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Menu E, Filori Q, Dufour JC, Ranque S, L’Ollivier C. A Repertoire of the Less Common Clinical Yeasts. J Fungi (Basel) 2023; 9:1099. [PMID: 37998905 PMCID: PMC10671991 DOI: 10.3390/jof9111099] [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: 10/09/2023] [Revised: 11/08/2023] [Accepted: 11/08/2023] [Indexed: 11/25/2023] Open
Abstract
Invasive fungal diseases are a public health problem. They affect a constantly increasing number of at-risk patients, and their incidence has risen in recent years. These opportunistic infections are mainly due to Candida sp. but less common or rare yeast infections should not be underestimated. These so-called "less common" yeasts include Ascomycota of the genera Candida (excluding the five major Candida species), Magnusiomyces/Saprochaete, Malassezia, and Saccharomyces, and Basidiomycota of the genera Cryptococcus (excluding the Cryptococcus neoformans/gattii complex members), Rhodotorula, and Trichosporon. The aim of this review is to (i) inventory the less common yeasts isolated in humans, (ii) provide details regarding the specific anatomical locations where they have been detected and the clinical characteristics of the resulting infections, and (iii) provide an update on yeast taxonomy. Of the total of 239,890 fungal taxa and their associated synonyms sourced from the MycoBank and NCBI Taxonomy databases, we successfully identified 192 yeasts, including 127 Ascomycota and 65 Basidiomycota. This repertoire allows us to highlight rare yeasts and their tropism for certain anatomical sites and will provide an additional tool for diagnostic management.
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Affiliation(s)
- Estelle Menu
- Laboratoire de Parasitologie-Mycologie, IHU Méditerranée Infection, 13385 Marseille, France; (S.R.); (C.L.)
- Institut de Recherche pour le Développement, Assistance Publique-Hôpitaux de Marseille, Service de Santé des Armées, VITROME: Vecteurs-Infections Tropicales et Méditerranéennes, Aix Marseille Université, 13385 Marseille, France
| | - Quentin Filori
- INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, ISSPAM, Aix Marseille University, 13385 Marseille, France; (Q.F.); (J.-C.D.)
| | - Jean-Charles Dufour
- INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, ISSPAM, Aix Marseille University, 13385 Marseille, France; (Q.F.); (J.-C.D.)
- APHM, Hôpital de la Timone, Service Biostatistique et Technologies de l’Information et de la Communication, 13385 Marseille, France
| | - Stéphane Ranque
- Laboratoire de Parasitologie-Mycologie, IHU Méditerranée Infection, 13385 Marseille, France; (S.R.); (C.L.)
- Institut de Recherche pour le Développement, Assistance Publique-Hôpitaux de Marseille, Service de Santé des Armées, VITROME: Vecteurs-Infections Tropicales et Méditerranéennes, Aix Marseille Université, 13385 Marseille, France
| | - Coralie L’Ollivier
- Laboratoire de Parasitologie-Mycologie, IHU Méditerranée Infection, 13385 Marseille, France; (S.R.); (C.L.)
- Institut de Recherche pour le Développement, Assistance Publique-Hôpitaux de Marseille, Service de Santé des Armées, VITROME: Vecteurs-Infections Tropicales et Méditerranéennes, Aix Marseille Université, 13385 Marseille, France
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First Reported Case of Candida dubliniensis Endocarditis Related to Implantable Cardioverter-Defibrillator. Case Rep Cardiol 2020; 2020:6032873. [PMID: 32015917 PMCID: PMC6988660 DOI: 10.1155/2020/6032873] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 12/23/2019] [Accepted: 01/06/2020] [Indexed: 12/02/2022] Open
Abstract
A 36-year-old male presented to the ED with acute chronic hyponatremia found on routine weekly lab work with one-week history of generalized weakness, confusion, nausea/vomiting, and diarrhea. The patient has nonischemic cardiomyopathy of unknown etiology diagnosed in his teens with an AICD device placed 8 years ago and receiving milrinone infusion 3 years ago via peripherally inserted central catheter (PICC) line. Two sets of blood cultures grew Candida dubliniensis. The patient was started on micafungin and the PICC line was removed and replaced with a central line. A transthoracic echocardiogram (TEE) showed findings consistent with AICD lead involvement. The patient was continued on treatment for fungal infective endocarditis and transferred to another hospital where he had successful AICD lead extraction. Blood cultures upon transfer back to our facility were positive for methicillin-sensitive Staphylococcus aureus (MSSA). This bacteremia was thought to be secondary to right-sided internal jugular (IJ) central line and resolved with line removal and initiation of intravenous (IV) cefazolin. The patient was discharged on IV cefazolin and IV micafungin. He had a LifeVest® until completion of his antibiotic course and a new AICD was placed.
