Systemic Fungal Infections Caused by Candida Species: Epidemiology, Infection Process and Virulence Attributes

Mavor, A.; Thewes, S.; Hube, B.

doi:10.2174/138945005774912735

Cited by 252Antifungal resistance and susceptibilityFungal and yeast genetics researchFungal Infections and Studies

Systemic Fungal Infections Caused by Candida Species: Epidemiology, Infection Process and Virulence Attributes

Mavor, A., Thewes, S., Hube, B.·2005·Current Drug Targets

DOI 10.2174/138945005774912735

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Abstract

Candida species, in particular C. albicans, represent a major threat to immunocompromised patients. Able to exist as a commensal on mucosal surfaces of healthy individuals, these opportunistic fungi frequently cause superficial infections of mucosae and skin. Furthermore, in hospital settings, Candida species may cause life-threatening invasive infections in a growing population of vulnerable patients. In fact, candidaemia is associated with the highest crude mortality of all bloodstream infections. Candida cells may enter the bloodstream by direct penetration from epithelial tissues, due to damage of barriers in the body caused by surgery, polytrauma or drug treatment, or may spread from biofilms produced on medical devices. From the bloodstream, cells may infect almost all organs but appear to prefer certain organs depending upon the route of infection. The exact mechanisms by which Candida cells survive the challenge of the blood environment and escape from the bloodstream to cause deep-seated infections have not yet been elucidated, but various investigations are reviewed. It is clear, however, that Candida must have particular attributes which enable the organism to survive and grow within the environment of healthy individuals and to invade tissues in the immunocompromised host. Most studies have focussed on C. albicans and this review will therefore summarise work on the various known virulence factors and methods used to identify further virulence attributes of this fungus.

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During dissemination, fungi are likely exposed only briefly to the bloodstream before they enter target organs, and hence early survival may be crucial for successful systemic infections.
“It is noteworthy, however, that during dissemination, fungi are likely exposed only briefly to the bloodstream before they enter the target organs and hence that early survival may be crucial for successful systemic infections (71).”
From A novel hybrid iron regulation network combines features from pathogenic and nonpathogenic yeasts (2016) · cites this paper as [71]

