Classification of Candidiasis

Introduction to Candidiasis

Candidiasis is fundamentally divided into two main categories: mucocutaneous (superficial) and invasive infections, with specific subdivisions according to anatomical location, clinical severity, and host characteristics, as noted by The Lancet Infectious Diseases 1, 2

The American College of Physicians and other medical guidelines suggest that mucocutaneous candidiasis affects the skin and mucous membranes in individuals who may be immunocompetent or immunocompromised, with various forms including oral, vulvovaginal, and cutaneous candidiasis 1, 2, 3, 4, 5
The Infectious Diseases Society of America recommends distinguishing between uncomplicated and complicated vulvovaginal candidiasis, where uncomplicated is typically caused by Candida albicans in immunocompetent women with mild to moderate symptoms, and complicated includes severe symptoms, recurrent disease, non-albicans species, or infection in abnormal hosts 3

The Critical Care Society notes that invasive candidiasis represents severe infections with high mortality (up to 45-50%) affecting mainly critically ill and immunocompromised patients, with forms including candidemia, intra-abdominal candidiasis, and disseminated candidiasis 6, 7, 8
The European Society of Clinical Microbiology and Infectious Diseases suggests that Candida albicans is the most frequent cause of invasive candidiasis, followed by Candida glabrata, Candida tropicalis, Candida parapsilosis, and Candida krusei, with Candida auris being a critically emerging pathogen due to its pan-antifungal resistance, high mortality, and nosocomial transmission capacity 6, 1, 7, 8

Distinguishing between contamination, colonization, and true infection in intra-abdominal samples is complex, as up to 80% of patients with peritonitis are colonized by Candida, according to the Critical Care Society 6, 7, 8
There is an epidemiological transition from C. albicans to non-albicans species as etiologic agents, especially in patients with azole prophylaxis, as noted by the Infectious Diseases Society of America and the Clinical Infectious Diseases journal 6, 5, 7, 8
The increase in antifungal-resistant strains, such as C. glabrata and C. krusei to fluconazole, and C. auris to echinocandins, complicates treatment and increases mortality, as reported by The Lancet Infectious Diseases and the Clinical Infectious Diseases journal 6, 5, 1, 7, 8