Kandidaemia

Kandidaemia refers to the presence of Candida species in the bloodstream, indicating a systemic fungal infection known as candidemia. It is a significant clinical concern, particularly in immunocompromised individuals, hospitalized patients, and those with devices such as catheters or prosthetic devices, which can serve as entry points or reservoirs for infection.

Candida species, most commonly Candida albicans, are yeasts that are part of the normal flora of the skin, gastrointestinal tract, and mucous membranes. However, under certain conditions, they can become pathogenic and enter the bloodstream, leading to kandidaemia. Factors that increase the risk include prolonged use of antibiotics, immunosuppressive therapies, cancer, diabetes, and critical illness.

Symptoms of kandidaemia are often nonspecific and can include fever, chills, and signs of septicemia. Diagnosis involves blood cultures, which remain the gold standard, though new diagnostic methods like Serology and molecular techniques are increasingly used for rapid detection. Elevated beta-D-glucan levels may also support the diagnosis.

Treatment typically involves antifungal agents such as echinocandins, azoles, or amphotericin B. The choice depends on the species involved, patient condition, and potential antifungal resistance. Managing underlying risk factors, removing infected devices, and supportive care are crucial components of therapy.

Kandidaemia carries a high risk of complications, including metastatic infections and organ failure, and has an associated mortality rate that underscores its severity. Prevention strategies focus on infection control practices, judicious use of antibiotics, and early recognition in at-risk populations.