RT Book, Section
A1 Edwards, Jr., John E.
A2 Jameson, J. Larry
A2 Fauci, Anthony S.
A2 Kasper, Dennis L.
A2 Hauser, Stephen L.
A2 Longo, Dan L.
A2 Loscalzo, Joseph
SR Print(0)
ID 1159155115
T1 Candidiasis
T2 Harrison's Principles of Internal Medicine, 20e
YR 2018
FD 2018
PB McGraw-Hill Education
PP New York, NY
SN 9781259644016
LK accesspharmacy.mhmedical.com/content.aspx?aid=1159155115
RD 2024/04/19
AB The  genus  Candida  encompasses  >150  species,  only  a  few  of  which  cause  disease  in  humans.  With  rare  exceptions  (although  the  exceptions  are  increasing  in  number),  the  human  pathogens  are  C.  albicans,  C.  guilliermondii,  C.  krusei,  C.  parapsilosis,  C.  tropicalis,  C.  kefyr,  C.  lusitaniae,  C.  dubliniensis,  C.  glabrata,  and  C.  auris.  Ubiquitous  in  nature,  they  inhabit  the  gastrointestinal  tract  (including  the  mouth  and  oropharynx),  the  female  genital  tract,  and  the  skin.  Although  cases  of  candidiasis  have  been  described  since  antiquity  in  debilitated  patients,  the  advent  of  Candida  species  as  common  human  pathogens  dates  to  the  introduction  of  modern  therapeutic  approaches  that  suppress  normal  host-defense  mechanisms.  Of  these  relatively  recent  advances,  the  most  important  is  the  use  of  antibacterial  agents  that  alter  the  normal  human  microbiota  and  allow  nonbacterial  species  to  become  more  prevalent  in  the  commensal  flora.  With  the  introduction  of  antifungal  agents,  the  causes  of  Candida  infections  shifted  from  an  almost  complete  dominance  of  C.  albicans  to  the  common  involvement  of  C.  glabrata  and  the  other  species  listed  above.  The  non-albicans  species  now  account  for  approximately  half  of  all  cases  of  candidemia  and  hematogenously  disseminated  candidiasis.  Recognition  of  this  change  is  clinically  important,  since  the  various  species  differ  in  susceptibility  to  the  newer  antifungal  agents.