''Candida tropicalis'' is a 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 ...

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 Amphotericin B is an antifungal medication used for serious fungal infections and leishmaniasis. The fungal infections it is used to treat include mucormycosis, aspergillosis, blastomycosis, candidiasis, coccidioidomycosis, and cryptococcosis. Fo ...

echinocandin Echinocandins are a class of antifungal drugs that inhibit the synthesis of β-glucan in the fungal cell wall via noncompetitive inhibition of the enzyme 1,3-β glucan synthase. The class has been termed the " penicillin of antifungals," along ...

s, or extended-spectrum

triazole 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 crypt ...

History and taxonomy

In the history of fungi, the name of genus ''Candida'', derived from the family Debaryomycetaceae, comes from the Latin term "" which has the meaning of “glowing white” and also refers to as smooth and glistering. Genus ''Candida'' referred to any asexual yeast without any of the following characteristics: production of

acetic acid Acetic acid , systematically named ethanoic acid , is an acidic, colourless liquid and organic compound with the chemical formula (also written as , , or ). Vinegar is at least 4% acetic acid by volume, making acetic acid the main component ...

, pigments of colours red, pink or orange,

arthroconidia Arthroconidia are a type of fungal spore typically produced by segmentation of pre-existing fungal hyphae. Background These spores are asexual and are generally not as durable and environmentally persistent as, for instance, bacterial endospores o ...

, unipolar or bipolar budding, enteroblastic-

basipetal This glossary of mycology is a list of definitions of terms and concepts relevant to mycology, the study of fungi. Terms in common with other fields, if repeated here, generally focus on their mycology-specific meaning. Related terms can be found ...

budding, blastoconidia formation on sympodulae, buds formation on stalks, triangular cells, needle-shaped terminal

conidia A conidium ( ; ), sometimes termed an asexual chlamydospore or chlamydoconidium (), is an asexual, non-motile spore of a fungus. The word ''conidium'' comes from the Ancient Greek word for dust, ('). They are also called mitospores due to the ...

, and having the ability to grow on

inositol Inositol, or more precisely ''myo''-inositol, is a carbocyclic sugar that is abundant in the brain and other mammalian tissues; it mediates cell signal transduction in response to a variety of hormones, neurotransmitters, and growth factors and ...

as a sole carbon source. Although there are 200 species identified in this genus, the taxonomy remains undefined and incomplete due to several reasons such as changing the words for some representations, the finding of new species and the reclassification of identified old species. This genus no longer includes species that test positive to diazonium blue B (DBB). The defunct genera ''Oidium'' and ''Monilia'' were used to represent the genus ''Candida''. In the genus ''Candida'', there are other species that are synonym of ''Candida tropicalis''. ''

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 ...

'' is taxonomically close to ''C. tropicalis'' sharing many pathogenic traits whereas '' C. maltosa'' and '' C. sake'' are physiologically similar to ''C. tropicalis'' but they can be differentiated by the growth at 35 °C (only ''C. sake'' showing negative) and assimilation of soluble starch (only ''C. tropicalis'' showing positive starch assimilation).

Identification

''C. tropicalis'' is easily identified using phenotypic and molecular methods. The identification of species in the genus ''Candida'' relies on morphological and physiological features. Species in the genus are vegetative cells which reproduce asexually by

budding Budding or blastogenesis is a type of asexual reproduction in which a new organism develops from an outgrowth or bud due to cell division at one particular site. For example, the small bulb-like projection coming out from the yeast cell is know ...

, and the structure, shape, septation, color and arrangement of buds is useful for identification. The production and appearance of pseudohyphae and blastoconidia may also be useful for identification. Physiological profiles relating to carbon and nitrogen utilization are of value in determining species, as are the presence certain distinctive biochemical features. Increasingly, molecular genetic methods such as DNA sequencing are used as primary tools for the accurate determination of species identifications in this group.

Growth and morphology

''C. tropicalis'' is a vegetative cell with the shape from round to oval ranging from approximately 2 – 10 micrometers. A mould exhibits dimorphism forming a single-celled yeast or so-called blastoconidia which reproduces by simple buddingㄡ

Conidia A conidium ( ; ), sometimes termed an asexual chlamydospore or chlamydoconidium (), is an asexual, non-motile spore of a fungus. The word ''conidium'' comes from the Ancient Greek word for dust, ('). They are also called mitospores due to the ...

is the asexual unit that are produced by budding of the tips or walls of the

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. Conidia is a type of simple and unicellular body that could take the form of multicellular cell with different shapes, sizes, and colors.

