Cited by 794Antifungal resistance and susceptibilityFungal Infections and StudiesFungal and yeast genetics research

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Candida albicans—The Virulence Factors and Clinical Manifestations of Infection

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Talapko, Jasminka, Juzbašić, Martina, Matijević, Tatjana, Pustijanac, Emina, Bekić, Sanja, Kotris, Ivan, Škrlec, Ivana·2021·Journal of Fungi

DOI 10.3390/jof7020079PMC PMC7912069

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Abstract

Candida albicans is a common commensal fungus that colonizes the oropharyngeal cavity, gastrointestinal and vaginal tract, and healthy individuals’ skin. In 50% of the population, C. albicans is part of the normal flora of the microbiota. The various clinical manifestations of Candida species range from localized, superficial mucocutaneous disorders to invasive diseases that involve multiple organ systems and are life-threatening. From systemic and local to hereditary and environmental, diverse factors lead to disturbances in Candida’s normal homeostasis, resulting in a transition from normal flora to pathogenic and opportunistic infections. The transition in the pathophysiology of the onset and progression of infection is also influenced by Candida’s virulence traits that lead to the development of candidiasis. Oral candidiasis has a wide range of clinical manifestations, divided into primary and secondary candidiasis. The main supply of C. albicans in the body is located in the gastrointestinal tract, and the development of infections occurs due to dysbiosis of the residential microbiota, immune dysfunction, and damage to the muco-intestinal barrier. The presence of C. albicans in the blood is associated with candidemia–invasive Candida infections. The commensal relationship exists as long as there is a balance between the host immune system and the virulence factors of C. albicans. This paper presents the virulence traits of Candida albicans and clinical manifestations of specific candidiasis.

