Candida Parapsilosis
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''Candida parapsilosis'' is a
fungal A fungus ( : fungi or funguses) is any member of the group of eukaryotic organisms that includes microorganisms such as yeasts and molds, as well as the more familiar mushrooms. These organisms are classified as a kingdom, separately from th ...
species of
yeast Yeasts are eukaryotic, single-celled microorganisms classified as members of the fungus kingdom. The first yeast originated hundreds of millions of years ago, and at least 1,500 species are currently recognized. They are estimated to constitut ...
that has become a significant cause of
sepsis Sepsis, formerly known as septicemia (septicaemia in British English) or blood poisoning, is a life-threatening condition that arises when the body's response to infection causes injury to its own tissues and organs. This initial stage is follo ...
and of wound and tissue infections in immunocompromised people. Unlike ''
Candida albicans ''Candida albicans'' is an opportunistic pathogenic yeast that is a common member of the human gut flora. It can also survive outside the human body. It is detected in the gastrointestinal tract and mouth in 40–60% of healthy adults. It is us ...
'' and ''
Candida tropicalis ''Candida tropicalis'' is a species of yeast in the genus '' Candida''. It is a common pathogen in neutropenic hosts, in whom it may spread through the bloodstream to peripheral organs. For invasive disease, treatments include amphotericin B, ec ...
'', ''C. parapsilosis'' is not an
obligate {{wiktionary, obligate As an adjective, obligate means "by necessity" (antonym ''facultative'') and is used mainly in biology in phrases such as: * Obligate aerobe, an organism that cannot survive without oxygen * Obligate anaerobe, an organism that ...
human pathogen, having been isolated from nonhuman sources such as domestic animals, insects and soil. ''C. parapsilosis'' is also a normal human
commensal Commensalism is a long-term biological interaction (symbiosis) in which members of one species gain benefits while those of the other species neither benefit nor are harmed. This is in contrast with mutualism, in which both organisms benefit fro ...
and it is one of the fungi most frequently isolated from human hands. There are several risk factors that can contribute to ''C. parapsilosis'' colonization. Immunocompromised individuals and surgical patients, particularly those undergoing surgery of the gastrointestinal tract, are at high risk for infection with ''C. parapsilosis''. There is currently no consensus on the treatment of
invasive candidiasis Invasive candidiasis is an infection (candidiasis) that can be caused by various species of ''Candida'' yeast. Unlike ''Candida'' infections of the mouth and throat (oral candidiasis) or vagina ( ''Candidal'' vulvovaginitis), invasive candidias ...
caused by ''C. parapsilosis'', although the therapeutic approach typically includes the removal of foreign bodies such as implanted prostheses and the administration of systemic
antifungal An antifungal medication, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis (thrush), serious systemic infections such as crypto ...
therapy.
Amphotericin B Amphotericin B is an antifungal medication used for serious mycosis, fungal infections and leishmaniasis. The fungal infections it is used to treat include mucormycosis, aspergillosis, blastomycosis, candida infections, candidiasis, coccidioidomy ...
and
Fluconazole Fluconazole is an antifungal medication used for a number of fungal infections. This includes candidiasis, blastomycosis, coccidiodomycosis, cryptococcosis, histoplasmosis, dermatophytosis, and pityriasis versicolor. It is also used to prevent ...
are often used in the treatment of ''C. parapsilosis'' infection.


History and taxonomy

''Candida parapsilosis'' was discovered in
Puerto Rico Puerto Rico (; abbreviated PR; tnq, Boriken, ''Borinquen''), officially the Commonwealth of Puerto Rico ( es, link=yes, Estado Libre Asociado de Puerto Rico, lit=Free Associated State of Puerto Rico), is a Caribbean island and Unincorporated ...
in 1928 by Ashford from a diarrheal stool. It was first named ''Monilia parapilosis'' and considered nonpathogenic. It was later encountered as a causative agent of sepsis in an intravenous drug user in 1940. It is now considered an important, emerging
nosocomial A hospital-acquired infection, also known as a nosocomial infection (from the Greek , meaning "hospital"), is an infection that is acquired in a hospital or other health care facility. To emphasize both hospital and nonhospital settings, it is ...
pathogen. ''C. parapsilosis'' is the most common non-''C. albicans'' species of ''Candida'' and the second most common pathogen in superficial candidiasis after ''C. albicans''.


