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Hatem NA, Pasqualotto AC, Severo CB, Bastos RH, de Lucena RDL, Riche CVW. Septic arthritis caused by Candida dubliniensis following arthroscopic surgery. Med Mycol Case Rep 2024; 43:100634. [PMID: 38405085 PMCID: PMC10891322 DOI: 10.1016/j.mmcr.2024.100634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 02/14/2024] [Accepted: 02/15/2024] [Indexed: 02/27/2024] Open
Abstract
A 37-year-old immunocompetent man was admitted to the emergency department due to recurrent pain and oedema of his right knee. Two months earlier, he had undergone surgery to repair his meniscus. Arthroscopic joint lavage was performed and Candida dubliniensis was recovered in culture. The authors describe the first case of septic arthritis caused by Candida dubliniensis.
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Affiliation(s)
| | - Alessandro C Pasqualotto
- Santa Casa de Misericordia de Porto Alegre, Porto Alegre, Brazil
- Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Cecília Bittencourt Severo
- Santa Casa de Misericordia de Porto Alegre, Porto Alegre, Brazil
- Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | | | | | - Cezar Vinícius Würdig Riche
- Santa Casa de Misericordia de Porto Alegre, Porto Alegre, Brazil
- Lutheran University of Brazil (ULBRA), Canoas, Brazil
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Kakehi A, Hagiya H, Iio K, Nakano Y, Ihoriya H, Taira Y, Nakamoto K, Hasegawa K, Higashikage A, Otsuka F. Candida dubliniensis fungemia in a patient with severe COVID-19: A case report. J Infect Chemother 2022; 28:1433-1435. [PMID: 35863730 PMCID: PMC9293379 DOI: 10.1016/j.jiac.2022.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 06/27/2022] [Accepted: 07/12/2022] [Indexed: 10/30/2022]
Abstract
Candida dubliniensis phenotypically mimics Candida albicans in its microbiological features; thus, its clinical characteristics have yet to be fully elucidated. Here we report the case of a 68-year-old Japanese man who developed C. dubliniensis fungemia during treatment for severe coronavirus disease 2019 (COVID-19). The patient was intubated and received a combination of immunosuppressants, including high-dose methylprednisolone and two doses of tocilizumab, as well as remdesivir, intravenous heparin, and ceftriaxone. A blood culture on admission day 11 revealed Candida species, which was confirmed as C. dubliniensis by mass spectrometry. An additional sequencing analysis of the 26S rDNA and ITS regions confirmed that the organism was 100% identical to the reference strain of C. dubliniensis (ATCC MYA-646). Considering the simultaneous isolation of C. dubliniensis from a sputum sample, the lower respiratory tract could be an entry point for candidemia. Although treatment with micafungin successfully eradicated the C. dubliniensis fungemia, the patient died of COVID-19 progression. In this case, aggressive immunosuppressive therapy could have caused the C. dubliniensis fungemia. Due to insufficient clinical reports on C. dubliniensis infection based on definitive diagnosis, the whole picture of the cryptic organism is still unknown. Further accumulation of clinical and microbiological data of the pathogen is needed to elucidate their clinical significance.
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Affiliation(s)
- Ayaka Kakehi
- Microbiology Division, Clinical Laboratory, Okayama University Hospital, Okayama, 700-8558, Japan
| | - Hideharu Hagiya
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, 700-8558, Japan.