Microconidia A conidium ( ; ), sometimes termed an asexual chlamydospore or chlamydoconidium (), is an asexual, non-motile spore of a fungus. The word ''conidium'' comes from the Ancient Greek word for dust, ('). They are also called mitospores due to th ...

is used to refer to small and unicellular conidia whereas macroconidia refers to large and multicellular conidia. There are different media on which ''C. tropicalis'' can grow effectively. A common medium used is the Sabouraud’s agar which contains

peptone Peptides (, ) are short chains of amino acids linked by peptide bonds. Long chains of amino acids are called proteins. Chains of fewer than twenty amino acids are called oligopeptides, and include dipeptides, tripeptides, and tetrapeptides. A p ...

and sugar. This is enough for identifying the species but with a disadvantage of promoting

mycelial Mycelium (plural mycelia) is a root-like structure of a fungus consisting of a mass of branching, thread-like hyphae. Fungal colonies composed of mycelium are found in and on soil and many other substrate (biology), substrates. A typical single ...

growth and suppressing conidia formation. Another commonly used medium is the

cornmeal Cornmeal is a meal (coarse flour) or a cell membrane ground from dried corn. It is a common staple food, and is ground to coarse, medium, and fine consistencies, but not as fine as wheat flour can be.Herbst, Sharon, ''Food Lover's Companion'', ...

agar which is useful in inducing formation of conidia. Potato-glucose, potato-

carrot The carrot ('' Daucus carota'' subsp. ''sativus'') is a root vegetable, typically orange in color, though purple, black, red, white, and yellow cultivars exist, all of which are domesticated forms of the wild carrot, ''Daucus carota'', nat ...

tomato The tomato is the edible berry of the plant ''Solanum lycopersicum'', commonly known as the tomato plant. The species originated in western South America, Mexico, and Central America. The Mexican Nahuatl word gave rise to the Spanish word ...

juice,

lima bean A lima bean (''Phaseolus lunatus''), also commonly known as the butter bean, sieva bean, double bean, Madagascar bean, or wax bean is a legume grown for its edible seeds or beans. Origin and uses ''Phaseolus lunatus'' is found in Meso- and Sou ...

and others are also types of media used for growth. The optimal temperature for growth is between and growth is enhanced if sugar or fat is added in the medium. Colony of ''C. tropicalis'' are white, smooth and butyrous with a fringed border.

Physiology

''C. tropicalis'' reproduces asexually by the production of blastoconidia through

. As blastoconidia increase in number they may elongate in shape producing structures called the pseudohyphae. Under specific conditions of reduced oxygen level in host tissues, submerged colonies in agar medium, or in the presence of 5-10% CO₂, true, septate

e may form.

Physiological characteristics of ''C. tropicalis''

Growth

* Positive for C1 D-glucose, C2 D-glucose, C6 D-xylose, C11 Maltose, C12 α,α-trehalose, C22 Starch, C28 D-glucitol, C29 D-mannitol, C32 D-glucono-1,5-lactone, C33 2-keto-d-gluconate, C34 5-keto-d-gluconate, C39 succinate, C42 ethanol, N3 ethylamine, N4 L-lysine, N4 cadaverine, V2 without

myo-inositol Inositol, or more precisely ''myo''-inositol, is a carbocyclic sugar that is abundant in the brain and other mammalian tissues; it mediates cell signal transduction in response to a variety of hormones, neurotransmitters, and growth factors and ...

, V3 without

pantothenate Pantothenic acid, also called vitamin B5 is a water-soluble B vitamin and therefore an essential nutrient. All animals require pantothenic acid in order to synthesize coenzyme A (CoA) – essential for fatty acid metabolism – as well as to, i ...

, V5 without

thiamine Thiamine, also known as thiamin and vitamin B1, is a vitamin, an essential micronutrient, that cannot be made in the body. It is found in food and commercially synthesized to be a dietary supplement or medication. Phosphorylated forms of thi ...