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Syzygium aromaticum essential oil and its major constituents: Assessment of activity against Candida spp. and toxicity
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Antifungal, Antioxidant, and Irritative Potential of Citronella Oil (Cymbopogon nardus) Associated with Phenethyl Ester of Caffeic Acid (CAPE)
Rolim, P. A. D. S., Catanoze, I. A., Fracasso, J. A. R., Barbosa, D. B., dos Santos, L., Ximenes, V. F., & Guiotti, A. M. (2024) · Cosmetics · doi:10.3390/cosmetics11050162 · Cited by 5
Anti-biofilm effect of clove oil against Candida albicans: A systematic review
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“[10,11] Further research is needed to confirm their safety, effectiveness, and proper usage, and consulting healthcare professionals before incorporating them into treatment regimens is advisable.”
Cadmium-induced augmentation of fungal translocation promotes systemic infection in mice via gut barrier disruption and immune dysfunction
Garg, M., Verma, M., Khan, A. S., Yadav, P., Rahman, S. S., Ali, A., & Kamthan, M. (2025) · Life Sciences · doi:10.1016/j.lfs.2025.123368 · Cited by 6
Revisiting the History of Candidiasis
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Nutritional Deficiencies and Oral Candidiasis in Children from Northeastern Romania: A Cross-Sectional Biochemical Assessment
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“However, this organism may shift to a pathogenic role under specific conditions, including, but not limited to, immunosuppression resulting from various medical conditions or treatments, inadequate oral hygiene practices, and nutritional deficiencies that compromise the host’s immune defenses [3].”
Clinical and microbiological analysis of fungal keratitis in Toronto, Canada: A 20-year study
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Insights into the structure and mechanism of action of the anti-candidal lectin Mo-CBP2 and evaluation of its synergistic effect and antibiofilm activity
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A longitudinal study of Candida bloodstream infections in a Japanese university hospital: species distribution, drug susceptibility, clinical features, and mortality predictors
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Background
A New Approach for the Treatment of Recurrent Vulvovaginal Candidiasis with a Combination of Pea Protein, Grape Seed Extract, and Lactic Acid Assessed In Vivo
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“In addition to pregnancy, some drugs such as antibiotics and systemic corticosteroids and concomitant diseases such as endocrinopathy and autoimmune diseases can cause infection [4,5].”
Background
The alternating 50 Hz magnetic field depending on the hydrophobicity of the strain affects the viability, filamentation and sensitivity to drugs of Candida albicans
Sztafrowski, D., Muraszko, J., Jasiura, A., Bryk, P., Urbanek, A. K., & Krasowska, A. (2023) · PLoS ONE · doi:10.1371/journal.pone.0291438 · Cited by 6
“albicans is a part of the normal microbiota [22].”
Background
Quinalizarin as a potential antifungal drug for the treatment of Candida albicans fungal infection in cancer patients
Janeczko, M., Kochanowicz, E., Górka, K., & Skrzypek, T. (2024) · Microbiology Spectrum · doi:10.1128/spectrum.03652-23 · Cited by 10
“These opportunistic pathogens are the most common cause of superficial vaginal or mucosal oral infections, but they may also enter the bloodstream, leading to deep tissue infections (6).”
Background
Anticandidal effectiveness of greenly synthesized zinc oxide nanoparticles against candidal pathogens
Maniah, K. (2023) · Journal of Environmental Science and Health Part A · doi:10.1080/10934529.2024.2315922 · Cited by 6
“[16] Although there are numerous species that have been documented, only a select few have the ability to harm human health.”
Background
The Effect of Different System Parameters on the Movement of Microbial Cells Using Light-Induced Dielectrophoresis
Keck, D. M., Ravi, S., Yadav, S. P., & Martínez‐Duarte, R. (2024) · Micromachines · doi:10.3390/mi15030342 · Cited by 6
“Although Candida cells have significant clinical relevance [25,26], their use here was limited to dielectric particles of a biological nature to facilitate the study of the performance of the LiDEP platform on bioparticles.”
Background
Analogies between HPV Behavior in Oral and Vaginal Cavity: Narrative Review on the Current Evidence in the Literature
Dellino, M., Pinto, G., D’Amato, A., Barbara, F., Gennaro, F. D., Saracino, A., Laganà, A. S., Vimercati, A., Malvası, A., Malvasi, V. M., et al. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13051429 · Cited by 7
“Candida albicans is an opportunistic pathogen carried by about 80% of the general population and is harmful to immunocompromised individuals (HIV, cancer, or transplant patients) [84].”
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Roles of alcohol dehydrogenase 1 in the biological activities of Candida albicans
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“C. albicans actively contributes to the initiation and progression of fungal infections through a variety of morphological features and virulence factors (talapko et al. 2021).”
Microbial Extracellular Vesicles in Host-Microbiota Interactions
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Dual-antigen fusion protein vaccination induces protective immunity against Candida albicans infection in mice
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Chemical Composition and Antimicrobial Potential of Essential Oil of Acritopappus confertus (Gardner) R.M.King & H.Rob. (Asteraceae)
da Cruz, R. P., Castro, J. W. G., Leite, D. O. D., de Carvalho, N. K. G., Almeida‐Bezerra, J. W., Pereira, R. L. S., Rodrigues, F. F. G., Bezerra, J. J. L., Costa, A. R., Mori, E., et al. (2022) · Pharmaceuticals · doi:10.3390/ph15101275 · Cited by 6
Biofilm formation in Zymoseptoria triticiPreprint
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“These mats of fungal material are reminiscent of biofilms produced by certain fungi, such as the mixed hyphal and blastosphore biofilms produced by Candida albicans[18].”
Background
Zerumbone disrupts mixed biofilms of Candida albicans and Streptococcus mutans on acrylic resin
Pereira, A. L. G., Abreu‐Pereira, C. A., Dias, L. M., Jorge, J. H., & Pavarina, A. C. (2024) · Biofouling · doi:10.1080/08927014.2024.2441259 · Cited by 6
“C. albicans maintains a commensal relationship with the host and its pathogenicity is associated with a morphological transition and to the ability to form biofilms (Talapko et al. 2021).”
Candida albicans and NCAC species: acidogenic and fluoride-resistant oral inhabitants
Mousa, H. R. F., Abiko, Y., Washio, J., Sato, S., & Takahashi, N. (2025) · Journal of Oral Microbiology · doi:10.1080/20002297.2025.2473938 · Cited by 5
“Among Candida species, C. albicans has always been the most commonly isolated species both in infections and healthy individuals [3].”
Superficial Candidiasis: Cluster Analysis of Species Distribution and Their Antifungal Susceptibility In Vitro
Ranđelović, M., Ignjatović, A., Đorđević, M., Golubović, M., Stalević, M., Rancic, N. K., & Otašević, S. (2025) · Journal of Fungi · doi:10.3390/jof11050338 · Cited by 5
Lipopeptide: Exploration for enhanced anticandidal therapeutic spectrum
Singh, V. K., & Kumar, A. (2025) · Microbial Pathogenesis · doi:10.1016/j.micpath.2025.107888 · Cited by 5
Exploring therapeutic strategies for candidiasis: From current treatments to future perspectives
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Harnessing Probiotics to Combat Candidiasis: Mechanisms, Evidence, and Future Directions
Wright, E., Valand, N., & Girija, U. V. (2025) · Journal of Fungi · doi:10.3390/jof11110779 · Cited by 5
