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We often think of fungal infections as simply bothersome conditions such as athlete’s foot or toenail fungus. But certain types of fungal infections, known as “ ”( ), can be dangerous and fatal. IFIs are systemic and are typically caused when fungi invade the body in various ways such as through the bloodstream or by the inhalation of spores. IFIs can also spread to many other organs such as the liver and kidney. They are associated with ( ) > % • Invasive candidiasis ( ) is a common hospital-acquired infection in the U.S., % cases each year.v • Invasive aspergillosis () occurs most often in people with weakened immune systems or lung disease, and its prevalence is vi An increasing number of people in the U.S. have putting them at greater risk for IFIs.x High-risk groups include: hospitalized patients cancer or transplant patients patients undergoing surgery patients with chronic diseases Rates of invasive candidiasis are dicult ( )is an emerging drug-resistant to estimate and can vary based on time, fungus that spreads quickly and has caused serious region, and study type. and deadly infections in over a dozen countries. + Still, it is clear that overall The CDC estimates that remain high – especially in the U.S. with invasive ix among viii There is an increasingly urgent need to develop new therapies for IFIs, Currently available treatments for IFIs have signicant limitations such as: • toxicities/side eects • inconsistent achievement of target drug levels • interactions with other drugs • increasing microbial resistance As the urgency around IFIs rises, multiple biopharma companies and researchers are working to develop new therapies to treat and prevent them. / i https://www.cidara.com/rezafungin/#opportunity ii http://ir.cidara.com/phoenix.zhtml?c=253962&p=RssLanding&cat=news&id=2354755 iii https://wwwnc.cdc.gov/eid/article/23/2/15-2042_article iv https://www.cidara.com/rezafungin/#opportunity v https://www.cdc.gov/fungal/diseases/candidiasis/invasive/statistics.html vi https://www.cdc.gov/fungal/diseases/aspergillosis/statistics.html vii https://www.cdc.gov/fungal/candida-auris/c-auris-drug-resistant.html viii https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3928396/ ix https://www.cdc.gov/fungal/diseases/candidiasis/pdf/Candida_auris_508.pdf x https://www.cdc.gov/fungal/cdc-and-fungal.html.

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Oral Candidiasis: a Review
International Journal of Pharmacy and Pharmaceutical Sciences ISSN- 0975-1491 Vol 2, Issue 4, 2010 Review Article ORAL CANDIDIASIS: A REVIEW YUVRAJ SINGH DANGI1, MURARI LAL SONI1, KAMTA PRASAD NAMDEO1 Institute of Pharmaceutical Sciences, Guru Ghasidas Central University, Bilaspur (C.G.) – 49500 Email: [email protected] Received: 13 Jun 2010, Revised and Accepted: 16 July 2010 ABSTRACT Candidiasis, a common opportunistic fungal infection of the oral cavity, may be a cause of discomfort in dental patients. The article reviews common clinical types of candidiasis, its diagnosis current treatment modalities with emphasis on the role of prevention of recurrence in the susceptible dental patient. The dental hygienist can play an important role in education of patients to prevent recurrence. The frequency of invasive fungal infections (IFIs) has increased over the last decade with the rise in at‐risk populations of patients. The morbidity and mortality of IFIs are high and management of these conditions is a great challenge. With the widespread adoption of antifungal prophylaxis, the epidemiology of invasive fungal pathogens has changed. Non‐albicans Candida, non‐fumigatus Aspergillus and moulds other than Aspergillus have become increasingly recognised causes of invasive diseases. These emerging fungi are characterised by resistance or lower susceptibility to standard antifungal agents. Oral candidiasis is a common fungal infection in patients with an impaired immune system, such as those undergoing chemotherapy for cancer and patients with AIDS. It has a high morbidity amongst the latter group with approximately 85% of patients being infected at some point during the course of their illness. A major predisposing factor in HIV‐infected patients is a decreased CD4 T‐cell count.
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Candida Auris
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Oral Antifungals Month/Year of Review: July 2015 Date of Last
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Fungal Infections – an Overview
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Fungal Sepsis: Optimizing Antifungal Therapy in the Critical Care Setting
Fungal Sepsis: Optimizing Antifungal Therapy in the Critical Care Setting a b,c, Alexander Lepak, MD , David Andes, MD * KEYWORDS Invasive candidiasis Pharmacokinetics-pharmacodynamics Therapy Source control Invasive fungal infections (IFI) and fungal sepsis in the intensive care unit (ICU) are increasing and are associated with considerable morbidity and mortality. In this setting, IFI are predominantly caused by Candida species. Currently, candidemia represents the fourth most common health care–associated blood stream infection.1–3 With increasingly immunocompromised patient populations, other fungal species such as Aspergillus species, Pneumocystis jiroveci, Cryptococcus, Zygomycetes, Fusarium species, and Scedosporium species have emerged.4–9 However, this review focuses on invasive candidiasis (IC). Multiple retrospective studies have examined the crude mortality in patients with candidemia and identified rates ranging from 46% to 75%.3 In many instances, this is partly caused by severe underlying comorbidities. Carefully matched, retrospective cohort studies have been undertaken to estimate mortality attributable to candidemia and report rates ranging from 10% to 49%.10–15 Resource use associated with this infection is also significant. Estimates from numerous studies suggest the added hospital cost is as much as $40,000 per case.10–12,16–20 Overall attributable costs are difficult to calculate with precision, but have been estimated to be close to 1 billion dollars in the United States annually.21 a University of Wisconsin, MFCB, Room 5218, 1685 Highland Avenue, Madison, WI 53705-2281, USA b Department of Medicine, University of Wisconsin, MFCB, Room 5211, 1685 Highland Avenue, Madison, WI 53705-2281, USA c Department of Microbiology and Immunology, University of Wisconsin, MFCB, Room 5211, 1685 Highland Avenue, Madison, WI 53705-2281, USA * Corresponding author.
