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Candida albicans—The Virulence Factors and Clinical Manifestations of Infection
Open accessAbstract
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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“The infection advance of C. albicans to the host is determined by the joint action of growth ability and virulence factors [56], but not all factors play an equally important role in the pathogenic process.”
From The F 1 F o -ATP synthase α subunit of Candida albicans induces inflammatory responses by controlling amino acid catabolism (2023) · cites this paper as [56]
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Lineage-specific adaptation and resistance in Candida albicans
Fernandes, M. Z., Maldonado, E., Martinez‐de‐Oliveira, J., Rolo, J., & Palmeira-de-Oliveira, A. (2026) · Fungal Genetics and Biology · doi:10.1016/j.fgb.2026.104116
In vitro evaluation of novel consensus-sequence-generated Brevinin-2 antimicrobial peptides
McDowell, C. M., Carder, J. D., Brozik, J. A., Horton, J., & Call, D. R. (2026) · Applied and Environmental Microbiology · doi:10.1128/aem.01553-26
“For example, this work did not address the activity of the peptides against Clostridioides difficile or Candida albicans , two organisms of extreme concern due to their propensity for nosocomial infections (42, 43).”
Shukla, J., & Dubey, A. K. (2026) · The Journal of Antibiotics · doi:10.1038/s41429-026-00958-4
“C. albicans remains a dominant fungal pathogen responsible for a wide range of infections from super fi cial mucosal infections to life-threatening systemic candidiasis [1, 2].”
Huq, M. A., & Rahman, M. M. (2026) · BioNanoScience · doi:10.1007/s12668-026-02858-1
“In immunocompromised individuals, it can lead to invasive systemic infections, presenting with fever and chills, and may progress to organ failure and death if left untreated [57, 59].”
Ghodrati, M., Sharifzadeh, A., Fasaei, B. N., Malakootikhah, J., Mirabi, S., & Koli, A. M. (2026) · BioNanoScience · doi:10.1007/s12668-026-02877-y
Resistant Candida spp. in Healthy Individuals: Mapping a Surveillance Blind Spot
Alves, A. M. C. V., de Lima, L. F., Cruz, G. S., Leite, A. C. R. D. M., de Brito, É. H. S., Azevedo, N. F., & Rodrigues, C. F. (2026) · Microbiology Research · doi:10.3390/microbiolres17090184
“This, of course, suggests that biofilm formation represents a key colonization strategy which grants persistence on mucosal surfaces that immunocompetent hosts tolerate without disease [33,34].”
InfluentialIron acquisition mechanisms of human skin-associated fungi
Jeon, J., Shin, J., & Jung, W. H. (2026) · FEMS Yeast Research · doi:10.1093/femsyr/foag045
“Although the skin is not usually considered the primary reservoir of commensal C. albicans , as the gut or mucosal surfaces are, it can clearly colonize and infect cutaneous sites under favorable conditions (Talapko et al. 2021 , Lopes and Lionakis 2022 , Song et al. 2024 ).”
Salih, M., & Yawoz, M. (2026) · Medical Mycology · doi:10.1093/mmy/myag104
Sriram, N., Sadiq, S. P., Vilwanathan, R., Sivaraman, T., Govindhapriya, M., Trivedi, R. K., & Sureshan, M. (2026) · Journal of Molecular Modeling · doi:10.1007/s00894-026-06962-7
Teixeira, K. S. S., de Mello, J. C. P., Nakamura, C. V., Ueda‐Nakamura, T., & Filho, B. P. D. (2026) · Natural Product Research · doi:10.1080/14786419.2026.2731632
Stack-Couture, S., Towriss, N., Skulska, I., Kalabina, A., Genereaux, J. L., Dumeaux, V., Shapiro, R. S., & Lajoie, P. (2026) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.64898/2026.09.24.753484
“C. albicans is the most common cause of invasive candidiasis, and its ability to switch between yeast and filamentous forms is crucial for invading host tissues, evading the immune system, and forming biofilms (Pappas et al., 2018; Shapiro et al., 2011; Soriano et al., 2023; Talapko et al., 2021) .”
Dawre, R., Malak, N. I., Raut, S. S., Mantri, R. S., & Parvez, S. (2026) · International Journal of Research in Medical Sciences · doi:10.18203/2320-6012.ijrms20263493
Ortiz‐Prado, E., Vásconez-González, J., Cuenca, K. A., Núñez-Loor, F., Acosta-Muñoz, M. C., Mesias, D. A., Villarreal-Burbano, K. B., Arias-Intriago, M., & Izquierdo‐Condoy, J. S. (2026) · Tropical Medicine and Infectious Disease · doi:10.3390/tropicalmed11100279
“…[98] Candida The morphological transition from blastospores to hyphae, adhesins (Als3 and Hwp1), biofilm formation, hydrolytic enzymes, and thigmotropism [99] Cryptococcus neoformans Adaptation to the host environment, phenotypic variations, and degradative enzymes such as proteases and lipases.”
