Candida parapsilosis- An Overview


Candida parapsilosis is a type of yeast that belongs to the genus Candida, which includes over 150 species of fungi that can cause infections in humans. Candida parapsilosis is one of the six most common species of Candida that cause invasive candidiasis, a serious infection that can affect the blood, tissues, and organs . Candida parapsilosis was first discovered in 1928 by Ashford from a stool sample of a patient with diarrhea in Puerto Rico. It was initially named Monilia parapsilosis, but later renamed to Candida parapsilosis in 1970.

Candida parapsilosis is normally found on the skin and mucous membranes of healthy people, where it usually does not cause any harm. However, in some situations, such as when the immune system is weakened or the skin is damaged, Candida parapsilosis can overgrow and cause infections. Candida parapsilosis is especially associated with infections in neonates (newborns) and patients in intensive care units (ICUs), who often have indwelling medical devices such as catheters, prosthetic valves, or artificial joints . Candida parapsilosis can also contaminate medical solutions such as parenteral nutrition (intravenous feeding) or blood products, and spread through the hands of health care workers .

Candida parapsilosis infections can range from mild to life-threatening, depending on the site and extent of infection. Some of the common types of infections caused by Candida parapsilosis are:

  • Candidemia: infection of the blood
  • Endocarditis: infection of the heart valves
  • Meningitis: infection of the membranes covering the brain and spinal cord
  • Peritonitis: infection of the lining of the abdomen
  • Ocular infection: infection of the eye
  • Arthritis: infection of the joints
  • Vulvovaginitis: infection of the vagina and vulva
  • Otomycosis: infection of the ear
  • Onychomycosis: infection of the nails
  • Urinary tract infection: infection of the bladder or kidneys

The symptoms and signs of Candida parapsilosis infections vary depending on the type and severity of infection. Some common symptoms include fever, chills, pain, swelling, redness, discharge, itching, burning, and reduced vision or hearing. In some cases, Candida parapsilosis infections can cause septic shock, organ failure, or death.

The diagnosis of Candida parapsilosis infections is based on clinical features, laboratory tests, and imaging studies. Laboratory tests include microscopic examination and culture of specimens from infected sites, such as blood, urine, tissue biopsies, or cerebrospinal fluid. Molecular methods such as polymerase chain reaction (PCR) or genomic sequencing can also be used to identify and differentiate Candida parapsilosis from other species of Candida. Imaging studies such as echocardiography or magnetic resonance imaging (MRI) can help to detect complications such as endocarditis or abscesses.

The treatment of Candida parapsilosis infections depends on the type and severity of infection, as well as the patient`s condition and response to therapy. Antifungal drugs are the mainstay of treatment for most types of Candida parapsilosis infections. The most commonly used antifungal drugs are fluconazole, amphotericin B, and echinocandins (caspofungin, micafungin, or anidulafungin). Some strains of Candida parapsilosis may be resistant to certain antifungal drugs, so susceptibility testing is recommended before starting treatment. In some cases, surgical interventions may be needed to remove infected devices or tissues.

The prevention and control of Candida parapsilosis infections involve measures to reduce the risk factors and transmission routes for infection. Some of these measures include:

  • Maintaining good hygiene and hand washing practices for health care workers and patients
  • Using sterile techniques and disinfecting procedures for medical devices and solutions
  • Removing or replacing indwelling devices as soon as possible
  • Avoiding unnecessary use or prolonged use of antibiotics or corticosteroids
  • Monitoring blood glucose levels and managing diabetes
  • Strengthening the immune system by eating a balanced diet and getting enough rest

Candida parapsilosis is an emerging pathogen that can cause serious infections in vulnerable people. By understanding its characteristics, risk factors, transmission routes, clinical features, diagnosis methods, treatment options, and prevention strategies, we can better manage and prevent Candida parapsilosis infections.