Candida Glabrata

Species of Candida Most Commonly Isolated in Bloodstream Infections

 • Symptomatic mucosal infection is detected in oropharyngeal, esophageal, & vaginal candidiasis, in HIV/AIDS & other immune-compromised pts.

 • Candiduria is common with invasive catheters, DM, elderly, & debilitated under antibacterial medications.

 • 20% of all urinary yeast infections.

 • Serious infections include rare cases of endocarditis, meningitis, & disseminated infections (fungemia).

 • Dissemination to organ systems & candidemia associated with persistent fever, deteriorating conditions, & unresponsiveness to antifungal agents.

Treatment:

 • Exhibits innate resistance ~30% of the time to azole antifungals.

 • Resistance sometimes be overcome by using higher doses of fluconazole, but not recommended for candidemias or invasive infections.

 • Fluconazole has efficacy in candiduria & require susceptibility testing.

 • Resistant or where fluconazole is not an option, consider echinocandin class (caspofungin, micafungin & anidulafungin)

 • Central venous catheters should be removed as early as possible when candidemia source is presumed to be the CVC.

 • If above options are unavailable - consider amphotericin B or flucytosine, which are more toxic & expensive.



Satyendra Dhar, MD @DharSaty



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