Belonging to the Candida species of fungi, Candida glabrata was known as Torulopsis glabrata. One of the most unique things about this species is that it indulges in no mating activity and is non-dimorphic. Even in the recent past, this species was thought and considered to be non-pathogenic. However, with the population increasing and technology upscaling, it has been observed that Candida glabrata is no less opportunistic than its other counterparts, but it does have a definite effect on the urogenital tract and bloodstream. This yeast tends to affect those suffering from HIV and also the aged people; hence it is definitely one of the very rare Candida pathogenic species.
Candida Glabrata- From the Candidiasis Family
The reason behind Candida glabrata (c. glabrata) is a fungus that does not have hyphae (branching filaments) which are mostly like tentacles. Due to the absence of hyphae, it becomes crucial to study or biopsy this culture under a microscope. As this cannot be discovered very easily, unless a person is too sick, it remains hidden. Once they are exposed, it can sometimes be too late and becomes very difficult to treat the individual. Another reason why C. glabrata are harmful is that they can morph and adapt to situations and survive. Candida glabrata have the advantage of thriving in both acidic as well as alkaline situations. This makes them pretty dangerous because science knows how to destroy fungus only by altering the pH level so that the yeast has an uncomfortable environment to thrive and multiply. So clearly, Candida glabrata can be responsible for the most severe fungal infection.
One of the most important reasons why Candida glabrata has grown to be a pathogen is the presence of epithelial adhesion genes. Residing in the subtelomeric area, the epithelial adhesion genes can react to cues that help them to be exposed in a group thus helping the organisms to stick to both biotic as well as abiotic portions in microbial mats. This is also the procedure followed by Candida glabrata for developing biofilms in the urinary catheters. It can also result into dentures, problems associated with dental devices.
How to Diagnose Candida Glabrata?
One of the most useful ways of detecting the vaginal infections caused due to species other than Candida albicans is through observing the cultures under microscope. Urinalysis proves to be less satisfying in this case. Culture may be a long procedure but once the yeast is successfully isolated, the identification of the yeast species becomes easier. Candida glabrata is immune to Echinocandin and therefore those infected are left with not many options but to spend on highly toxic and expensive treatment options. The ‘T2Candida Panel’ is a promising tool which can identify not only glabrata cells but also tropicalis, albicans, parapsilolis, kruzei. It requires no culture, but the just the blood sample itself. The T2Candida Panel was approved by FDA in September, 2014.
Research on Medication
A study in 1993 form the ‘Antimicrobial Agents & Chemotherapy Journal‘ aimed to find the resistance of C. glabrata species against the antifungal medication ‘fluconazole’. In this case a 69 year old woman was admitted with an infection caused by C. glabrata and it was reported that the pre-treatment isolates and post-treatment isolates were studied, and it was found that due to permeability factor of the cell barrier, the glabrata species was resistant against fluconazole.
This particular report showed a common nature of C. glabrata and proved that although fluconazole can clearly treat albicans and tropicalis with success, the Candida glabarata species was resistant to it and hence in case the patient is affected with both species, albicans and glabrata, using fluconazole for treatment wouldn’t prove to be extremely successful.
Since Candida glabrata possess low intrinsic resistance towards ‘azole’ drugs, which are the generic drugs prescribed for treatment, it becomes a bit difficult to treat this infection. Fluconazole and ketoconazole fail to serve the purpose however; amphotericin and caspofungin are some of the drugs, Candida glabrata fears.
Another study was carried out in the ‘Clinical Infectious Diseases Journal ‘ to find the resistance of C. glabrata against the antifungal medication ‘Amphotericin B’ as well as ‘Capsofungin’. 4 isolates were studied from a patient in intensive care unit using a mouse model as well as susceptibility tests. It was found that 1 isolate was in fact resistant to Amphotericin B, 1 was some-what susceptible and 1 was completely susceptible. Two of the 3 were found to be resistant to Capsofungin.
This study surely emphasizes on the importance of having fungal strains tested from a patient while under fungal treatment to ensure that the fungal strain is susceptible to the medication used and is not resistant to it. This will ensure that resistance doesn’t cause a sort-term or a long –term problem with the treatment.
Amphotericin B is kind of a last resort drug as it can have some major consequences like renal problems. One of the primary solutions would be terconazole cream for seven days along with several sessions. Re-occurrence is a chance which has adverse effects on blood, hair, skin, scalp etc.
Candida glabrata Review – Clinical Microbiology Reviews – 1999 – By Paul L. Fidel Jr., Jose A. Vazquez, Jack D. Sobel
Fluconazole resistance For Candida glabrata – Antimicrobial Agents & Chemotherapy Journal – 1993 – By C A Hitchcock, G W Pye, P F Troke, & e M Johnson
Amphotericin B and Caspofungin Resistance to Candida glabrata – Clinical Infectious Diseases Journal – 2006 – By Mikkel Krogh-Madsen, Maiken Cavling Arendrup, and Lars Heslet
Murine model of Candida glabrata – The Journal of Infectious Diseases – 1996 – By Fidel PL Jr, Cutright JL and Tait L