| | - Koji Iio
- Microbiology Division, Clinical Laboratory, Okayama University Hospital, Okayama, 700-8558, Japan
| | - Yasuhiro Nakano
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, 700-8558, Japan
| | - Hiromi Ihoriya
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, 700-8558, Japan
| | - Yuki Taira
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, 700-8558, Japan
| | - Kenta Nakamoto
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, 700-8558, Japan
| | - Kou Hasegawa
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, 700-8558, Japan
| | - Akihito Higashikage
- Microbiology Division, Clinical Laboratory, Okayama University Hospital, Okayama, 700-8558, Japan
| | - Fumio Otsuka
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, 700-8558, Japan
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Molkenthin F, Hertel M, Neumann K, Schmidt-Westhausen AM. Factors influencing the presence of Candida dubliniensis and other non-albicans species in patients with oral lichen planus: a retrospective observational study. Clin Oral Investig 2021; 26:333-342. [PMID: 34142239 PMCID: PMC8791885 DOI: 10.1007/s00784-021-04004-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 05/20/2021] [Indexed: 11/24/2022]
Abstract
Objectives The epidemiologic distribution of non-albicans species in the oral cavity of oral lichen planus (OLP) patients remains uncertain. Therefore, the aim of this study was to identify factors associated with the presence of C. dubliniensis and other non-albicans species. Furthermore, independent risk factors for Candida superinfection in OLP should be identified. Material and methods Epidemiologic data and microbiological findings from 268 symptomatic OLP patients who underwent continuous oral swab culture over a 5-year period (2015–2019) were retrospectively reviewed. Candida species identification and semi-quantification were obtained by culture on CHROMagar Candida, followed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). Results C. albicans was the most frequently isolated species (72.3%), followed by C. glabrata (7.3%), C. dubliniensis (5.8%), C. krusei and C. parapsilosis (both 2.6%). The presence of C. dubliniensis was significantly associated with tobacco smoking. Other non-albicans spp. were significantly more often detected in patients using removable dentures. Increasing age and the intake of psychotropic drugs were identified as independent risk factors of Candida superinfection in OLP. Conclusion In OLP patients, certain local and systemic factors increase the risk of carrying potentially drug-resistant Candida species and the development of Candida superinfection of OLP lesions. Clinical relevance Due to the frequent detection of non-albicans species in OLP, resistance or at least reduced sensitivity to azole antifungals should be expected, especially in smokers and patients using removable dentures. In the case of oral complaints, a superinfection with Candida should be considered, whereby older patients and patients taking psychotropic drugs have an increased risk for oral infection with Candida.
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Affiliation(s)
- Florian Molkenthin
- CharitéCentre 3, Department of Periodontology, Oral Medicine and Oral Surgery, Charité - Universitätsmedizin Berlin, Aßmannshauser Str. 4, 14197, Berlin, Germany.
| | - Moritz Hertel
- CharitéCentre 3, Department of Periodontology, Oral Medicine and Oral Surgery, Charité - Universitätsmedizin Berlin, Aßmannshauser Str. 4, 14197, Berlin, Germany
| | - Konrad Neumann
- Institute of Medical Biometrics and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Andrea Maria Schmidt-Westhausen
- CharitéCentre 3, Department of Periodontology, Oral Medicine and Oral Surgery, Charité - Universitätsmedizin Berlin, Aßmannshauser Str. 4, 14197, Berlin, Germany
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Scharmann U, Kirchhoff L, Chapot VLS, Dziobaka J, Verhasselt HL, Stauf R, Buer J, Steinmann J, Rath PM. Comparison of four commercially available chromogenic media to identify Candida albicans and other medically relevant Candida species. Mycoses 2020; 63:823-831. [PMID: 32449997 DOI: 10.1111/myc.13119] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 05/18/2020] [Accepted: 05/19/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND The number of invasive Candida infections has significantly increased in recent decades. For the successful treatment of fungal infections, rapid identification at the species level, particularly in polyfungal infections, is a key factor. In this study, four commercially available chromogenic media, CandiSelect™ 4 (CS4), chromID™ Candida Agar (CCA), BBL™ CHROMagar™ Candida Medium (BBL) and Brilliance™ Candida Agar (BCA) were evaluated for Candida identification. MATERIAL/METHODS Overall, 181 bronchial secretion samples from intensive care patients were analysed prospectively. In addition, 18 primarily sterile materials, previously tested positive for Candida, were investigated retrospectively. All samples were cultured as recommended by the manufacturer and visually inspected after 24 and 48 hours by three independent investigators. As a control, colonies were identified by MALDI-TOF MS. Specificity and sensitivity were determined for C albicans identification prospectively. RESULTS CS4 and BCA showed the best overall consensus with the identification results reached by MALDI-TOF MS for Candida albicans and species. A clear differentiation between the species could be ascertained via easily identifiable, species-specific coloration in contrast to BBL and CCA. Sensitivity for C albicans (n = 73) identification varied between 32% (BCA) and 69% (CS4 and CCA) after 24 hours and 68% (BBL) and 82% (BCA) after 48 hours incubation, while specificity ranged between 62% (BBL) and 81% (CCA) after 24 hours and 82% (BBL) and 85% (CS4) after 48 hours. CONCLUSION CS4 and BCA are recommended for routine identification of Candida species in human samples.