Fraga, A. S., Lage, A. C. P., Kemmerich, K. K., Bartachini, J. C. F. J., Ribeiro, F. D. C., Garcia, M. T., Junqueira, J. C., & do Carmo, P. H. F. (2026) · ACS Omega · doi:10.1021/acsomega.6c04006
Investigation of naturally derived compounds with antibiofilm activity against Candida albicans
Guimarães, C. D. R. E., de Freitas, H. F., de Souza, T. A., Abreu, L. S., Tavares, J. F., & Barros, T. F. (2026) · Natural Product Research · doi:10.1080/14786419.2026.2738216
Ferroptosis Regulates the Biofilm Formation and Antifungal Drug Resistance of Candida albicans
Shen, J., Bian, M., & Miao, H. (2026) · International Dental Journal · doi:10.1016/j.identj.2026.111209
Course of invasive candidiasis in full-term newborns. Clinical cases
Семеко, О. Р., Sarkisyan, H. A., Zhirkova, Y. V., Muscherova, D. M., Сергеевна, З. К., Mitina, Y. Y., Kuksova, O. N., & Валентинович, Ш. П. (2026) · CHILDREN INFECTIONS · doi:10.22627/2072-8107-2026-25-3-67-72
Hamarsha, A. M., Atatra, M., Watted, N., Irekeola, A. A., Sulaiman, M. M., & Hasbullah, N. (2026) · International Journal of Molecular Sciences · doi:10.3390/ijms27209031
“Their principal biological failure mode is microbial colonisation, and Candida albicans is the organism most consistently recovered from prosthetic surfaces [3,4].”
Wang, G., Zhang, N., Peng, Y., Wen, X., Chen, X., Mei, Z., Gao, S., Min, C., Min, X., & Huang, J. (2026) · mSystems · doi:10.1128/msystems.00837-26
Attenuation of neutrophil driven inflammation and fungal growth by pilocarpine hydrochloridePreprint
Fingerhut, L., Burté, F., Ghobrial, J. M. W., Vermeren, S., Rossi, A. G., & Mills, B. (2026) · Research Square · doi:10.21203/rs.3.rs-10766704/v1
Chrysin-loaded PCL nanocapsule spray as a topical strategy against cutaneous candidiasis
da Silva, M. L., Domingos, E. L., Zein, A. K. E., Pontarolo, R., Sari, M. H. M., Reolon, J. B., & Ferreira, L. M. (2026) · Frontiers in Pharmacology · doi:10.3389/fphar.2026.1975087
“…which causes membrane disruption and triggers an inflammatory response; and biofilm formation on both biotic and abiotic surfaces, which provides high resistance to antifungal agents and shields the fungus from immune defenses (Shahabudin et al., 2024; Talapko et al., 2021; Tong and Tang, 2017).”
Khodashenas, S., Aboualigalehdari, E., Safdarian, M., Rezaei‐Matehkolaei, A., Didehdar, M., & Fatahinia, M. (2026) · Jundishapur Journal of Microbiology · doi:10.5812/jjm-168836
Dabiri, S., Qiao, J., Zafarbalanezhad, S., & Khorashad, A. S. (2026) · International Journal of Infection · doi:10.5812/iji-174674
“Despite advances in hospital care and the treatment of infectious diseases, the incidence of Candida infections involving mucosal sites, including the gastrointestinal and respiratory tracts and the vaginal mucosa, has increased substantially (3, 4).”
Headaches-associated CNS and systemic infections
Vongvaivanich, K., Thanprasertsuk, S., Rattanawong, W., Anukoolwittaya, P., & Roque, J. C. V. (2026) · Elsevier eBooks · doi:10.1016/b978-0-323-95313-9.00026-5
Risueño, I., Amigo-Morán, L., de Aranda-Izuzquiza, G., Gago-López, N., Quílez, C., Valencia, L., & Velasco, D. (2026) · Elsevier eBooks · doi:10.1016/b978-0-443-16110-0.00029-7
Metadata
- 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
- Venue
- Journal of Fungi
- Publisher
- MDPI AG
- Published
- 2021-01-22
- Volume
- 7
- Issue
- 2
- Pages
- 79
- ISSN
- 2309-608X (ISSN-L)
- 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
- 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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