Abstract
The incidence of fungal infections has increased significantly, so contributing to morbidity and mortality. This is caused by an increase in antimicrobial resistance and the restricted number of antifungal drugs, which retain many side effects. Candida species are major human fungal pathogens that cause both mucosal and deep tissue infections. Recent evidence suggests that the majority of infections produced by this pathogen are associated with biofilm growth. Biofilms are biological communities with a high degree of organization, in which micro-organisms form structured, coordinated and functional communities. These biological communities are embedded in a self-created extracellular matrix. Biofilm production is also associated with a high level of antimicrobial resistance of the associated organisms. The ability of Candida species to form drug-resistant biofilms is an important factor in their contribution to human disease. The study of plants as an alternative to other forms of drug discovery has attracted great attention because, according to the World Health Organization, these would be the best sources for obtaining a wide variety of drugs and could benefit a large population. Furthermore, silver nanoparticles, antibodies and photodynamic inactivation have also been used with good results. This article presents a brief review of the literature regarding the epidemiology of Candida species, as well as their pathogenicity and ability to form biofilms, the antifungal activity of natural products and other therapeutic options.
Highlights
The incidence and prevalence of invasive fungal infections have increased since the 1980s, especially in the large population of immunocompromised patients and/or those hospitalized with serious underlying diseases (Arendrup et al, 2005; Espinel-Ingroff et al, 2009)
The genus is composed of a heterogeneous group of organisms, and more than 17 different Candida species are known to be aetiological agents of human infection; more than 90 % of invasive infections are caused by Candida albicans, Candida glabrata, Candida parapsilosis, Candida tropicalis and Candida krusei (Pfaller et al, 2007)
Many studies have focused on the formation of C. albicans biofilms on implanted vascular catheters because this is a major source of infection (Finkel & Mitchell, 2011)
Summary
The incidence and prevalence of invasive fungal infections have increased since the 1980s, especially in the large population of immunocompromised patients and/or those hospitalized with serious underlying diseases (Arendrup et al, 2005; Espinel-Ingroff et al, 2009). In a study with 2019 patients at major North American medical centres, a predominance of non-albicans species was observed; C. albicans was the most frequently isolated species, it was followed by C. glabrata and other non-C. albicans species This change in epidemiology could be associated with severe immunosuppression or illness, prematurity, exposure to broad-spectrum antibiotics and older patients (Horn et al, 2009). In Chile, the prevalence of C. albicans has changed, and a progressive increase of non-albicans infection has been observed; C. parapsilosis was the most frequent species, followed by C. tropicalis and C. glabrata. Do patients colonized with this species develop candidaemia (Loreto et al, 2010) The reasons for this limited ability of C. dubliniensis to cause invasive disease have been the focus of recent studies (Jackson et al, 2009). Doctors retain the option of giving the drugs for prophylaxis, empiric therapy, preventive treatment or while waiting for the disease to be diagnosed, so there is a degree of excessive exposure to these agents (Rodrıguez-Tudela et al, 2007)
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