Emerging Multidrug-Resistant Candida Species

Arnaldo L. Colombo; João N. de Almeida Júnior; Jesus Guinea


Curr Opin Infect Dis. 2017;30(6):528-538. 

In This Article

Abstract and Introduction


Purpose of review: To describe the epidemiology, strategies for early detection, and clinical management of infections caused by the most commonly found multidrug-resistant (MDR) Candida spp.

Recent findings: Increasing numbers of reports describing invasive infections by MDR Candida auris and Candida glabrata has been reported in medical centers worldwide.

Summary: We checked all papers published along the last 10 years describing epidemiological, diagnostic, and clinical aspects of infections by MDR Candida spp., with emphasis on C. auris and C. glabrata spp. C. auris has been reported in 15 countries and multidrug resistance rates is usually above 30%. Horizontal transmission is a great concern regarding C. auris. C. glabrata ranks the second most reported Candida spp. in deep-seated infections from United States and some European Centers, although multidrug resistance rates above 10% are restricted to some US centers. Candida haemulonii complex isolates with poor susceptibility to azoles and amphotericin B have been isolated in superficial and deep-seated infections, whereas Candida guilliiermondii complex isolates with poor susceptibility to azoles and echinocandins have been recovered from catheter-related bloodstream infections. Other potential MDR Candida species are Candida krusei, Candida lusitaniae, Candida kefyr, Yarrowia (Candida) lypolitica, and Candida rugosa.


Until few years ago, the term multidrug-resistant (MDR) Candida spp. had been used scarcely in the literature to describe few anecdotal case reports of fungal MDR infections with limited significance in terms of public health.[1]

Recently, with the widespread use (and misuse) of echinocandins in different regimens of prophylaxis, empirical, and targeted therapy of fungal infections in different populations, this reality has changed dramatically.[2] Indeed, we are facing now an ever increasing numbers of invasive infections caused by non-Candida albicans MDR spp. being described worldwide, most of them involving Candida glabrata and Candida auris strains.[3,4]

The present study focuses on the epidemiology, detection, and clinical management of infections caused by the most commonly found MDR Candida spp.