, V7 without

pyridoxine Pyridoxine, is a form of vitamin B6 found commonly in food and used as a dietary supplement. As a supplement it is used to treat and prevent pyridoxine deficiency, sideroblastic anaemia, pyridoxine-dependent epilepsy, certain metabolic disorde ...

, V9 without

niacin Niacin, also known as nicotinic acid, is an organic compound and a form of vitamin B3, an essential human nutrient. It can be manufactured by plants and animals from the amino acid tryptophan. Niacin is obtained in the diet from a variet ...

, V10 without PABA, O1 0.01%

cycloheximide Cycloheximide is a naturally occurring fungicide produced by the bacterium ''Streptomyces griseus''. Cycloheximide exerts its effects by interfering with the translocation step in protein synthesis (movement of two tRNA molecules and mRNA in rela ...

, O2 0.1% cycloheximide. * Positive temperatures from .

Fermentation

* positive for F1 D-glucose, F2 D-glucose, F3 Maltose * positive delay after 7 days for F6 α,α-trehalose. * negative for F7 Melibiose, F8 Lactose, F9 Cellobiose, F11 Raffinose, F12 Inulin, F14 D-xylose. * negative delay after 7 days for F4 Me-α-D-glucoside, F10 Melezitose. * positive and negative for F5 Sucrose and F13 Starch.

Urea hydrolysis

This test is to detect yeast’s ability to produce enzyme urease. Once there's a compatible substrate,

urease Ureases (), functionally, belong to the superfamily of amidohydrolases and phosphotriesterases. Ureases are found in numerous bacteria, fungi, algae, plants, and some invertebrates, as well as in soils, as a soil enzyme. They are nickel-containin ...

will split urea to produce

ammonia Ammonia is an inorganic compound of nitrogen and hydrogen with the formula . A stable binary hydride, and the simplest pnictogen hydride, ammonia is a colourless gas with a distinct pungent smell. Biologically, it is a common nitrogenous was ...

increasing the pH. ''C. tropicalis'' is found to be urease negative.

Diazonium Blue B Test

This test uses the

azo dye Azo dyes are organic compounds bearing the functional group R−N=N−R′, in which R and R′ are usually aryl and substituted aryl groups. They are a commercially important family of azo compounds, i.e. compounds containing the C-N=N ...

, diazonium blue B which differentially stains cells from species affiliated with the Division, Basidiomycota. For ''C. tropicalis'', this test is negative.

Parasexuality

''C. tropicalis'' diploid cells of opposite

mating type Mating types are the microorganism equivalent to sexes in multicellular lifeforms and are thought to be the ancestor to distinct Sex, sexes. They also occur in macro-organisms such as fungi. Definition Mating types are the microorganism equivalent ...

can mate to form

tetraploid Polyploidy is a condition in which the cells of an organism have more than one pair of ( homologous) chromosomes. Most species whose cells have nuclei (eukaryotes) are diploid, meaning they have two sets of chromosomes, where each set contains ...

cells. These cells may then undergo

chromosome A chromosome is a long DNA molecule with part or all of the genetic material of an organism. In most chromosomes the very long thin DNA fibers are coated with packaging proteins; in eukaryotic cells the most important of these proteins are ...

loss during long-term propagation in rich medium resulting in the eventual regeneration of diploid cells. Such diploid cells are again mating competent thus completing a

parasexual cycle The parasexual cycle, a process restricted to fungi and single-celled organisms, is a nonsexual mechanism of parasexuality for transferring genetic material without meiosis or the development of sexual structures. It was first described by Italian ...

. Opaque ''C. tropicalis'' cells can also form an architecturally complex sexual

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 ...