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Affiliation(s)
- Ulrike Scharmann
- Institute of Medical Microbiology, University Hospital Essen, Essen, Germany
| | - Lisa Kirchhoff
- Institute of Medical Microbiology, University Hospital Essen, Essen, Germany
| | | | - Jan Dziobaka
- Institute of Medical Microbiology, University Hospital Essen, Essen, Germany
| | | | - Raphael Stauf
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Paracelsus Medical University, Nuremberg, Germany
| | - Jan Buer
- Institute of Medical Microbiology, University Hospital Essen, Essen, Germany
| | - Joerg Steinmann
- Institute of Medical Microbiology, University Hospital Essen, Essen, Germany.,Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Paracelsus Medical University, Nuremberg, Germany
| | - Peter-Michael Rath
- Institute of Medical Microbiology, University Hospital Essen, Essen, Germany
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Chupácová J, Borghi E, Morace G, Los A, Bujdáková H. Anti-biofilm activity of antibody directed against surface antigen complement receptor 3-related protein-comparison of Candida albicans and Candida dubliniensis. Pathog Dis 2018; 76:4791528. [PMID: 29315379 DOI: 10.1093/femspd/ftx127] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 12/27/2017] [Indexed: 11/13/2022] Open
Abstract
Candida albicans and C. dubliniensis are related yeasts that differ in the expression of virulence-associated proteins involved in adherence and biofilm development. CR3-RP (complement receptor 3-related protein) is one of the surface antigens expressed by Candida species. The main objective of this research was to elucidate the effect of the polyclonal anti-CR3-RP antibody (Ab) on adherence and the biofilm formed by C. albicans SC5314 and C. dubliniensis CBS 7987 and two clinical isolates in vitro, ex vivo and in vivo. A comparison of species, and of treated vs. non-treated with the anti-CR3-RP Ab showed a reduction in adherence (22%-41%) that was dependent on the time point of evaluation (60, 90 or 120 min), but did not prove to be species-dependent. Confocal microscopy revealed a decreased thickness in biofilms formed by both species after pre-treatment with the anti-CR3-RP Ab. This observation was confirmed ex vivo by immunohistochemistry analysis of biofilms formed on mouse tongues. Moreover, anti-CR3-RP Ab administration, 1 h post-infection, has been shown to promote larval survival compared to the control group in a Galleria mellonella infection model. Our data suggest a potential activity of the anti-CR3-RP Ab relevant to immunotherapy or vaccine development against biofilm-associated Candida infections.
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Affiliation(s)
- Jaroslava Chupácová
- Department of Microbiology and Virology, Comenius University in Bratislava, Faculty of Natural Sciences, Ilkovicova 6, 84215 Bratislava, Slovakia
| | - Elisa Borghi
- Università degli Studi di Milano, Department of Health Sciences, San Paolo Medical School, Via A. di Rudini 8, 20142 Milan, Italy
| | - Giulia Morace
- Università degli Studi di Milano, Department of Health Sciences, San Paolo Medical School, Via A. di Rudini 8, 20142 Milan, Italy
| | - Agata Los
- Department of Microbiology and Virology, Comenius University in Bratislava, Faculty of Natural Sciences, Ilkovicova 6, 84215 Bratislava, Slovakia
| | - Helena Bujdáková
- Department of Microbiology and Virology, Comenius University in Bratislava, Faculty of Natural Sciences, Ilkovicova 6, 84215 Bratislava, Slovakia
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