Emerging antifungal resistance in Candida parapsilosis: the end of the innocence

Abstract

Candida parapsilosis is an opportunistic yeast that was recently deemed a high- importance fungal pathogen by the World Health Organization. In fact, C. parapsilosis poses an escalating threat in healthcare settings due to its ability to adapt to diverse environments, propensity for human-to-human transmission, and capacity to develop antifungal resistance. Recent studies emphasize its rising clinical importance, particularly with the increasing resistance to antifungals and the emergence of clonal outbreaks, making it a serious threat to public health. This review provides an up-to-date synthesis of our current knowledge on this yeast, addressing its epidemiology, environmental adaptability, and the molecular mechanisms driving resistance to azoles and echinocandins. In particular, it provides a comprehensive overview of the resistome of C. parapsilosis, offering insights into the genetic determinants associated with antifungal resistance. We also identify key unresolved questions and emphasize the need for further research to mitigate its impact on healthcare systems.