.Jones SK Jr, Hirakawa MP, Bennett RJ. Sexual biofilm formation in Candida tropicalis opaque cells. Mol Microbiol. 2014 Apr;92(2):383-98. doi: 10.1111/mmi.12565. PMID 24612417

Habitat and ecology

Candida species are very pervasive yeasts that are distributed worldwide geographically. They are more likely to be found in tropical climate where temperature and humidity will enhance the adaptability of ''C. tropicalis''. They can be found in food such as

sauerkraut Sauerkraut (; , "sour cabbage") is finely cut raw cabbage that has been fermented by various lactic acid bacteria. It has a long shelf life and a distinctive sour flavor, both of which result from the lactic acid formed when the bacteria ferme ...

molasses Molasses () is a viscous substance resulting from refining sugarcane or sugar beets into sugar. Molasses varies in the amount of sugar, method of extraction and age of the plant. Sugarcane molasses is primarily used to sweeten and flavour foods ...

miso is a traditional Japanese seasoning. It is a thick paste produced by fermenting soybeans with salt and ''kōji'' (the fungus ''Aspergillus oryzae'') and sometimes rice, barley, seaweed, or other ingredients. It is used for sauces and spread ...

fruit In botany, a fruit is the seed-bearing structure in flowering plants that is formed from the ovary after flowering. Fruits are the means by which flowering plants (also known as angiosperms) disseminate their seeds. Edible fruits in particu ...

, baker’s yeast and some fruits. They are commonly found on plants and in the digestive system of

mammal Mammals () are a group of vertebrate animals constituting the class Mammalia (), characterized by the presence of mammary glands which in females produce milk for feeding (nursing) their young, a neocortex (a region of the brain), fur or ...

s, especially in the

gastrointestinal tract The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the digestive system that leads from the mouth to the anus. The GI tract contains all the major organ (biology), organs of the digestive syste ...

, and in the mucocutaneous membranes of humans. ''C. tropicalis'' is considered as an osmotolerant yeast; microorganisms that are able to survive in high salt concentration and able to develop fungal persistence in saline environments.

Storage and transportation

The selection of medium for sample growth is very important accounting for the pros and cons of each type of growth medium. Once decided on the medium, need to add 8 ug of

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 ...

per mL to limit bacterial growth and contamination. When the medium is ready, it is optional to add supplement to help and optimize specimen growth. After the growth, features examination including shape, size, bud arrangement, cell wall thickness, temperature of growth, pseudohyphae presence, arthroconidia presence, and capsule presence are all important to take into account. If the species are grown using any type of the medium mentioned, the transportation of specimens for testing should be completed in less than two hours. If there is any delay, the samples should be stored at 37 °C with the exception of contaminated specimens that need be stored in 4 °C.

Pathogenicity

In tropical countries, ''C. tropicalis'' is one of the most common colonizer and pathogen causing human disease, especially found on human skin, in the gastrointestinal tract and also in female genitourinary tract. It can be transmitted between health-care workers and patients, especially in environments such as hospitals. ''C. tropicalis'' can survive for up to 24 hours therefore be cross-transmitted to a second hand with a probability of 69% and to a third hand with 38% probability. It is the cause responsible for approximately half of the beyond-surface candida infections. ''C. tropicalis'' is the second most virulent ''Candida'' species that can significantly affect by spreading through the weakened immune system host and can occupy the gastrointestinal tract within 30 minutes of inoculation, all this resulting in increased mortality. Impact of

candidiasis Candidiasis is a fungal infection due to any type of '' Candida'' (a type of yeast). When it affects the mouth, in some countries it is commonly called thrush. Signs and symptoms include white patches on the tongue or other areas of the mouth ...

, infections cause by ''C. tropicalis'', have increased globally. ''C. tropicalis'' is virulent due to its ability to produce

, secrete lytic enzymes, adhere to epithelial and endothelial cells, and undergo transition of bud to hyphae. Biofilms are complex structures that are formed from the grouping of microorganisms on a local surface, either biotic or abiotic, dependent on the ability of cellular adhesion to substrates. For ''C. tropicalis'' to fully enter and cause infection in the host, it needs some helpers. First, once it is attached onto the host tissues, extracellular enzymes called the proteases will be produced to facilitate the penetration of the pathogen and allow it to interfere with the host defense system.

protease A protease (also called a peptidase, proteinase, or proteolytic enzyme) is an enzyme that catalyzes (increases reaction rate or "speeds up") proteolysis, breaking down proteins into smaller polypeptides or single amino acids, and spurring the ...

s will hydrolyze peptide bonds; secreted

aspartic protease Aspartic proteases are a catalytic type of protease enzymes that use an activated water molecule bound to one or more aspartate residues for catalysis of their peptide substrates. In general, they have two highly conserved aspartates in the active ...