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Chang EY, Fatima S, Balan S, Bhyravabhotla K, Erickson M, Chan A, Ivonye C, Bradley C. Candida dubliniensis abscess: A clinical case and a review of the literature. Med Mycol Case Rep 2018; 21:41-43. [PMID: 30090694 PMCID: PMC6077146 DOI: 10.1016/j.mmcr.2018.04.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Revised: 03/16/2018] [Accepted: 04/16/2018] [Indexed: 11/29/2022] Open
Abstract
Candida dubliniensis infections are rare in the absence of prolonged immunocompromised status or intravenous drug abuse. We present a case of a C. dubliniensis soft tissue abscess in a patient with uncontrolled diabetes as his only immunocompromising risk factor, treated with surgical drainage and medical management.
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Affiliation(s)
- Eric Y Chang
- Department of Internal Medicine, Morehouse School of Medicine, 720 Westview Dr. S.W., Atlanta, GA 30310, USA
| | - Shaheen Fatima
- Department of Internal Medicine, Morehouse School of Medicine, 720 Westview Dr. S.W., Atlanta, GA 30310, USA
| | - Shuba Balan
- Department of Internal Medicine, Morehouse School of Medicine, 720 Westview Dr. S.W., Atlanta, GA 30310, USA
| | - Kshama Bhyravabhotla
- Department of Internal Medicine, Morehouse School of Medicine, 720 Westview Dr. S.W., Atlanta, GA 30310, USA
| | - Marc Erickson
- Department of Internal Medicine, Morehouse School of Medicine, 720 Westview Dr. S.W., Atlanta, GA 30310, USA
| | - Austin Chan
- Department of Internal Medicine, Morehouse School of Medicine, 720 Westview Dr. S.W., Atlanta, GA 30310, USA.,Division of Infectious Diseases, Department of Internal Medicine, Morehouse School of Medicine, 720 Westview Dr. S.W., Atlanta, GA 30310, USA
| | - Chinedu Ivonye
- Department of Internal Medicine, Morehouse School of Medicine, 720 Westview Dr. S.W., Atlanta, GA 30310, USA
| | - Cinnamon Bradley
- Department of Internal Medicine, Morehouse School of Medicine, 720 Westview Dr. S.W., Atlanta, GA 30310, USA
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Giuliano S, Guastalegname M, Russo A, Falcone M, Ravasio V, Rizzi M, Bassetti M, Viale P, Pasticci MB, Durante-Mangoni E, Venditti M. Candida endocarditis: systematic literature review from 1997 to 2014 and analysis of 29 cases from the Italian Study of Endocarditis. Expert Rev Anti Infect Ther 2017; 15:807-818. [PMID: 28903607 DOI: 10.1080/14787210.2017.1372749] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
INTRODUCTION Candida Endocarditis (CE) is a deadly disease. It is of paramount importance to assess risk factors for acquisition of both Candida native (NVE) and prosthetic (PVE) valve endocarditis and relate clinical features and treatment strategies with the outcome of the disease. Areas covered: We searched the literature using the Pubmed database. Cases of CE from the Italian Study on Endocarditis (SEI) were also included. Overall, 140 cases of CE were analyzed. Patients with a history of abdominal surgery and antibiotic exposure had higher probability of developing NVE than PVE. In the PVE group, time to onset of CE was significantly lower for biological prosthesis compared to mechanical prosthesis. In the whole population, greater age and longer time to diagnosis were associated with increased likelihood of death. Patients with effective anti-biofilm treatment, patients who underwent cardiac surgery and patients who were administered chronic suppressive antifungal treatment showed increased survival. For PVE, moderate active anti-biofilm and highly active anti-biofilm treatment were associated with lower mortality. Expert commentary: Both NVE and PVE could be considered biofilm-related diseases, pathogenetically characterized by Candida intestinal translocation and initial transient candidemia. Cardiac surgery, EAB treatment and chronic suppressive therapy might be crucial in increasing patient survival.