Biology

''Candida parapsilosis'' does not form true
hypha A hypha (; ) is a long, branching, filamentous structure of a fungus, oomycete, or actinobacterium. In most fungi, hyphae are the main mode of vegetative growth, and are collectively called a mycelium. Structure A hypha consists of one or ...
e; it exists in either a yeast phase or pseudohyphal form. It is white, creamy, and shiny in dextrose agar and its cell shape is oval, round, or cylindrical. When ''C. parapsilosis'' is in yeast form, its
phenotype In genetics, the phenotype () is the set of observable characteristics or traits of an organism. The term covers the organism's morphology or physical form and structure, its developmental processes, its biochemical and physiological proper ...
is smooth or cratered. In contrast, the phenotype of the pseudohyphae form is wrinkled or concentric. Recently found the formation of pseudohyphae is another significant factor that changes the morphology and phenotype of colonies which is related to
citrulline The organic compound citrulline is an α-amino acid. Its name is derived from ''citrullus'', the Latin word for watermelon. Although named and described by gastroenterologists since the late 19th century, it was first isolated from watermelon in 1 ...
. ''C. parapsilosis'' is encountered more frequently in nature than other species ''Candida'', likely because it is one of the few species of the genus not restricted to humans. ''C. parapsilosis'' does not need prior colonization and is usually transmitted by external sources. Invasive infection occurs very often in low-birth weight newborn babies in the United States, and bloodstream infection found in North America. It is most commonly isolated from human skin and is most frequently encountered in Asia and Latin America. ''C. parapsilosis'' is considered a
killer yeast A killer yeast is a yeast, such as ''Saccharomyces cerevisiae'', which is able to secrete one of a number of toxic proteins which are lethal to susceptible cells. These "killer toxins" are polypeptides that kill sensitive cells of the same or relat ...
and fungal antagonist based on its ability to produce chemicals that exert cytotoxic effects on the cells of other organisms.


Disease

Endocarditis Endocarditis is an inflammation of the inner layer of the heart, the endocardium. It usually involves the heart valves. Other structures that may be involved include the interventricular septum, the chordae tendineae, the mural endocardium, or the ...
can be caused by ''C. parapsilosis'' in patients using prosthetic valves (57.4%), intravenous drug (20%), or having intravenous parenteral nutrition (6.9%), abdominal surgery (6.9%), immunosuppression (6.4%), treatment with broad-spectrum antibiotics (5.6%), and previous valvular disease (4.8%). Although the mortality rate is 41.7% to 61%, the treatment is still unknown. Ocular infection caused by ''C. parapsilosis'' has been reported after cataract extraction and with corticosteroid eye drop use. ''C. parapsilosis'' infection of the skin and gastrointestinal tract can occur, in which the production of pseudohyphae is associated with the elicitation of an inflammatory response. ''Candida parapsilosis'' is occasionally encountered in
onychomycosis Onychomycosis, also known as tinea unguium, is a fungal infection of the nail. Symptoms may include white or yellow nail discoloration, thickening of the nail, and separation of the nail from the nail bed. Toenails or fingernails may be affected ...
.Different toenail onychomycosis due to Rhodotorula mucilaginosa and Candida parapsilosis in an immunocompetent young adult
Gai Ge,a Dongmei Li,b Huan Mei,c Guixia Lu,c Hailin Zheng,c Weida Liu,c and Dongmei Shid,∗
Adhesion Adhesion is the tendency of dissimilar particles or surfaces to cling to one another ( cohesion refers to the tendency of similar or identical particles/surfaces to cling to one another). The forces that cause adhesion and cohesion can be ...
capacity and
biofilm A biofilm comprises any syntrophic consortium of microorganisms in which cells stick to each other and often also to a surface. These adherent cells become embedded within a slimy extracellular matrix that is composed of extracellular ...
are important for ''C. parapsilosis'', because ''C. parapilosis'' infection is mostly due to the use of in-dwelling devices. Adhesion capacity is the ability of fungus to adhere to other organisms' cells or tissue, especially mucosal surfaces, which is required for initial colonization. ''C. parapsilosis'' is associated with thin, unstructured biofilms that consist of aggregated
blastospore A blastospore is an asexual fungal spore produced by budding. Produced by fungi within the phylum Glomeromycota and others. It is also known as a blastoconidium (plural = blastoconidia). An example of a fungus that forms blastospores is ''Ca ...
s whose membranes contain more carbohydrate than protein. The existence of the fungus in a biofilm contributes to its ability to resist antifungal treatment. Thus, adhesion to abiotic and biotic surfaces is often a precursor to infection. The risk of ''C. parapsilosis'' infection is increased in the setting of implanted medical devices, prostheses, and therapy with hyperalimentation solutions. Also, low-birth weight infants are at higher risk of sepsis from this species.


References

{{taxonbar , from = Q144068 parapsilosis Yeasts Fungi described in 1932