“Invasive candidiasis is a life-threatening, systemic infection whereby the fungus enters the bloodstream (candidaemia) or infects organs, causing deep-seated abscesses requiring intravenous or oral antifungal medications [10].”
Update on the role of mycobiome in Gastrointestinal cancers: mechanisms and therapeutic implications
Zhang, X., Li, Y., & Cao, D. (2025) · Medical Oncology · doi:10.1007/s12032-025-03207-0 · Cited by 5
“Fungi—particularly members of the Candida genus—con-tribute to GI carcinogenesis through three interconnected mechanistic axes [48, 49]: (1) subversion of host immunity 1 3 C. tropicalis levels can inhibit the activation of inflamma - somes, reducing the maturation and secretion of IL-1β and IL-18,…”
The Tricalbin-Family Endoplasmic Reticulum-Plasma Membrane Tethering Proteins Attenuate ROS-Involved Caspofungin Sensitivity in Candida albicans
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K-aurein: A notable aurein 1.2-derived peptide that modulates Candida albicans filamentation and reduces biofilm biomass
Silva, M. L., Carneiro, M. N., Cavalcante, R. M. B., Guerrero, J. A. P., Fontenelle, R. O. D. S., Lorenzón, E. N., Cilli, E. M., & Carneiro, V. A. (2023) · Amino Acids · doi:10.1007/s00726-023-03288-z · Cited by 5
A Comparative Study between Invasive and Superficial Candida albicans Infections Regarding Biofilm Formation, ALS3 and SAP1-6 Genes Expression and Anti-Fungal Drug Susceptibility
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Sustainable Nanomaterials as Promising Antibacterial Agents
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Comparative analysis of enzymatic profiles and biofilm formation in clinical and environmental Candida kefyr isolates
Nouraei, H., Zare, S., Nemati, M., Amirzadeh, N., Motamedi, M., Shabanzadeh, S., Zomorodian, K., & Pakshir, K. (2024) · Environmental Microbiology Reports · doi:10.1111/1758-2229.13282 · Cited by 5
“The increase in numbers can be attributed to the usage of cortico-steroids and antibacterial drugs in the field of clinical medicine (Ciurea et al., 2020; Talapko et al., 2021).”
Background
Clinical aPDT's effect on Candida albicans: Antifungal susceptibility, virulence gene expression, and correlation with leukocyte and neutrophil counts
Du, M., Xuan, W., Hamblin, M. R., & Huang, L. (2024) · Photodiagnosis and Photodynamic Therapy · doi:10.1016/j.pdpdt.2024.104327 · Cited by 6
Perspectives on the Use of Echinocandins in the Neonatal Intensive Care Unit
Dermitzaki, N., Balomenou, F., Gialamprinou, D., Giapros, V. I., Rallis, D., & Baltogianni, M. S. (2024) · Antibiotics · doi:10.3390/antibiotics13121209 · Cited by 5
“The formation of biofilms, which are three-dimensional structures of fungal cells organized within an extracellular polymeric matrix that adheres to either host tissue or implanted medical devices, is an important aspect of the pathogenesis of Candida spp. infections [115–117].”
Enhanced electrochemical biosensing of Candida albicans via NiFe₂O₄ nanoparticle-doped imprinted polymers
İşbilir, H., Kaya, H. O., Tekintaş, Y., Kurul, F., Çetin, A. E., & Topkaya, S. N. (2025) · Microchemical Journal · doi:10.1016/j.microc.2025.114513 · Cited by 5
Epidemiology of dermatomycoses in children in Northern Mato Grosso 2015‐2020
Correia, N. S., Balbinot, R. T. S., Bonacorsi, C., & Donofrio, F. C. (2022) · Mycoses · doi:10.1111/myc.13439 · Cited by 5
In vitro Evaluation of Fungal Susceptibility and Inhibition of Virulence by Diosgenin
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Extracellular phospholipase production by Malassezia pachydermatis strains and its inhibition by selected antimycotics and plant essential oil components
Čonková, E., Váczi, P., & Malinovská, Z. (2024) · Veterinary Research Communications · doi:10.1007/s11259-024-10446-5 · Cited by 5
“Phos - pholipases (PLs) are a heterogeneous group of enzymes that catalyse the hydrolysis of glycerophospholipids by cleaving one or more ester bonds, resulting in the release of free fatty acids that trigger inflammation in the host (Tee et al. 2019 ; Talapko et al. 2021 ).”
Background
Structural analogs of 2-(4-fluorophenyl)-6-methyl-3-(pyridin-4-yl)pyrazolo[1,5-a]pyridine for targeting Candida albicans non-essential stress kinase Yck2 through protein-ligand binding and dynamics analysis
Hassan, A. M., Khateb, A. M., Turkistani, S. A., Alhamdan, M. M., Garout, R. M., Dwivedi, V. D., & Azhar, E. I. (2024) · Frontiers in Chemistry · doi:10.3389/fchem.2024.1430157 · Cited by 5
“As a common organism in the human skin and gut, Candida albicans can cause invasive fungal diseases worldwide due to its ability to change its form in different environments (Talapko et al., 2021).”
Early Candida colonisation impact on patients and healthcare professionals in an intensive care unit
Dalben, Y. R., Pimentel, J., Maifrede, S. B., de Carvalho, J. A., Bessa‐Neto, F. O., Gomes, J. F. S., Leite, G. R., Rodrigues, A. M., Cayô, R., Velloso, T. R. G., et al. (2024) · Mycoses · doi:10.1111/myc.13786 · Cited by 6
“5,6 8 Risk factors associated with the development of invasive candidiasis include prolongated stay in the intensive care unit (ICU), use of immunosuppressive drugs, central and peripheral venous catheters (CVC), corticosteroids, and extended treatment with broad-spectrum antibiotics.”
Development, Safety, and Therapeutic Evaluation of Voriconazole-Loaded Zein–Pectin–Hyaluronic Acid Nanoparticles Using Alternative In Vivo Models for Efficacy and Toxicity
Fin, M. T., dos Santos, K. S., Gualque, M. W. D. L., Santos, R., Aoki, N. C. M., Auler, M. E., Fusco‐Almeida, A. M., Mendes‐Giannini, M. J. S., & Mainardes, R. M. (2025) · Pharmaceutics · doi:10.3390/pharmaceutics17020231 · Cited by 5
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Díez, A., Arrieta-Aguirre, I., Carrano, G., Bregón-Villahoz, M., Moragues, M. D., & Fernandez-de-Larrinoa, Í. (2025) · Vaccine · doi:10.1016/j.vaccine.2025.127102 · Cited by 5
Molecular discrimination and antifungal susceptibility profile of cryptic Candida albicans complex species isolated from patients in Iran
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Background
Antifungal and Anti-Inflammatory Activities of PS1-2 Peptide against Fluconazole-Resistant Candida albicans
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“albicans is a common commensal fungus that colonizes the human skin and inside the body, such as the mouth, gut, throat, and vagina [26].”
Background
Sfl1 is required for Candida albicans biofilm formation under acidic conditions
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Targeted piperine-coated zinc oxide nanoparticle induces the biofilm inhibition of dental pathogens and apoptosis of oral cancer through the BCL-2/BAX/P53 signaling pathwayPreprint
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Anti‐Candida Phytochemicals and Isolated Compounds in Anacardiaceae Family—An Updated Review and In‐Silico AnalysisPreprint
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Insights Into the Role of Streptococcus mutans and Candida albicans in Dental Biofilm Formation and Cariogenicity: A Literature Review
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“Its morphological versatility - existing as yeast, pseudohyphae, or hyphae - significantly contributes to pathogenesis, with hyphae enabling tissue penetration while yeast forms facilitate dissemination and less invasive infections [39].”
Influential
Current and emerging therapies for fungal biofilms and systemic infections
Elgammal, Y., Martinez, R. I. G., Requejo, A., & Martinez, L. R. (2025) · Critical Reviews in Microbiology · doi:10.1080/1040841x.2025.2570185 · Cited by 4
“…of bloodstream infections (Gulati and nobile 2016). its virulence is linked to its ability to undergo morphological switching between a yeast and hyphae, with the hyphal form containing more chitin, providing additional structural protection against extracellular conditions (talapko et al. 2021).”