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Affiliation(s)
- Simone Giuliano
- a Department of Public Health and Infectious Diseases , Policlinico Umberto I 'Sapienza' University of Rome , Rome , Italy
| | - Maurizio Guastalegname
- a Department of Public Health and Infectious Diseases , Policlinico Umberto I 'Sapienza' University of Rome , Rome , Italy
| | - Alessandro Russo
- a Department of Public Health and Infectious Diseases , Policlinico Umberto I 'Sapienza' University of Rome , Rome , Italy
| | - Marco Falcone
- a Department of Public Health and Infectious Diseases , Policlinico Umberto I 'Sapienza' University of Rome , Rome , Italy
| | - Veronica Ravasio
- b Infectious Diseases Unit , ASST Papa Giovanni XXIII , Bergamo , Italy
| | - Marco Rizzi
- b Infectious Diseases Unit , ASST Papa Giovanni XXIII , Bergamo , Italy
| | - Matteo Bassetti
- c Infectious Diseases Division , Santa Maria Misericordia University Hospital , Udine , Italy
| | - Pierluigi Viale
- d Infectious Diseases Unit, Department of Medical and Surgical Sciences , Alma Mater Studiorum University of Bologna , Bologna , Italy
| | | | - Emanuele Durante-Mangoni
- f Department of Clinical and Experimental Medicine , Università della Campania 'Luigi Vanvitelli', AORN dei Colli-Ospedale Monaldi , Naples , Italy
| | - Mario Venditti
- a Department of Public Health and Infectious Diseases , Policlinico Umberto I 'Sapienza' University of Rome , Rome , Italy
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Kovács R, Saleh Q, Bozó A, Tóth Z, Gesztelyi R, Kardos T, Kardos G, Takacs I, Majoros L. Killing Activity of Micafungin Against Candida albicans, C. dubliniensis and Candida africana in the Presence of Human Serum. Mycopathologia 2017; 182:979-987. [PMID: 28699056 DOI: 10.1007/s11046-017-0178-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 07/06/2017] [Indexed: 11/26/2022]
Abstract
We compared killing activity of micafungin in time-kill experiments in RPMI-1640 with and without 50% serum against Candida albicans, Candida dubliniensis and Candida africana reference strains and clinical isolates. Killing rates (k values) were determined for each strain and concentration. In RPMI-1640 MIC ranges were 0.015-0.03, 0.015-0.03 and 0.015 mg/L against C. albicans, C. dubliniensis and C. africana, respectively. In 50% serum MIC values for the three species increased 16- to 64-fold. In RPMI-1640 micafungin was fungicidal against two of three C. albicans isolates at 16 and 32 mg/L within 14.54 h and fungistatic against all C. africana and C. dubliniensis. Fifty per cent serum significantly decreased the growth rate of C. africana, but not of the other two species; weak in vivo replication ability of C. africana was confirmed in murine model. In 50% serum micafungin at 0.25 and 1 mg/L did not inhibit any of the three species (k values were always negative). Micafungin killing rate in 50% serum at 4, 16 and 32 mg/L was significantly decreased for C. albicans, but increased for C. dubliniensis compared to RPMI-1640. Killing activity of micafungin against C. africana was comparable or higher in 50% serum than in RPMI-1640. Although micafungin is a highly protein-bound drug, it was equally effective against the species of the C. albicans complex in 50% serum at therapeutic trough concentration (4 mg/L). Both in vitro and in vivo data confirmed the low virulence of C. africana compared to the two sibling species.
