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Candida vulturna, the Next Fungal Menace? A Narrative Review

Summary

Candida vulturna is a newly identified fungus that causes serious bloodstream infections, particularly in newborns and hospitalized patients in tropical regions. Unlike many common fungal infections, it resists several antifungal medications, though it remains susceptible to certain antibiotics called echinocandins. Scientists have documented 94 cases worldwide, including three hospital outbreaks, and the infection has a relatively low death rate of 18%. Accurate identification requires genetic testing since standard hospital laboratory tests often misidentify this pathogen.

Background

Candida vulturna is a member of the Candida haemulonii species complex, a group of yeasts characterized by high antifungal resistance and thermotolerance. First identified less than 10 years ago from flowers in the Philippines and human blood in Malaysia, C. vulturna has increasingly been reported causing invasive infections globally, particularly in Asian and Latin American countries.

Objective

This narrative review compiles all reported cases and outbreaks of invasive C. vulturna infections to characterize this emerging pathogen, including epidemiological features, clinical characteristics, antifungal susceptibility patterns, and treatment outcomes.

Results

Ninety-four invasive cases were identified from 11 studies, including three outbreaks in Brazil (14 cases), Vietnam (31 cases), and China (19 cases). Patients were predominantly male (82%), with low 30-day mortality of 18%. Most isolates showed reduced susceptibility to azoles and amphotericin B, while maintaining susceptibility to echinocandins. MALDI-ToF mass spectrometry routinely misidentified C. vulturna as related species, requiring molecular identification by ITS sequencing or whole genome sequencing.

Conclusion

Although C. vulturna remains rare, invasive infections are increasingly reported with outbreak potential, particularly in tropical regions. The yeast exhibits reduced susceptibility to azoles and amphotericin B but remains highly susceptible to echinocandins, which are the recommended treatment agents. Accurate species identification and strict antifungal stewardship are crucial for surveillance and prevention of therapy-induced resistance.
  • Published in:Mycoses,
  • Study Type:Narrative Review,
  • Source: PMID: 40396413, DOI: 10.1111/myc.70070
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