Advances in epidemiology and treatment of invasive Candida infection in the immunocompromised population

doi:10.3969/j.issn.1674-8115.2021.04.018

Abstract

Abstract:

With the development of modern medical technology, such as organ transplantation, the extensive application of broad-spectrum antibiotics and immunosuppressants and the prolongation of human life span, the number of people with low immunity is increasing. The morbidity and mortality of invasive fungal infection are increasing in these population. Invasive fungal infection has become the direct cause of death of critical diseases, such as malignant tumor and organ transplantation. Candida is the primary pathogenic fungi of invasive fungal infection. It can infect human subcutaneous tissue, mucous membrane, other tissues and organs of the whole body, and then spread in the blood. The main clinical manifestations of Candida infectionare candidemia and deep candidiasis, and the prognosis is often poor. At present, antifungal infection is still the main treatment for invasive Candida (IC) in immunocompromised population, and drug treatment is one of the effective ways. Clinical conventional antifungal drugs include polyenes, azoles and echinocandins. Among them, echinocandins is the first choice for the treatment of IC. However, the existing treatments fail to improve the prognosis of patients with IC infection, and drug resistance caused by long-term use frequently occurr. At present, the number of antifungal drugs available is extremely limited. Therefore, in order to solve the above problems, drug combination therapy, adjuvant immunotherapy, photodynamic therapy and laser therapy provide new perspectives for the treatment of IC. This article reviews the epidemiology and treatment of IC infetcion in the population with low immunity. In this paper, the incidence and mortality of IC infection in patients in intensive care unit, patients with hematological malignancies, solid organ transplant patients, neonates, the elderly, and human immunodeficiency virus (HIV)-infected people at home and abroad, and the distribution of main pathogenic Candida species, as well as the therapeutic potential and limitations of new research were discussed in depth. The future research direction was proposed.

Key words: immunocompromised population, invasive Candida infection, epidemiology, anti-Candida infection

CLC Number:

R117

Lin LIU, Hui WANG, Ning-ning LIU. Advances in epidemiology and treatment of invasive Candida infection in the immunocompromised population[J]. JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE), 2021, 41(4): 525-529.

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References 40

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