Authors: Talapko, J., Juzbašić, M., Matijević, T., Pustijanac, E., Bekić, S., Kotris, I., & Škrlec, I.
Affiliations: University of Osijek (HR)
Klinički bolnički centar Osijek (HR)
Juraj Dobrila University of Pula (HR)
Department of Internal Medicine, General County Hospital Vukovar, HR-3200 Vukovar, Croatia
Corresponding author: Škrlec, Ivana
ORCID: Talapko, Jasminka
Juzbašić, Martina
Matijević, Tatjana
Pustijanac, Emina
Škrlec, Ivana
Venue: Journal of Fungi
Publisher: MDPI AG
Published: 2021-01-22
Volume: 7
Issue: 2
Pages: 79
ISSN: 2309-608X (ISSN-L)
DOI: 10.3390/jof7020079
PMC: PMC7912069
OpenAlex: W3124481512
Cited by: 794
References: 175
Citations by year: 2026: 149 · 2025: 231 · 2024: 187 · 2023: 121 · 2022: 89 · 2021: 15
FWCI: 12.05
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
creativecommons.org/licenses/by/4.0/ (vor)
Locations: Journal of Fungi (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics: Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
Health Sciences › Medicine › Infectious Diseases › Fungal Infections and Studies
Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Fungal and yeast genetics research
Keywords: Candida albicans, virulence factors, candidiasis, oral candidiasis, invasive candidiasis, candidemia, commensalism, dysbiosis, mucosal barrier, host immune response, opportunistic fungal infection, clinical features

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Candida albicans—The Virulence Factors and Clinical Manifestations of Infection

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