Global guideline for the diagnosis and management of candidiasis: an initiative of the ECMM in cooperation with ISHAM and ASM
Oliver A. Cornely, Rosanne Sprute, Matteo Bassetti, Wen Chen, Andreas H. Groll, Oliver Kurzai, Cornelia Lass‐Flörl, Luis Ostrosky‐Zeichner, Riina Rautemaa‐Richardson, Gunturu Revathi, Marı́a Elena Santolaya, P Lewis White, Ana Alastruey‐Izquierdo, Maiken Cavling Arendrup, John W. Baddley, Aleksandra Barac, Ronen Ben‐Ami, Adrian Brink, Jan Grothe, Jesús Guinea, Ferry Hagen, Bruno Hochhegger, Martin Hoenigl, Shahid Husain, Kauser Jabeen, Henrik Elvang Jensen, Souha S. Kanj, Philipp Koehler, Thomas Lehrnbecher, Russell E. Lewis, Jacques F. Meis, M. Hong Nguyen, Zoi Dorothea Pana, Peter‐Michael Rath, Ilana Reinhold, Danila Seidel, Takahiro Takazono, Donald C. Vinh, Sean X. Zhang, Javier Afeltra, Abdullah M. S. Al‐Hatmi, Amir Arastehfar, Sevtap Arıkan-Akdağlı, Felix Bongomin, Fabianne Carlesse, Methee Chayakulkeeree, Louis Yi Ann Chai, Leili Chamani‐Tabriz, Tom Chiller, Anuradha Chowdhary, Cornelius J. Clancy, Arnaldo Lopes Colombo, Andrea Cortegiani, Dora Corzo-León, Ľuboš Drgoňa, Anna Dudakova, Joveria Farooqi, Sara Gago, Macit İlkit, Jeffrey D. Jenks, Н Н Климко, Robert Krause, Anil Kumar, Katrien Lagrou, Michail S. Lionakis, B. Lmimouni, Michael K. Mansour, Joseph Meletiadis, Sibylle C. Mellinghoff, Mervyn Mer, Małgorzata Mikulska, Philippe Montravers, Chin Fen Neoh, Volkan Özenci, Livio Pagano, Peter G. Pappas, Thomas F. Patterson, Pedro Puerta‐Alcalde, Laman Rahimli, Sebastian Rahn, Emmanuel Roilides, Coleman Rotstein, Tamara Ruegamer, Raquel Sabino, Jon Salmanton‐García, Ilan S. Schwartz, Esther Segal, Neeraj Sidharthan, Tanu Singhal, János Sinkó, Rajeev Soman, Andrej Spec, Joerg Steinmann, Jannik Stemler, Saad J. Taj‐Aldeen, Alida Fe Talento, George R Thompson, Christina Toebben, Hiram Villanueva‐Lozano, Retno Wahyuningsih
Abstract
Candida species are the predominant cause of fungal infections in patients treated in hospital, contributing substantially to morbidity and mortality. Candidaemia and other forms of invasive candidiasis primarily affect patients who are immunocompromised or critically ill. In contrast, mucocutaneous forms of candidiasis, such as oral thrush and vulvovaginal candidiasis, can occur in otherwise healthy individuals. Although mucocutaneous candidiasis is generally not life-threatening, it can cause considerable discomfort, recurrent infections, and complications, particularly in patients with underlying conditions such as diabetes or in those taking immunosuppressive therapies. The rise of difficult-to-treat Candida infections is driven by new host factors and antifungal resistance. Pathogens, such as Candida auris (Candidozyma auris) and fluconazole-resistant Candida parapsilosis, pose serious global health risks. Recent taxonomic revisions have reclassified several Candida spp, potentially causing confusion in clinical practice. Current management guidelines are limited in scope, with poor coverage of emerging pathogens and new treatment options. In this Review, we provide updated recommendations for managing Candida infections, with detailed evidence summaries available in the appendix.