AmBisome, three challenges: Candida auris infection, central nervous system infection, and biofilm-associated infection

Autores de IIS La Fe

• Alba Cecilia Ruiz Gaitán

  Autor

Participantes ajenos a IIS La Fe

• del Pozo, JL

Grupos

• Infección Grave

  

  Investigador Principal

  María Ángeles Tormo Mas

Abstract

The treatment of invasive fungal infections remains a challenge, both for the diagnosis and for the need of providing the appropriate antifungal therapy. Candida auris is a pathogenic yeast that is responsible for hospital outbreaks, especially in intensive care units; it is characterized by a high resistance to the antifungal agents and can become multidrug-resistant. At present, the recommended antifungal agents for the invasive infections with this pathogen are echinocandins, always after carrying out an antifungal susceptibility testing. In case of no clinical response or persistent candidemia, the addition of liposomal amphotericin B or isavuconazole may be considered. Both fungal infection of the central nervous system and that associated with biomedical devices remain rare entities affecting mainly immunocompromised patients. However, an increase in their incidence in recent years, along with high morbidity and mortality, has been shown. The treatment of these infections is conditioned by the limited knowledge of the pharmacokinetic properties of antifungals. A better understanding of the pharmacokinetic and pharmacodynamic parameters of the different antifungals is essential to determine the efficacy of the antifungal agents in the treatment of these infections. (C) 2021 Asociacion Espanola de Micologla. Published by Elsevier Espana, S.L.U. All rights reserved.

Keywords

• Candida auris; Candidaemia; Antifungal therapy; Central nervous system infection; Biofilm; Catheter; Prosthetic joint; Liposomal amphotericin B