Abstract
Candida glabrata is a yeast of increasing medical relevance, particularly in critically ill patients. It is the second most isolated Candida species associated with invasive candidiasis (IC) behind C. albicans. The attributed higher incidence is primarily due to an increase in the acquired immunodeficiency syndrome (AIDS) population, cancer, and diabetic patients. The elderly population and the frequent use of indwelling medical devices are also predisposing factors. This work aimed to review various virulence factors that facilitate the survival of pathogenic C. glabrata in IC. The available published research articles related to the pathogenicity of C. glabrata were retrieved and reviewed from four credible databases, mainly Google Scholar, ScienceDirect, PubMed, and Scopus. The articles highlighted many virulence factors associated with pathogenicity in C. glabrata, including adherence to susceptible host surfaces, evading host defences, replicative ageing, and producing hydrolytic enzymes (e.g., phospholipases, proteases, and haemolysins). The factors facilitate infection initiation. Other virulent factors include iron regulation and genetic mutations. Accordingly, biofilm production, tolerance to high-stress environments, resistance to neutrophil killings, and development of resistance to antifungal drugs, notably to fluconazole and other azole derivatives, were reported. The review provided evident pathogenic mechanisms and antifungal resistance associated with C. glabrata in ensuring its sustenance and survival.
Highlights
Invasive candidiasis (IC) is a clinical condition that is not associated with a singleCandida species
The published in vitro data have shown that deoxycholate amphotericin B and echinocandins such as caspofungin or micafungin demonstrated high activity against C. albicans and C. glabrata growing in biofilms settings [84]
According to the findings reported by Norimatsu et al [4], the liposomal Amphotericin B (AmB) (3 mg/kg/day) showed better activity than micafungin in the treatment of both C. glabrata and C. parapsilosis bloodstream infections in the case of an 80-year-old woman
Summary
Invasive candidiasis (IC) is a clinical condition that is not associated with a single. Each Candida species holds unique characteristics comparative to invasive potential, virulence, and antifungal susceptibility pattern [1] It is an infection with many clinical manifestations that potentially affect any organs. Candida species commonly cause invasive nosocomial infections in immunocompromised patients [5]. It accounts for 70–90% of all aggressive mycoses [6]. Candida glabrata is commonly found in the environment, on flowers, leaves, surfaces, water, and soil It is the second most frequently isolated cause of candidiasis after Candida albicans. The infection thrives best in the presence of Candida species-specific virulence factors such as the presence of hyphae for invasion into host tissues [19].
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