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Candida albicans is able to use M cells as a portal of entry across the intestinal barrier in vitro
Albac, S., Schmitz, A., Lopez-Alayon, C., d’Enfert, C., Sautour, M., Ducreux, A., Labruère, C., Laue, M. M., Holland, G., Bonnin, A., et al. (2015) · Cellular Microbiology · doi:10.1111/cmi.12495 · Cited by 42 · see citing works
“However, in certain circumstances, C. albicans can overgrow the microbial flora and cause superficial infections and epithelial damages (Mavor et al., 2005).”
Background
Identification of clinically relevant yeast species by DNA sequence analysis of the D2 variable region of the 25–28S rRNA gene
Putignani, L., Paglia, M. G., Bordi, E., Nebuloso, E., Pucillo, L. P., & Visca, P. (2008) · Mycoses · doi:10.1111/j.1439-0507.2007.01472.x · Cited by 42 · see citing works
Interaction among the vacuole, the mitochondria, and the oxidative stress response is governed by the transient receptor potential channel in Candida albicans
Yu, Q., Zhang, B., Yang, B., Chen, J., Wang, H., Jia, C., Ding, X., Xu, N., Dong, Y., Zhang, B., et al. (2014) · Free Radical Biology and Medicine · doi:10.1016/j.freeradbiomed.2014.09.011 · Cited by 40 · see citing works
Ahr1 and Tup1 Contribute to the Transcriptional Control of Virulence-Associated Genes in Candida albicans
Ruben, S., Garbe, E., Mogavero, S., Albrecht-Eckardt, D., Hellwig, D., Häder, A., Krüger, T., Gerth, K., Jacobsen, I. D., Elshafee, O., et al. (2020) · mBio · doi:10.1128/mbio.00206-20 · Cited by 41 · see citing works
“This morphological plasticity is crucial for fungal pathogenicity as formation of hyphae is involved in adhesion to and invasion of host cells and tissues, while yeast cells are required for dissemination within the bloodstream (2, 3).”
BackgroundSelf-citation
Antifungal and antitumor models of bioactive protective peptides
Rodrigues, E. G., Dobroff, A. S., Taborda, C. P., & Travassos, L. R. (2009) · Anais da Academia Brasileira de Ciências · doi:10.1590/s0001-37652009000300015 · Cited by 39 · see citing works
Regulatory network modelling of iron acquisition by a fungal pathogen in contact with epithelial cells
Linde, J., Wilson, D., Hube, B., & Guthke, R. (2010) · BMC Systems Biology · doi:10.1186/1752-0509-4-148 · Cited by 36 · see citing works
“Commonly, patients suffer from superficial mucusal infections, but the fungus is also able to enter the bloodstream and to cause systemic infections with high mortality rates [25].”
BackgroundSelf-citation
Impact of oxidative and osmotic stresses on Candida albicans biofilm formation
Pemmaraju, S. C., Padmapriya, K., Pruthi, P. A., Prasad, R., & Pruthi, V. (2016) · Biofouling · doi:10.1080/08927014.2016.1212021 · Cited by 38 · see citing works
“…stress leads to rapid water loss, cell size reduction and a fall in turgor pressure, while, when exposed to oxidative stress, it encounters reactive oxygen species (ROS) released by polymorphonuclear leukocytes (PMNLs) and macrophages (Klipp et al. 2005; Mavor et al. 2005; Kühn & Klipp 2012).”
Background
Effect of β-1,6-Glucan Inhibitors on the Invasion Process of Candida albicans : Potential Mechanism of Their In Vivo Efficacy
Kitamura, A., Higuchi, S., Hata, M., Kawakami, K., Yoshida, K., Namba, K., & Nakajima, R. (2009) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.00435-09 · Cited by 38 · see citing works
Functional Characterization of the Small Heat Shock Protein Hsp12p from Candida albicans
Fu, M. S., Sordi, L. D., & Mühlschlegel, F. A. (2012) · PLoS ONE · doi:10.1371/journal.pone.0042894 · Cited by 35 · see citing works
“However, it is also a major opportunistic fungal pathogen, causing superficial infections of mucosa and skin, or life-threatening invasive infections when either the innate or acquired immune system is compromised [1,2].”
An ectophosphatase activity inCandida parapsilosisinfluences the interaction of fungi with epithelial cells
Kiffer-Moreira, T., Pinheiro, A. A. D. S., Alviano, W. S., Barbosa, F. M., Souto-Padrón, T. C. B. S., Nimrichter, L., Rodrigues, M. L., Alviano, C. S., & Meyer‐Fernandes, J. R. (2007) · FEMS Yeast Research · doi:10.1111/j.1567-1364.2007.00223.x · Cited by 37 · see citing works
“Cell wall structures are key elements in the interaction of Candida species with host cells (Mavor et al., 2005).”
Background
Intraluminal Release of an Antifungal β-Peptide Enhances the Antifungal and Anti-Biofilm Activities of Multilayer-Coated Catheters in a Rat Model of Venous Catheter Infection
Raman, N., Marchillo, K., Lee, M., López, A. D. L. R., Andes, D. R., Palecek, S. P., & Lynn, D. M. (2015) · ACS Biomaterials Science & Engineering · doi:10.1021/acsbiomaterials.5b00427 · Cited by 37 · see citing works
Evaluation of the antifungal and plasma membrane H+-ATPase inhibitory action of ebselen and two ebselen analogs in S. cerevisiae cultures
