Updates on Candida albicans infections: pathogenesis, resistance, and emerging nanopharmaceutical strategies.

Introduction: Candidiasis comprises a spectrum of infections ranging from superficial mucosal to life-threatening systemic infections caused by the opportunistic yeast, Candida, a genus containing several species of heterogeneous behavior and unique pathogenesis in the human host. Candida albicans is the most prevalent species. The aim of this review is to provide an update on pathogenesis, resistance and emerging therapeutic strategies in candidiasis, with a focus on C. albicans.

Areas covered: We discuss recent advancements that have deepened our understanding of Candida pathogenesis, particularly the roles of morphological plasticity, metabolic flexibility, biofilm formation, multidrug resistance and gut dysbiosis. We interrogated three major databases, mainly PubMed, Scopus and Google Scholar for the latest (with emphasis on the works published in the last 5 years) developments in antifungal resistance trends, diagnostic innovations, and novel therapeutic strategies, including next-generation antifungals, combination therapies and nanopharmaceuticals. Additionally, we explore emerging strategies, such as probiotics, vaccines, and antifungal stewardship, and discuss the impact of post-COVID-19 immunosuppression, cancer therapies, and climate change on candidiasis epidemiology.

Expert opinion: The future of C. albicans management lies in personalized approaches, leveraging genomics, host-pathogen interactions and advanced drug-delivery platforms to combat resistance, overcome the limitations of current systemic therapy and improve patient outcomes.