Candida Glabrata Species of Candida Most Commonly Isolated in Bloodstream Infections • Symptomatic mucosal infection is detected in oropharyngeal, esophageal, & vaginal candidiasis, in HIV/AIDS & other immune-compromised pts. • Candiduria is common with invasive catheters, DM, elderly, & debilitated under antibacterial medications. • 20% of all urinary yeast infections. • Serious infections include rare cases of endocarditis, meningitis, & disseminated infections (fungemia). • Dissemination to organ systems & candidemia associated with persistent fever, deteriorating conditions, & unresponsiveness to antifungal agents. Treatment: • Exhibits innate resistance ~30% of the time to azole antifungals. • Resistance sometimes be overcome by using higher doses of fluconazole, but not recommended for candidemias or invasive infections. • Fluconazole has efficacy in candiduria & require susceptibility testing. • Resistant or where fluconazole is not an option, consider echinocandin class (caspofungin, micafungin & anidulafungin) • Central venous catheters should be removed as early as possible when candidemia source is presumed to be the CVC. • If above options are unavailable - consider amphotericin B or flucytosine, which are more toxic & expensive. Satyendra Dhar, MD @DharSaty #Candida #Glabrata #CGlabrata #candidemia #diagnosis #management #fungemia #management #infectiousdiseases #microbiology