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“In the present study, the antifungal efficacy of 2-(3-pyridinyl)-benzisoselenazol-3(2H)-one (2) and 2-phenylbenzisoselenazol-3(2H)-one 1-oxide (3), two ebselen analogs, was evaluated using a strain of S.”
Method
Combinatory effect of fluconazole and FDA-approved drugs against Candida albicans
Kaneko, Y., Fukazawa, H., Ohno, H., & Miyazaki, Y. (2013) · Journal of Infection and Chemotherapy · doi:10.1007/s10156-013-0639-0 · Cited by 35 · see citing works
“albicans is known as the primary cause of systemic candidiasis, which has a high mortality rate [1].”
Background
Integrating GWAS with bulk and single-cell RNA-sequencing reveals a role for LY86 in the anti-Candida host response
de Vries, D. H., Matzaraki, V., Bakker, O. B., Brugge, H., Westra, H.-J., Netea, M. G., Franke, L., Kumar, V., & van der Wijst, M. G. P. (2020) · PLoS Pathogens · doi:10.1371/journal.ppat.1008408 · Cited by 34 · see citing works
“albicans) is an opportunistic fungus colonizing the skin and/or mucosae of approximately 70% of the population [1].”
Background
Development of oxidative stress tolerance resulted in reduced ability to undergo morphologic transitions and decreased pathogenicity in at-butylhydroperoxide-tolerant mutant ofCandida albicans
Fekete, A., Emri, T., Gyetvai, Á., Gazdag, Z., Pesti, M., Varga, Z., Balla, J., Cserháti, C., Emödy, L., Gergely, L., et al. (2007) · FEMS Yeast Research · doi:10.1111/j.1567-1364.2007.00244.x · Cited by 36 · see citing works
Kinetic and thermodynamic characterization of the interactions between the components of human plasma kinin-forming system and isolated and purified cell wall proteins of Candida albicans.
Seweryn, K., Karkowska-Kuleta, J., Wolak, N., Bocheńska, O., Kędracka-Krok, S., Kozik, A., & Rapała-Kozik, M. (2015) · Acta Biochimica Polonica · doi:10.18388/abp.2015_1142 · Cited by 27 · see citing works
“…for humans, C. albicans is the most common, causing more than 70% cases of candidiases, ranging from relatively mild superficial mucosal infections to life-threatening fungaemia, deep-seated mycoses of almost all internal organs and systemic diseases (Mavor et al., 2005; Pfaller & Diekema, 2007).”
Background
Characterization of the Candida albicans Amino Acid Permease Family: Gap2 Is the Only General Amino Acid Permease and Gap4 Is an S -Adenosylmethionine (SAM) Transporter Required for SAM-Induced Morphogenesis
Kraidlová, L., Schrevens, S., Tournu, H., Zeebroeck, G. V., Sychrová, H., & Dijck, P. V. (2016) · mSphere · doi:10.1128/msphere.00284-16 · Cited by 34 · see citing works
The Early Transcriptional Response of Human Granulocytes to Infection withCandida albicansIs Not Essential for Killing but Reflects Cellular Communications
Fradin, C., Mavor, A. L., Weindl, G., Schaller, M., Hanke, K., Kaufmann, S. H. E., Mollenkopf, H., & Hube, B. (2006) · Infection and Immunity · doi:10.1128/iai.01651-06 · Cited by 34 · see citing works
“albicans infections of blood seem to be important since the fungal cells can be “cleared” from the circulating blood within a very short time, as quickly as 5 to 15 min in animal models (22).”
BackgroundSelf-citation
How the host fights against Candida infections
Richardson, M. D. (2009) · Frontiers in Bioscience-Elite · doi:10.2741/e24 · Cited by 34 · see citing works
OralCandida albicanscolonization in healthy individuals: prevalence, genotypic diversity, stability along time and transmissibility
Mesquita, Â. S. G., Carvalho-Pereira, J., Franco‐Duarte, R., Alvés, A., Gerós, H., Pais, C., & Sampaio, P. (2020) · Journal of Oral Microbiology · doi:10.1080/20002297.2020.1820292 · Cited by 33 · see citing works
“In severely immunocompromised patients, such as those under chemotherapy, patients with AIDS or with endocrinal or blood diseases, the commensal fungi can proliferate, penetrate the bloodstream and disseminate throughout the human body causing lifethreatening infections [8,11,12].”
Background
Ti surface modification with a natural antioxidant and antimicrobial agent
Dumitriu, C., Ungureanu, C., Popescu, S., et al. (2015) · Surface and Coatings Technology · doi:10.1016/j.surfcoat.2015.06.063 · Cited by 32 · see citing works
Deletion of Vacuolar Proton-translocating ATPase Voa Isoforms Clarifies the Role of Vacuolar pH as a Determinant of Virulence-associated Traits in Candida albicans*
Raines, S. M., Rane, H. S., Bernardo, S. M., Binder, J., Lee, S. A., & Parra, K. J. (2013) · Journal of Biological Chemistry · doi:10.1074/jbc.m112.426197 · Cited by 33 · see citing works
Distinct stages during colonization of the mouse gastrointestinal tract by Candida albicans
Prieto, D., & Plá, J. (2015) · Frontiers in Microbiology · doi:10.3389/fmicb.2015.00792 · Cited by 30 · see citing works
“6:792. doi: 10.3389/fmicb.2015.00792 Distinct stages during colonization of the mouse gastrointestinal tract by Candida albicans Daniel Prieto and Jesús Pla * Departamento de Microbiología II, Facultad de Farmacia, Universidad Complutense de Madrid, Madrid, Spain Candida albicans is a member of the…”
