemiology, and ecology of in the nosocomial setting are understudied. New clinical strategies, such as de-escalation therapy, infection control strategies, are critically needed to improve our prevention and treatment of infections.

Citation: Spellberg B, Marr K, Filler S. 2012. : What Should Clinicians and Scientists Be Talking About?, p 1-8. In Calderone R, Clancy C (ed), and Candidiasis, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817176.ch1
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