By Chibuike Ibe et al.
Source Lancet
Globally, 1 565 000 people have invasive candidiasis every year. These individuals are mainly immunocompromised people, including critically ill patients in the intensive care unit, people receiving extended use of broad-spectrum antibiotics, and of late, individuals with complications of post-COVID-19 condition (also known as long COVID). Invasive candidiasis is often misdiagnosed and accounts for 995 000 deaths (63·6% of all cases) annually.1 As per estimates, Africa has a greater share of the invasive candidiasis burden than the rest of the world. These estimates are rough, and the paucity of accurate epidemiological data due to insufficient fungal diagnostics complicates efforts to accurately contextualise the disease.2
The Candida genus contains a mix of pathogens showing heterogeneous behaviour and unique pathogenic traits within the human host. For example, Candida glabrata commonly infects older individuals (≥65 years), whereas Candida parapsilosis is frequently isolated from neonates and infants. Candida albicans is the most versatile of all Candida pathogens and can cause infection that affects multiple organs, including the lungs and brain. Although these species are not generally transmitted between hosts, a newly emerging species, Candida auris, comprising six clades, causes large hospital outbreaks, changing the epidemiological landscape of invasive candidiasis (appendix p 1).
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