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Medicine Grand Rounds - Invasive Candidiasis and Antifungal Drug Resistance

Dr. Lee discusses the clinical importance and differences between candida species, candida albicans, which is the most common; and the non-albicans strains, specifically candida auris, which has generated worldwide alerts from the CDC and other public health organizations. This emerging pathogen has a high crude mortality rate and can cause hospital based outbreaks in compromised patients. These fungi thrive in biofilms that have high resistance to conventional antifungal therapy because of their complex structures that challenge drug penetration. Dr. Lee reviews the treatment guidelines and their limitations for different types of candida and stresses the need for further research to treat this emerging threat.

Activity Details

Start Date:   April 26, 2019
End Date:  April 26, 2021

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  5. Complete and Submit the evaluation and attestation form.

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  • Samuel A. Lee, MD, PhD
    Chief, Medicine Service, White River Junction VA Medical Center
    Professor of Medicine, Geisel School of Medicine

    Dr. Samuel Lee is a graduate of the combined BA/MD Program at Boston University. He completed his internship and residency at the Hospital of the University of Pennsylvania. He completed a fellowship in Infectious Diseases and his PhD in Investigative Medicine at Yale University School of Medicine, and continued at Yale as a Staff Physician at the VA Connecticut Healthcare System. He joined the faculty at University of New Mexico in September of 2007 as Section Chief of Infectious Diseases at VA Albuquerque Medical Center, and Medical Director of the HIV clinic. He joined the faculty at Geisel School of Medicine at Dartmouth in August 2018 as Professor of Medicine and Chief of the Medicine Service at the White River Junction VA Medical Center. His research is funded by the Department of Veterans Affairs and NIH.
Learning Outcome

Participants will be able to describe the clinical epidemiology of different Candida species, including Candida auris, explain the clinical significance of Candida biofilms, and discuss the limitations of current antifungal therapy for invasive candidiasis.


Dartmouth-Hitchcock is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Dartmouth-Hitchcock designates this enduring material for a maximum of 1 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Requirements for Successful Completion

In order to receive credit for this Continuing Medical Education (CME) activity, you must:

  • View the entire presentation
  • Complete the online Attestation of Attendance & Evaluation Form (you must register to access).

In accordance with the disclosure policy of Dartmouth-Hitchcock/Geisel School of Medicine at Dartmouth as well as standards set forth by the Accreditation Council on Continuing Medical Education and the Nursing Continuing Education Council standards set forth by the American Nurses Credentialing Center Commission on Accreditation, continuing medical education and nursing education activity director(s), planning committee member(s), speaker(s), author(s) or anyone in a position to control the content have been asked to disclose any financial relationship* they have to a commercial interest (any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on patients). Such disclosure is not intended to suggest or condone bias in any presentation, but is elicited to provide participants with information that might be of potential importance to their evaluation of a given activity.

The following Activity Physician Director(s), planning committee member(s), speaker(s), author(s) or anyone in a position to control the content for Invasive Candidiasis and Antifungal Drug Resistance (Medicine Grand Rounds) have reported the following financial interest or relationship* with various companies/organizations. The Activity Director and Planning Committee member roles were resolved by altering the individual’s control over content about the products or services of the commercial interest by the Associate Dean for CME and the Department of Medicine Chair. All potential conflict(s) were resolved.

* Kelly Kieffer, MD ~ her spouse is a consultant for OcculoBio. 

* Richard I. Rothstein, MD ~ has research support from Baranova (research grant to Dartmouth-Hitchcock Medical Center) and has other financial interest from Allurion. 

Other planning committee member(s), speaker(s), activity director(s), author(s) or anyone in a position to control the content for this program report no financial interest or relationship* with any company(ies) or organizations whose product may be germane to the content of their presentations.

*A “financial interest or relationship" refers to an equity position, receipt of royalties, consultantship, funding by a research grant, receiving honoraria for educational services elsewhere, or to any other relationship to a company that provides sufficient reason for disclosure, in keeping with the spirit of the stated policy.

Provider Contact Information

Provider contact information for questions regarding accreditation of the activity:

Center for Learning and Professional Development
Dartmouth-Hitchcock Medical Center

Type:     Internet Activity (Enduring Material)
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