Changing Climate, Changing Candida: Environmental and Social Pressures on Invasive Candidiasis and Antifungal Resistance in Latin America

Author: mycolabadmin
8/22/2025
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Summary

Invasive fungal infections caused by Candida yeasts are becoming more serious in Latin America, with drug-resistant strains spreading rapidly in hospitals. The problem is worsened by climate change and overuse of antifungal medicines in agriculture, which help resistant fungi survive and spread. Many hospitals in the region lack modern diagnostic tools to quickly identify the specific type of infection, delaying treatment. The authors recommend a comprehensive approach combining better environmental monitoring, smarter use of antifungal drugs, improved diagnostic access, and coordinated public health efforts across the region.

Background

Invasive candidiasis (IC) in Latin America is experiencing a significant epidemiological shift toward non-albicans strains such as Candida tropicalis, Candida parapsilosis, and Candidozyma auris, many exhibiting multidrug resistance. Environmental pressures including climate change and agricultural azole use appear to favor selection of resistant and thermotolerant strains. Diagnostic limitations in resource-limited settings delay detection and treatment initiation.

Objective

To review the epidemiology, risk factors, diagnostic challenges, and antifungal resistance patterns of invasive candidiasis in Latin America. To propose a One Health-oriented framework combining environmental surveillance, antifungal stewardship, diagnostic access, and coordinated public health actions.

Results

IC incidence in Latin America ranges from 0.23-2.3 cases per 1000 admissions with mortality rates of 30-80%. Non-albicans strains account for over 60% of cases, with C. parapsilosis (20.5%), C. tropicalis (15.3%), and C. auris as major pathogens. Azole resistance in C. parapsilosis reaches 25-54%, with emerging echinocandin resistance. C. auris Clade IV predominates with 35% FCZ resistance and 33% amphotericin B resistance. Advanced diagnostics (MALDI-TOF, qPCR, mNGS) available in only 20-50% of laboratories.

Conclusion

A multifaceted One Health approach integrating environmental surveillance, robust antifungal stewardship programs, broader diagnostic access, and coordinated cross-sector public health actions is essential to mitigate the IC burden and slow antifungal resistance advance in Latin America.

Published in:Journal of Fungi (Basel),
Study Type:Narrative Review,
Source: PMID: 41003155, PMC12471215