Infection by Candida Parapsilosis Multifactorial Analysis of an Emerging Medical Problem

• Main Author: e Silva, Ana Teresa Pinto
• Format: Dissertation
• Language: English
• Published: ProQuest Dissertations & Theses 01-01-2012
• Subjects: Epidemiology; Medical equipment; Medicine; Mortality; Yeast
• ISBN: 9798383282441

Fungi have emerged as a major cause of human disease, particularly among immunocompromised patients and patients with serious underlying medical conditions [1], which has led to increased research in this area. Invasive candidosis now is widely recognized as an important public health problem, with considerable morbidity, mortality, and associated health care costs [2].Candidaspecies represent the fourth most common group of isolates from bloodstream infections in the United States; recent reports also suggest an increase of candidaemia in Europe [2-5].C. parapsilosis was first isolated from the stools of a patient with diarrhea in Puerto Rico in 1928 [6, 7]. The species was named Monilia parapsilosis to distinguish it from the more common isolate, Monilia psilosis, known today as C. albicans. In 1932, Monilia parapsilosiswas renamed Candida parapsilosis. C. parapsilosis cells display an oval, round, or cylindrical shape. The colonies, on Sabouraud dextrose agar, are white, creamy, shiny, and smooth or wrinkly. C. parapsilosis can exist in either a yeast shape or pseudohyphal form. C. parapsilosis is typically a commensal of the human skin, but is also a disease agent. Over the past decade, the incidence and clinical relevance of C. parapsilosishas increased. It is of special concern among critically ill neonates [8-10].Lodderomyces elongisporus was previously believed to be the teleomorph of C. parapsilosisdue to similarities between: (1) GC nuclear content; (2) conserved rRNA portions and (3) behavior in biochemical tests and substrate assimilation [11, 12]. Nowadays, they are considered distinct species, although very closely related [13-15]. This is an example of a masquerading species, becoming molecular identification and genotyping more needed in clinical practice. It is quite possible that there are a number of new yeast species in clinicalmaterial that cannot be distinguished phenotypically from a more common species; implicationscould arise due to distinct antifungal susceptibility patterns.Given the continued emergence of C. parapsilosis, comprehensive studies regarding itsepidemiology, virulence traits, clinical manifestations, genetics, and antimicrobial susceptibilityare needed.