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Up to Date Epidemiology, Diagnosis and Management of Invasive Fungal Infections
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Candida Albicans
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CDHO Factsheet Oral Candidiasis
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Estimation of Direct Healthcare Costs of Fungal Diseases in the United States
HHS Public Access Author manuscript Author ManuscriptAuthor Manuscript Author Clin Infect Manuscript Author Dis. Author manuscript; Manuscript Author available in PMC 2020 May 17. Published in final edited form as: Clin Infect Dis. 2019 May 17; 68(11): 1791–1797. doi:10.1093/cid/ciy776. Estimation of direct healthcare costs of fungal diseases in the United States Kaitlin Benedict, Brendan R. Jackson, Tom Chiller, and Karlyn D. Beer Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA Abstract Background: Fungal diseases range from relatively minor superficial and mucosal infections to severe, life-threatening systemic infections. Delayed diagnosis and treatment can lead to poor patient outcomes and high medical costs. The overall burden of fungal diseases in the United States is challenging to quantify because they are likely substantially underdiagnosed. Methods: To estimate total national direct medical costs associated with fungal diseases from a healthcare payer perspective, we used insurance claims data from the Truven Health MarketScan® 2014 Research Databases, combined with hospital discharge data from the 2014 Healthcare Cost and Utilization Project National Inpatient Sample and outpatient visit data from the 2005–2014 National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey. All costs were adjusted to 2017 dollars. Results: We estimate that fungal diseases cost more than $7.2 billion in 2017, including $4.5 billion from 75,055 hospitalizations and $2.6 billion from 8,993,230 outpatient visits. Hospitalizations for Candida infections (n=26,735, total cost $1.4 billion) and Aspergillus infections (n=14,820, total cost $1.2 billion) accounted for the highest total hospitalization costs of any disease.
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The Evolving Landscape of Fungal Diagnostics, Current and Emerging Microbiological Approaches
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Oral Candidiasis: a Disease of Opportunity
Journal of Fungi Review Oral Candidiasis: A Disease of Opportunity 1, 1, 1, Taissa Vila y , Ahmed S. Sultan y , Daniel Montelongo-Jauregui y and Mary Ann Jabra-Rizk 1,2,* 1 Department of Oncology and Diagnostic Sciences, School of Dentistry, University of Maryland, Baltimore, MD 21201, USA; [email protected] (T.V.); [email protected] (A.S.S.); [email protected] (D.M.-J.) 2 Department of Microbiology and Immunology, School of Medicine, University of Maryland, Baltimore, MD 21201, USA * Correspondence: [email protected]; Tel.: +1-410-706-0508; Fax: +1-410-706-0519 These authors contributed equally to the work. y Received: 13 December 2019; Accepted: 13 January 2020; Published: 16 January 2020 Abstract: Oral candidiasis, commonly referred to as “thrush,” is an opportunistic fungal infection that commonly aﬀects the oral mucosa. The main causative agent, Candida albicans, is a highly versatile commensal organism that is well adapted to its human host; however, changes in the host microenvironment can promote the transition from one of commensalism to pathogen. This transition is heavily reliant on an impressive repertoire of virulence factors, most notably cell surface adhesins, proteolytic enzymes, morphologic switching, and the development of drug resistance. In the oral cavity, the co-adhesion of C. albicans with bacteria is crucial for its persistence, and a wide range of synergistic interactions with various oral species were described to enhance colonization in the host. As a frequent colonizer of the oral mucosa, the host immune response in the oral cavity is oriented toward a more tolerogenic state and, therefore, local innate immune defenses play a central role in maintaining Candida in its commensal state.
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Journal of Fungi Review Vulvovaginal Candidiasis: A Current Understanding and Burning Questions Hubertine M. E. Willems 1, Salman S. Ahmed 2, Junyan Liu 1, Zhenbo Xu 1,2 and Brian M. Peters 1,* 1 Department of Clinical Pharmacy and Translational Science, College of Pharmacy, University of Tennessee Health Science Center, Memphis, TN 38163, USA; [email protected] (H.M.E.W.); [email protected] (J.L.); [email protected] (Z.X.) 2 School of Food Science and Engineering, South China University of Technology, Guangzhou 510641, China; [email protected] * Correspondence: [email protected] Received: 22 January 2020; Accepted: 19 February 2020; Published: 25 February 2020 Abstract: Candida albicans, along with other closely related Candida species, are the primary causative agents of vulvovaginal candidiasis (VVC)—a multifactorial infectious disease of the lower female reproductive tract resulting in pathologic inflammation. Unlike other forms of candidiasis, VVC is a disease of immunocompetent and otherwise healthy women, most predominant during their child-bearing years. While VVC is non-lethal, its high global incidence and profound negative impact on quality-of-life necessitates further understanding of the host and fungal factors that drive disease pathogenesis. In this review, we cover the current state of our understanding of the epidemiology, host response, fungal pathogenicity mechanisms, impact of the microbiome, and novel approaches to treatment of this most prevalent human candidal infection. We also offer insight into the latest advancements in the VVC field and identify important questions that still remain. Keywords: vaginitis; vulvovaginal; Candida; vagina; VVC; fungal; candidiasis 1. Pathology and Epidemiology of Vulvovaginal Candidiasis Vulvovaginal candidiasis (VVC), is an exceedingly common mucosal infection of the lower female reproductive tract (FRT), caused mostly by the polymorphic opportunistic fungus Candida albicans.
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