Candida parapsilosis (C. parapsilosis) is a yeast-like fungus of the genus Candida. It is commonly found on the skin, hands and mucous membranes of healthy people. However, since 2000, it has become a significant cause of serious, drug-resistant, hospital-acquired infections. Candida infections are the fourth most common cause of hospital-acquired blood infections, with a fatality rate of about 40%. C. parapsilosis is responsible for about 15% of Candida infections. It is now the second most commonly detected Candida species in blood cultures taken in Europe, Canada and Latin America, and it has become the most common one in some European hospitals.
Symptoms
The symptoms of C. parapsilosis infection vary depending on its location and severity. In hospitals, it was first detected as endocarditis, an infection of the heart lining in intravenous drug addicts. In mild versions, it can manifest as an itchy, red, painful infection of the eyes, mouth or vagina. In more serious cases, it can cause systemic shock with a danger of death if it infects the internal membranes, such as the peritoneum (lining that surrounds the digestive system). In rare cases, it may cause septic arthritis or pneumonia.
Risk Factors
People with compromised immune systems, such as those with HIV/AIDS, new babies and elderly people have the highest risk of infection. People who are in a hospital for gastrointestinal surgery have the highest risk for serious C. parapsilosis infections. Steroid therapies, malnutrition, diabetes and recent use of antibiotics also increase risk.
Modes of Infection
Most people have C. parapsilosis on their bodies all the time. Minor C. parapsilosis infections of the mouth or mucous membranes may happen because the natural factors that keep the yeast in check (healthy bacteria and a strong immune system) are not in place. In serious hospital-based infections, a health care provider or patient may accidentally contaminate a wound or surgical device with C. parapsilosis. The organism has the unusual ability to cling to and form biofilms (slick, film-like colonies) on plastic and it thrives on sugar solutions. If a surgical feeding tube, shunt, feeding tube or other plastic surgical device becomes contaminated with it, C. parapsilosis can spread to the bloodstream of the already weakened patient, quickly causing a serious infection. If it forms a biofilm on the device, it can become even harder to treat.
Treatment
Remove any foreign bodies (including medical devices) that may be carrying the yeast, and then using an appropriate dose of prescription antifungal medication. More than a dozen antifungal medications that may be effective on various types of Candida parapsilosis infections; fluconazole is recommended most often. Amphotericin B may be used in many types of the infection as well, as well as caspofungin.
Three Different Species
Three major strains of C. parapsilosis have been identified. They are categorized as Group I, Group II and Group III. Group I has been most often detected in clinical settings.
Genetic evidence supports classifying the three groups as three different species. It recommends having Group 1 remain named C. parapsilosis. Group II would be renamed Candida orthopsilosis (C. orthopsilosis) and Group III would be named Candida metapsilosis (C. metapsilosis).