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The ignored invisible killer: Why is Nakaseomyces glabratus a deadly threat to modern medicine?
In today’s healthcare environment, many everyday germs have their harmful effects underestimated to varying degrees. Among them, Nakaseomyces glabratus (formerly Candida glabrata) is becoming an urgent threat. Although this haploid yeast has no known sexual reproductive cycle, bisexual strains are ubiquitous in the environment. It is unimaginable that this yeast, which is normally a commensal microorganism in healthy humans, can cause serious infections in immunocompromised individuals.
In the current era of widespread human immunodeficiency,
N. glabratushas become one of the most common opportunistic pathogens, accounting for approximately 15-20% of Candida infection cases.
This yeast most easily manifests its pathogenicity in the urethra and vagina after infection. Even in malignant cases, N. glabratus may enter the bloodstream and cause systemic infection, which is important for This is especially dangerous for patients with suppressed immune systems. This further shows the importance of this strain in hospital settings and the challenge it poses to infectious disease control.
Medical relevance
N. glabratus is characterized by natural resistance to antifungal drugs, especially azoles. This makes many commonly used antifungal treatments significantly less effective against them, which poses new challenges for clinical diagnosis and treatment.
As antifungal resistance increases,
N. glabratus's resistance to common treatments such as fluconazole continues to rise, leaving a handful of expensive and toxic antifungal drugs available .
Diagnostic Challenges
Diagnosing infection with N. glabratus is not simple. In non-albicans vaginal infections, culture is an effective method, but urine testing is less accurate. Confirmation of this yeast usually requires several days of culture, but once isolated it can be quickly identified. At the same time, the diagnosis of skin diseases is relatively complex and requires professional evaluation to determine.
Treatment options
For the treatment of N. glabratus, antifungal options are rather limited. Although it has inherent low-level resistance to most azole drugs, it is still relatively vulnerable to certain treatments, such as polyenes. Antifungal treatment can be carried out through the use of drugs such as dapsinol, but the possible side effects need to be carefully considered.
Although drugs such as dapsinol are a last resort, they may cause problems such as chronic renal failure and are not suitable for all patients.
It is worth noting that the effectiveness of dapsinol suppositories in the treatment of vaginal infections has received more and more attention. When used in combination with other antifungal drugs such as boric acid capsules, it has become one of the frontline options for the treatment of vaginal infections.
Gene and system development
N. glabratus's phylogenetic relationship with other yeasts such as Saccharomyces cerevisiae places it within the Nakaseomyces group. According to phylogenetic studies, rearrangements of its genome are thought to be key factors promoting the adaptation and pathogenicity displayed by this microorganism in the face of stressful environments.
Genomic rearrangements in this yeast have the potential to improve its viability and may also be associated with its pathogenicity.
Future challenges
Researchers and clinicians face increasingly complex challenges due to the rapid evolution and increasing drug resistance of N. glabratus and other non-albicans Candida species. Further genomic research, collection of clinical data and development of new treatment options are particularly important. As these new challenges emerge, can the spread of these invisible killers still be effectively controlled?
