review · Medical Mycology
This systematic review examined the characteristics and global impact of invasive infections caused by *Candida albicans*, a common fungal pathogen and a leading cause of invasive candidiasis. The review, covering studies from 2016 to 2021, found that *C. albicans* is the most prevalent *Candida* species in invasive disease and is associated with high mortality rates. Standard infection control measures are the primary prevention method. While resistance to common antifungals remains rare, there is evidence of increasing azole resistance, particularly in middle-income settings, though data from low-income settings are limited. *C. albicans* remains susceptible to echinocandins, amphotericin B, and flucytosine. The review also noted a potential decrease in the proportion of infections caused by *C. albicans* relative to other *Candida* species, requiring further epidemiological study. More robust data on complications, sequelae, and attributable mortality are needed.
This review provides a critical understanding of *Candida albicans*, a major fungal pathogen, informing global health strategies. Recognising its high mortality, emerging drug resistance, and data gaps is crucial for public health, guiding prevention efforts, and highlighting areas for urgent research, especially in under-represented regions, to improve patient outcomes.
The abstract highlights the need for improved data collection on complications, sequelae, and attributable mortality, suggesting a potential for advanced diagnostic tools or surveillance technologies. It also reinforces the importance of effective infection control products and the continued development of new antifungals, particularly those targeting emerging resistance patterns. This is early-stage research informing public health priorities and potential future product development in diagnostics and therapeutics.
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Candida albicans is a common fungal pathogen and amongst the leading causes of invasive candidiasis globally. This systematic review examines the characteristics and global impact of invasive infections caused by C. albicans. We searched on PubMed and Web of Science for studies reporting on criteria such as mortality, morbidity, drug resistance, preventability, yearly incidence, and distribution/emergence during the period from 2016 to 2021. Our findings indicate that C. albicans is the most common Candida species causing invasive disease and that standard infection control measures are the primary means of prevention. However, we found high rates of mortality associated with infections caused by C. albicans. Furthermore, there is a lack of data on complications and sequelae. Resistance to commonly used antifungals remains rare. Although, whilst generally susceptible to azoles, we found some evidence of increasing resistance, particularly in middle-income settings-notably, data from low-income settings were limited. Candida albicans remains susceptible to echinocandins, amphotericin B, and flucytosine. We observed evidence of a decreasing proportion of infections caused by C. albicans relative to other Candida species, although detailed epidemiological studies are needed to confirm this trend. More robust data on attributable mortality, complications, and sequelae are needed to understand the full extent of the impact of invasive C. albicans infections.
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DOI: 10.1093/mmy/myae045
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