Candida
catheter-related
bloodstream infection (CRBSI) is a biofilm-related disease, which is usually refractory because antifungals show limited effect. With medical development and increase in number of compromised hosts, CRBSI became more frequent. Candida, which is one of the opportunistic pathogens, ranks the fourth causative organism of
bacteremia. The onset of
bacteremia is greatly associated with the presence of
catheter. Repeated blood cultures and the
central venous catheter (CVC) tip culture are done for the definitive diagnosis of Candida CRBSI. Additionally serological examinations such as (1 --> 3)-beta-
D-glucan and
mannan antigen are also useful for early diagnosis. It is important for the appropriate treatment to remove CVC, which is an artificial contaminated material, and administer antifungals promptly. As to the choice of antifungals, we should also take into account the ability of antibiofilm effect of antifungals as well as immunological state of host including
neutropenia, prior administration of
azoles, isolated or estimated Candida species, sensitivity against antifungals, administration route, pharmacokinetics (bioavailability, metabolic and excretion pathway, distribution) and drug interaction. As to complication of Candida
bacteremia, first we should check
endophthalmitis, which occurs frequently and leads to the loss of eyesight, as well as
infective endocarditis,
arthritis, metastatic
infections such as embolic
pneumonia and suppurative thrombotic
phlebitis of
catheter insertion site. Lastly we emphasize that the appropriate treatment based on the character of Candida
bacteremia and biofilm leads to favorable prognosis.