Let's learn about a common, dangerous fungal infection (Candida parapsilosis) in hospital environments

You probably know that we all have microorganisms that live harmlessly on our bodies, on our skin, in our mouths, and in our intestines. Candida is one such type of fungus (yeast). Although it usually doesn't bother us, sometimes this fungus starts to grow out of control. That's when it starts to cause serious conditions that can range from minor infections to life-threatening ones.

How does Candida infection become a problem?

Although there are over 150 types of Candida, only six types affect humans most commonly. The most common type is Candida albicans. You may have heard of thrush in your mouth or vaginal yeast infections in women. This is because the Candida fungus grows out of control. Medically, we call this condition candidiasis. Although it can be uncomfortable, it is rarely life-threatening. However, the problem begins when the Candida fungus enters your bloodstream or an internal organ. This serious infection is called invasive candidiasis. It can affect places like the heart, brain, and bones. If the fungus enters your bloodstream, it is called candidemia. This can be very serious, leading to prolonged hospitalization and sometimes even death.

So, what is Candida parapsilosis?

Recently, Candida parapsilosis has been identified as the second most common cause of fungal infections after Candida albicans. In some Asian, European, and South American countries, infections with C. parapsilosis have surpassed those of Candida albicans in hospitals. This has attracted the attention of doctors because of some of the dangerous characteristics of this fungus.

Why is C. parapsilosis different and more dangerous than other fungi?

Unlike other Candida species, C. parapsilosis is common in our environment. It can be found in soil, water, and on insects and domestic animals. It is also commonly found on our skin. There are several reasons why this fungus is a big problem, especially in hospital environments. Let's take a look at what they are.

Who is most at risk of this infection?

This fungal infection is not a major threat to a healthy, immune-compromised person. However, it is a major problem for patients in hospitals, especially those in intensive care units (ICUs). When this infection occurs in people who are already seriously ill, it is difficult to say for sure whether the cause of death is the infection itself or other underlying conditions. However, studies show that between 19% and 24% of patients with Candida infection in the blood die. The groups most at risk of infection with `Candida parapsilosis` are:

• Newborns : The risk is particularly high for babies born prematurely or with low birth weight.
• People with implanted medical devices : Patients with catheters, saline tubes, and other devices (implants) implanted in the body.
• Tube-fed patients: Those who are unable to eat by mouth and are fed through a tube.
• Immunocompromised patients: especially those whose HIV infection has progressed to AIDS .
• Those who have undergone surgery: Patients who have had major surgery, especially in the abdomen.

What is a biofilm? Why is it dangerous?

Another major reason why Candida is so dangerous is its ability to form a `Biofilm`. Simply put, a `Biofilm` is a protective colony of microorganisms that gather on a surface. It's like a fortress built to protect against enemies. This colony forms in several steps. First, the fungal cells attach to a surface. Then, they form a protective layer of slime around themselves. Then it becomes a well-grown colony. In the final step, parts of this colony can break off and spread the infection to other parts of the body.

Symptoms and diagnosis

The symptoms of C. parapsilosis infection are similar to those of other Candida infections. The main symptoms are an unexplained fever and chills . If the infection spreads to other parts of the body, other symptoms may also appear. Also, if there is an infection that does not go away despite antibiotics, doctors suspect a fungal infection. To diagnose the disease, the doctor will take a blood sample or a sample of infected tissue and send it to a laboratory. The sample can be cultured to identify the specific type of Candida that is causing the infection.

Treatment and prevention

Candidiasis infections are treated with antifungal drugs. Usually, a drug from a group of drugs called echinocandins is given intravenously. Once the type of fungus is identified, the drug may need to be changed. Fluconazole and amphotericin B are other commonly used drugs. However, Candida parapsilosis can sometimes be difficult to treat because the fungus can become resistant to some drugs. This means that the drugs cannot kill the fungus. This can reduce the effectiveness of the treatment and increase the cost of treatment. Therefore, it is more important to think about prevention than treatment.

What can be done to prevent it?

• Hand washing : This is the most important thing. It is essential for hospital staff to wash their hands properly when moving from one patient to another. In some studies, 28% of hospital staff had the fungus `C. parapsilosis` on their hands. So, when you visit a hospital, you should also take care to keep your hands clean.
• Preventive treatment: For patients at very high risk, doctors may prescribe antifungal medications as a measure to prevent an infection before it occurs.

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