s (SAP) support ''C. tropicalis'' to be attached and penetrate deep into the tissues to affect the organs.

phospholipase A phospholipase is an enzyme that hydrolyzes phospholipids into fatty acids and other lipophilic substances. Acids trigger the release of bound calcium from cellular stores and the consequent increase in free cytosolic Ca2+, an essential step in ...

s will hydrolyze phospholipid; assist to break the epithelial cell membrane structure allowing the hyphal tip to enter into the cytoplasm. Many conditions that contribute to ''C. tropicalis'' survival and colonization are: a) increase the use of antifungal regimen, b) increased number of immunocompromised patients, c) long-term use of

catheter In medicine, a catheter (/ˈkæθətər/) is a thin tube made from medical grade materials serving a broad range of functions. Catheters are medical devices that can be inserted in the body to treat diseases or perform a surgical procedure. Cath ...

s, and d) use of broad-spectrum

antibiotics An antibiotic is a type of antimicrobial substance active against bacteria. It is the most important type of antibacterial agent for fighting bacterial infections, and antibiotic medications are widely used in the treatment and prevention o ...

. Although different tests are able to use for identification of species, each of the tests will have different limitations such as sensitivity, specificity, cost and equipment availability.

Human diseases

Types of disease caused by ''C. tropicalis'' will vary depending on the location where the species colonizes. With an infection in the mucous membrane, subject will experience oropharyngeal candidiasis,

angular cheilitis Angular cheilitis (AC) is inflammation of one or both corners of the mouth. Often the corners are red with skin breakdown and crusting. It can also be itchy or painful. The condition can last for days to years. Angular cheilitis is a type of ch ...

balanoposthitis Balanitis is inflammation of the glans penis. When the foreskin is also affected, the proper term is balanoposthitis. Balanitis on boys still in diapers must be distinguished from redness caused by ammoniacal dermatitis. The word ''balanitis'' is ...

oral thrush Oral candidiasis, also known as oral thrush among other names, is candidiasis that occurs in the mouth. That is, oral candidiasis is a mycosis (yeast/fungal infection) of ''Candida'' species on the mucous membranes of the mouth. ''Candida albica ...

and

vulvovaginal candidiasis Vaginal yeast infection, also known as candidal vulvovaginitis and vaginal thrush, is excessive growth of yeast in the vagina that results in irritation. The most common symptom is vaginal itching, which may be severe. Other symptoms include burn ...

. Although provided with oral cavity defenses such as epithelial cells, saliva, salivary immunoglobin (IgA),

lysozyme Lysozyme (EC 3.2.1.17, muramidase, ''N''-acetylmuramide glycanhydrolase; systematic name peptidoglycan ''N''-acetylmuramoylhydrolase) is an antimicrobial enzyme produced by animals that forms part of the innate immune system. It is a glycoside ...

lactoferrin Lactoferrin (LF), also known as lactotransferrin (LTF), is a multifunctional protein of the transferrin family. Lactoferrin is a globular glycoprotein with a molecular mass of about 80 kDa that is widely represented in various secretory fluids, su ...

, histidine-rich polypeptide and

lactoperoxidase Lactoperoxidase is a peroxidase enzyme secreted from mammary, salivary and other mucosal glands including the lungs, bronchii and nose that functions as a natural and the first line of defense against bacteria and viruses. Lactoperoxidase is a m ...

to suppress ''C. tropicalis''’ overgrowth, ''C. tropicalis'' is reported to secrete additional products that can preferably target onto

T-cell A T cell is a type of lymphocyte. T cells are one of the important white blood cells of the immune system and play a central role in the adaptive immune response. T cells can be distinguished from other lymphocytes by the presence of a T-cell rec ...

deficient host. ''C. tropicalis'' is a normal flora which is found on the skin and nails on approximately 10% of the patients. Superficial and localized mucosal infections are mostly reported with a higher risk factor when combined with other diseases found in a patient. Patients with ''C. tropicalis'' infections are also seen with

denture Dentures (also known as false teeth) are prosthetic devices constructed to replace missing teeth, and are supported by the surrounding soft and hard tissues of the oral cavity. Conventional dentures are removable (removable partial denture or ...

