Explorando una nueva perspectiva de las Candida no albicans: Su microbiología, epidemiología, patogenicidad, respuesta inmune y resistencia antifúngica.
Palabras clave:
Virulencia, microbiología, patogenicidad, resistencia antifúngica, epidemiología, Candida glabrata, Candida tropicalis, Candida krusei, Candida parapsilosis, Candida auris, Candida guilliermondii.Resumen
Las Cándidas no albicans (CNA) son un grupo de hongos oportunistas que causan infecciones cada vez más frecuentes en humanos. Estas infecciones pueden tener un gran impacto clínico en los servicios hospitalarios, ya que suelen ser difíciles de tratar y pueden llegar a provocar complicaciones graves. La epidemiología de las infecciones por CNA, como Candida glabrata, Candida tropicalis, Candida krusei, Candida parapsilosis, Candida auris y Candida guilliermondii, varía según la ubicación geográfica, y se ha observado un aumento en la incidencia de estas infecciones en comparación con C. albicans. Diversos factores biológicos contribuyen a su patogénesis, entre ellos los cambios morfológicos frente a situaciones de estrés celular, así como la secreción de enzimas hidrolíticas y antioxidantes que favorecen la supervivencia y adaptación a diferentes microambientes del hospedero. El sistema inmune desempeña un papel fundamental en el control de la infección mediante el reconocimiento de antígenos fúngicos, lo que activa la respuesta inmune innata y adaptativa para la eliminación de las CNA. El manejo de estas infecciones implica el uso de fármacos antifúngicos, como los azoles o las equinocandinas; sin embargo, los mecanismos de resistencia mediados por mutaciones han conducido al fracaso de numerosos tratamientos farmacoterapéuticos. A pesar de su gran relevancia clínica, la literatura existente sobre las CNA es fragmentada y muchos estudios integrales son antiguos. Por lo tanto, en este artículo se realizó una revisión actualizada de la literatura sobre la microbiología, epidemiología, patogenicidad, respuesta inmune y resistencia antifúngica de las CNA de relevancia clínica.
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