Candida: What Should Clinicians and Scientists Be Talking About?

Brad Spellberg; Kieren A. Marr; Scott G. Filler

doi:10.1128/9781555817176.ch1

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

Authors: Brad Spellberg¹, Kieren A. Marr³, Scott G. Filler⁴

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Affiliations: 1: David Geffen School of Medicine at UCLA, Los Angeles, CA 90095; 2: Division of General Internal Medicine, Los Angeles Biomedical Research Institute at Harbor-University of California Los Angeles (UCLA) Medical Center, Torrance, CA 90502; 3: Johns Hopkins University School of Medicine, Baltimore, MD 21205; 4: David Geffen School of Medicine at UCLA, Los Angeles, CA 90095; 5: Division of Infectious Diseases, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA 90502

Content Type: Monograph

Publication Year: 2012

Category: Fungi and Fungal Pathogenesis; Clinical Microbiology

Book DOI: 10.1128/9781555817176

Chapter DOI: 10.1128/9781555817176.ch1

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Abstract:

Candida is often described as an ''opportunistic'' pathogen. While Candida 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 Candida 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 Candida 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 Candida 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 Candida infections.

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

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