HIV The human immunodeficiency viruses (HIV) are two species of ''Lentivirus'' (a subgroup of retrovirus) that infect humans. Over time, they cause acquired immunodeficiency syndrome (AIDS), a condition in which progressive failure of the immune ...

infection or irradiation for malignancies. 38% of

AIDS Human immunodeficiency virus infection and acquired immunodeficiency syndrome (HIV/AIDS) is a spectrum of conditions caused by infection with the human immunodeficiency virus (HIV), a retrovirus. Following initial infection an individual m ...

patients with recurrent disease are more likely to get infected by ''C. tropicalis'', getting

and oropharyngeal candidiasis. Only filamentous growth of ''C. tropicalis'' have the ability to invade and colonize orally in the epithelium, commonly seen in cancer patients and higher risk for someone who subsequently develops disseminated invasive disease. Candiduria is referred to as urinary tract infections caused by ''C. tropicalis'' which are often presented as

nosocomial infections 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 ...

. Although up to 2% of patients are asymptomatic, those with

diabetes mellitus Diabetes, also known as diabetes mellitus, is a group of metabolic disorders characterized by a high blood sugar level ( hyperglycemia) over a prolonged period of time. Symptoms often include frequent urination, increased thirst and increased ap ...

and with

leukemia Leukemia ( also spelled leukaemia and pronounced ) is a group of blood cancers that usually begin in the bone marrow and result in high numbers of abnormal blood cells. These blood cells are not fully developed and are called ''blasts'' or ' ...

are more likely to be infected. If an infection involves interdigital candidiasis,

paronychia Paronychia is an inflammation of the skin around the nail, which can occur suddenly, when it is usually due to the bacterium '' Staphylococcus aureus'', or gradually when it is commonly caused by the fungus ''Candida albicans''. The term is fr ...

and diaper rash, subject is likely to have cutaneous candidiasis. Otherwise, if an infection involves body fluid and internal organs damages, subject will experience pulmonary candidiasis, invasive and disseminated candidiasis, gastrointestinal candidiasis and

candidemia Fungemia is the presence of fungi or yeasts in the blood. The most common type, also known as candidemia, candedemia, or systemic candidiasis, is caused by '' Candida'' species; candidemia is also among the most common bloodstream infections of a ...

. ''C. tropicalis'' colonization is favoured in the gastrointestinal tract; a common risk factor for individuals that are susceptible for invasive candidiasis development. Candidemia is a worldwide bloodstream disease mainly affecting peripheral organs in humans. Usually, candidemia caused by ''C. tropicalis'' are associated with cancer patients that have either leukemia or

neutropenia Neutropenia is an abnormally low concentration of neutrophils (a type of white blood cell) in the blood. Neutrophils make up the majority of circulating white blood cells and serve as the primary defense against infections by destroying bacteria ...

. According to the data obtained from 2010, frequency of candidemia is 12-25% in the US, 4.5-9% in Europe, 20-24% in Brazil and 20-60% in South Asia. ''C. tropicalis'' can cause nosocomial fungal bloodstream infections along with ''C. glabrata'' and ''C. parapsilosis''. Mortality rate of invasive and disseminated infections caused by ''C. tropicalis'' is high, ranging from 40% to 70%. Risk factors that contribute to the high rate are leukemia, anti-neoplastic chemotherapy, previous neutropenia, central venous catheters, long stay on intensive care and total parenteral nutrition. Although children infections are not as common seen as in adults, leukemia, secondary neutropenia and bone marrow transplantation are factors favouring ''C. tropicalis'' infections. Another infection seen commonly in patients who have leukemia and secondary neutropenia, is chronic disseminated candidiasis (CDC) is another type of disseminated candida infection that mainly develops in the liver, spleen and kidney.

Treatment and prevention

The most important and most essential step to prevent contact with the fungi species is by washing the hands. There are several types of therapy for the different level of infections caused by ''C. tropicalis''. Normally, antifungal agents are used to treat these infections.

