Candida species as potential nosocomial pathogens – A review

The frequency of nosocomial fungal infections is being increased because of the advent of newer diagnostic and therapeutic techniques. Among various fungal pathogens, Candida spp. are the cause of substantial morbidity and mortality in hospitalized patients, especially among critically ill hospitalized patients. The frequency of non-ablicans spp. of Candida (NAC) causing nosocomial infections is increasing. The Candida infections are usually endogenous, however, the exogenous infections may also occur. The important predisposing factors leading to nosocomial candidiasis include treatment with broad spectrum antibiotics, immunosuppression, malignancy, surgical intervention, diabetes and prolonged hospitalization. Virulence factors like adherence to biotic and abiotic substances and production of hydrolytic enzymes play important role. Also the biofilm forming ability makes it more noxious. Nosocomial Candida infections are difficult to diagnose clinically and refractory to therapy. Therefore, rapid and accurate laboratory diagnosis is very important to provide appropriate antifungal treatment. This review is structured to know the key factors responsible for emergence of Candida spp. as important nosocomial pathogens. The available data suggests that the nosocomial infections caused by Candida spp. should be dealt through awareness and constant vigilance.