BackgroundInfluential
Infection-Associated Genes of Candida Albicans
Hube, B. (2006) · Future Microbiology · doi:10.2217/17460913.1.2.209 · Cited by 29 · see citing works
“albicans can invade, either from the bloodstream or directly from mucosal surfaces, almost all organs of the human body (disseminated or systemic candidosis) [4].”
BackgroundSelf-citation
A Synthetic System That Senses Candida albicans and Inhibits Virulence Factors
Tscherner, M., Giessen, T. W., Markey, L., Kumamoto, C. A., & Silver, P. A. (2019) · ACS Synthetic Biology · doi:10.1021/acssynbio.8b00457 · Cited by 30 · see citing works
Proteinous Components of Neutrophil Extracellular Traps Are Arrested by the Cell Wall Proteins of Candida albicans during Fungal Infection, and Can Be Used in the Host Invasion
Karkowska-Kuleta, J., Smolarz, M., Seweryn-Ożóg, K., Satala, D., Zawrotniak, M., Wronowska, E., Bocheńska, O., Kozik, A., Nobbs, A., Gogól, M., et al. (2021) · Cells · doi:10.3390/cells10102736 · Cited by 25 · see citing works
Two aspartic proteinases secreted by the pathogenic yeast Candida parapsilosis differ in expression pattern and catalytic properties
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Carbon nanotube-based electrochemical biosensors for determination of Candida albicans’s quorum sensing molecule
Hassan, R. Y. A., El‐Attar, R. O., Hassan, H., et al. (2017) · Sensors and Actuators B Chemical · doi:10.1016/j.snb.2017.01.028 · Cited by 28 · see citing works
The Calcium Channel Blocker Verapamil Inhibits Oxidative Stress Response in Candida albicans
Yu, Q., Xiao, C., Zhang, K., Jia, C., Ding, X., Zhang, B., Wang, Y., & Li, M. (2014) · Mycopathologia · doi:10.1007/s11046-014-9735-7 · Cited by 27 · see citing works
“blood, causing life-threatening systemic infections [3, 4].”
Role of pH-regulated antigen 1 of Candida albicans in the fungal recognition and antifungal response of human neutrophils
Losse, J., Svobodová, E., Heyken, A., Hube, B., Zipfel, P. F., & Józsi, M. (2011) · Molecular Immunology · doi:10.1016/j.molimm.2011.07.007 · Cited by 26 · see citing works
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Degradation of human kininogens with the release of kinin peptides by extracellular proteinases of Candida spp.
Rąpała‐Kozik, M., Karkowska‐Kuleta, J., Ryzanowska, A., et al. (2010) · Biological Chemistry · doi:10.1515/bc.2010.083 · Cited by 27 · see citing works
“…fungal pathogens to humans are yeasts of the genus Candida , predominantly C. albicans , which belongs to the normal endogenous host flora and commen-sally occurs in the gastrointestinal tract, oral cavity and vagina of healthy individuals, often causing superficial infections (Mavor et al., 2005).”
Background
Inhibitory effect of novel Eugenol Tosylate Congeners on pathogenicity of Candida albicans
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Extracellular aspartic protease SAP2 of Candida albicans yeast cleaves human kininogens and releases proinflammatory peptides, Met-Lys-bradykinin and des-Arg9-Met-Lys-bradykinin
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“Candida albicans and other Candida species can also cause a range of persistent superfi cial infections of the gastrointes tinal tract, oral cavity and vagina (Mavor et al. , 2005 ).”
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The adaptive response to iron involves changes in energetic strategies in the pathogen Candida albicans
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Authors: Mavor, A., Thewes, S., & Hube, B.
Affiliations: Robert Koch Institute (DE)
Corresponding author: Hube, B.
ORCID: Thewes, S.
Hube, B.
Venue: Current Drug Targets
Publisher: Bentham Science Publishers Ltd.
Published: 2005-12-01
Volume: 6
Issue: 8
Pages: 863-874
ISSN: 1389-4501 (ISSN-L)
DOI: 10.2174/138945005774912735
OpenAlex: W2152663489
Cited by: 252
References: 0
Citations by year: 2026: 5 · 2025: 6 · 2024: 11 · 2023: 9 · 2022: 11 · 2021: 18 · 2020: 15 · 2019: 15 · 2018: 8 · 2017: 9 · 2016: 16 · 2015: 18 · 2014: 15 · 2013: 14 · 2012: 9
FWCI: 5.76
Type: journal article
Language: en
Open access: closed
Locations: Current Drug Targets (publishedVersion)
PubMed (publishedVersion)
Funders: Deutsche Forschungsgemeinschaft
Robert Koch Institut
Topics: Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Fungal and yeast genetics research
Health Sciences › Medicine › Epidemiology › Fungal Infections and Studies
Keywords: systemic candidiasis, Candida albicans, candidemia, invasive fungal infections, virulence factors, immunocompromised patients, opportunistic fungal pathogens, bloodstream infection, fungal pathogenesis, epidemiology
MeSH terms: Candida, Candidiasis, Humans

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Systemic Fungal Infections Caused by Candida Species: Epidemiology, Infection Process and Virulence Attributes

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