Candida parapsilosis sensu stricto Antifungal Resistance Mechanisms and Associated Epidemiology

Fungal diseases cause millions of deaths per year worldwide. Antifungal resistance has become a matter of great concern in public health. In recent years rates of non-albicans species have risen dramatically. Candida parapsilosis is now reported to be the second most frequent species causing candidemia in several countries in Europe, Latin America, South Africa and Asia. Rates of acquired azole resistance are reaching a worrisome threshold from multiple reports as in vitro susceptibility testing is now starting also to explore tolerance and heteroresistance to antifungal compounds. With this review, the authors seek to evaluate known antifungal resistance mechanisms and their worldwide distribution in Candida species infections with a specific focus on C. parapsilosis.

Automated summary

Fungal diseases cause a significant number of deaths annually, with antifungal resistance becoming a major concern in public health. The prevalence of non-albicans species, particularly Candida parapsilosis, as a cause of candidemia has been increasing in various countries. Acquired azole resistance has reached alarming levels, and there is a need to explore tolerance and heteroresistance to antifungal compounds. This review aims to assess the distribution of known antifungal resistance mechanisms in Candida species infections, focusing on C. parapsilosis.