Amphotericin B deoxycholate Amphotericin B is an antifungal medication used for serious fungal infections and leishmaniasis. The fungal infections it is used to treat include mucormycosis, aspergillosis, blastomycosis, candidiasis, coccidioidomycosis, and cryptococcosis. ...

is the most common treatment antifungal agent used to treat ''Candida'' infections. Topical antifungal agents are commonly taken in 3 forms: oral suspension, ointment and powder. Oral suspension is mainly used to treat thrush whereas ointment is directly applied onto the infected section.

Nystatin Nystatin, sold under the brandname Mycostatin among others, is an antifungal medication. It is used to treat '' Candida'' infections of the skin including diaper rash, thrush, esophageal candidiasis, and vaginal yeast infections. It may also be ...

is a type of antifungal agent used because it is not absorbed by the gastrointestinal tract. These types of agents will function to lower candida species’ phospholipases activities. Flucytosine ( 5FC) is another type of therapy treatment including 3 agents used;

caspofungin Caspofungin (INN) (brand name Cancidas) is a lipopeptide antifungal drug from Merck & Co., Inc. discovered by James Balkovec, Regina Black and Frances A. Bouffard. It is a member of a new class of antifungals termed the echinocandins. It wor ...

micafungin Micafungin, sold under the brand name Mycamine, is an echinochandin antifungal medication used to treat and prevent invasive fungal infections including candidemia, abscesses, and esophageal candidiasis. It inhibits the production of beta-1,3-g ...

and

anidulafungin Anidulafungin (International nonproprietary name, INN) (trade names Eraxis, Ecalta) is a Semisynthesis, semisynthetic echinocandin used as an antifungal medication, antifungal drug. It was previously known as LY303366. It may also have applicatio ...

. Usage of caspofungin will efficiently target against oropharyngeal and oesophgeal candidiasis and invasive candidiasis. Micafungin, compared to amphotericin B, it is more efficient. Anidulafungin results are similar to Caspofungin and Micafungin.

are a type of non-competitive inhibitors of cell wall 1,3-b-D-glucan synthase complex mainly used to treat fungal infections.

Azole Azoles are a class of five-membered heterocyclic compounds containing a nitrogen atom and at least one other non-carbon atom (i.e. nitrogen, sulfur, or oxygen) as part of the ring. Their names originate from the Hantzsch–Widman nomenclature. Th ...

s are agents that can deplete

ergosterol Ergosterol (ergosta-5,7,22-trien-3β-ol) is a sterol found in cell membranes of fungi and protozoa, serving many of the same functions that cholesterol serves in animal cells. Because many fungi and protozoa cannot survive without ergosterol, the ...

, the main component of the fungus cell wall membrane, in order to inhibit fungal growth.

is water-soluble, ready to be taken orally. ''C. tropicalis'' can rapidly develop resistance towards fluconazole therefore it's not recommended to retreat fluconazole-treated patients with recurrent candidiasis. Other azoles that are highly active against ''C. tropicalis'' are

itraconazole Itraconazole, sometimes abbreviated ITZ, is an antifungal medication used to treat a number of fungal infections. This includes aspergillosis, blastomycosis, coccidioidomycosis, histoplasmosis, and paracoccidioidomycosis. It may be given by mouth ...

voriconazole Voriconazole, sold under the brand name Vfend among others, is an antifungal medication used to treat a number of fungal infections. This includes aspergillosis, candidiasis, coccidioidomycosis, histoplasmosis, penicilliosis, and infections by '' ...

posaconazole Posaconazole, sold under the brand name Noxafil among others, is a triazole antifungal medication. It was approved for medical use in the United States in September 2006, and is available as a generic medication. Medical uses Posaconazole is u ...

ravuconazole Ravuconazole (codenamed BMS-207147 and ER-30346) is a potent triazole antifungal, the development of which was discontinued in 2007. The drug has shown to have a similar spectrum of activity to voriconazole, with an increased half-life. Howev ...

and isavuconazole. Voriconazole is a new generation from fluconazole with a higher potential of broad spectrum activity. All of the mentioned treatments and drug therapies can also be applied onto neonates and premature newborns taking into account the amount of recommended dose. Although there are several ways to treat the different types of ''C. tropicalis''’ infections, the best way to improve treatments results is to improve host immune system.

References

{{Authority control Yeasts tropicalis Organisms with an alternative genetic code Pathogenic microbes Fungi described in 1910