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Affiliation(s)
- Renátó Kovács
- Department of Medical Microbiology, Faculty of Medicine, University of Debrecen, Debrecen, Nagyerdei krt. 98., 4032, Hungary
- Faculty of Pharmacy, University of Debrecen, Debrecen, Hungary
| | - Qasem Saleh
- Department of Medical Microbiology, Faculty of Medicine, University of Debrecen, Debrecen, Nagyerdei krt. 98., 4032, Hungary
| | - Aliz Bozó
- Department of Medical Microbiology, Faculty of Medicine, University of Debrecen, Debrecen, Nagyerdei krt. 98., 4032, Hungary
| | - Zoltán Tóth
- Department of Medical Microbiology, Faculty of Medicine, University of Debrecen, Debrecen, Nagyerdei krt. 98., 4032, Hungary
| | - Rudolf Gesztelyi
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Tamás Kardos
- Department of Pulmonology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Gábor Kardos
- Department of Medical Microbiology, Faculty of Medicine, University of Debrecen, Debrecen, Nagyerdei krt. 98., 4032, Hungary
| | - István Takacs
- Faculty of Health, University of Miskolc, Miskolc, Hungary
| | - László Majoros
- Department of Medical Microbiology, Faculty of Medicine, University of Debrecen, Debrecen, Nagyerdei krt. 98., 4032, Hungary.
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Candida dubliniensis Pneumonia: A Case Report and Review of Literature. Mycopathologia 2016; 181:765-8. [PMID: 27342836 DOI: 10.1007/s11046-016-0032-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Accepted: 06/18/2016] [Indexed: 11/27/2022]
Abstract
Candida dubliniensis is an uncommon species of Candida which has been implicated in fungal pneumonia only very rarely. We present the case of a 75-year-old man with laryngeal cancer undergoing chemotherapy on broad-spectrum antibiotics and tuberculosis therapy with blood and endotracheal cultures positive for C. dubliniensis. Subsequent autopsy was performed with postmortem lung cultures positive for C. dubliniensis and lung histopathology demonstrating an invasive fungal infection. Molecular analysis of the lung tissue confirmed the identity of the fungi as C. dubliniensis. Since its discovery as a pathogen in the oral cavities of HIV-positive patients, C. dubliniensis has been identified in a wide spectrum of clinical scenarios and anatomic locations but manifests only rarely as pneumonia. This report represents a novel case of C. dubliniensis pneumonia confirmed by culture, histopathology, and molecular identification.
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7
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Antinori S, Ferraris L, Orlando G, Tocalli L, Ricaboni D, Corbellino M, Sollima S, Galli M, Milazzo L. Fungal Endocarditis Observed Over an 8-Year Period and a Review of the Literature. Mycopathologia 2014; 178:37-51. [DOI: 10.1007/s11046-014-9754-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 05/01/2014] [Indexed: 12/13/2022]
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8
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Third case of Candida dubliniensis endogenous endophthalmitis in North America: case report and review of the literature. Int Ophthalmol 2013; 34:945-50. [DOI: 10.1007/s10792-013-9880-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Accepted: 10/31/2013] [Indexed: 11/26/2022]
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9
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Abstract
Endocarditis caused by Candida dubliniensis is a rare event and limited to few case reports. In this report, the authors present a patient with a history of intravenous drug use and hepatitis C and endocarditis involving a prosthetic aortic valve. Also reviewed are the treatment guidelines for Candida sp. endocarditis.
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10
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Khan Z, Ahmad S, Joseph L, Chandy R. Candida dubliniensis: an appraisal of its clinical significance as a bloodstream pathogen. PLoS One 2012; 7:e32952. [PMID: 22396802 PMCID: PMC3292580 DOI: 10.1371/journal.pone.0032952] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2012] [Accepted: 02/06/2012] [Indexed: 11/18/2022] Open
Abstract
A nine-year prospective study (2002–2010) on the prevalence of Candida dubliniensis among Candida bloodstream isolates is presented. The germ tube positive isolates were provisionally identified as C. dubliniensis by presence of fringed and rough colonies on sunflower seed agar. Subsequently, their identity was confirmed by Vitek2 Yeast identification system and/or by amplification and sequencing of the ITS region of rDNA. In all, 368 isolates were identified as C. dubliniensis; 67.1% came from respiratory specimens, 11.7% from oral swabs, 9.2% from urine, 3.8% from blood, 2.7% from vaginal swabs and 5.4% from other sources. All C. dubliniensis isolates tested by Etest were susceptible to voriconazole and amphotericin B. Resistance to fluconazole (≥8 µg/ml) was observed in 2.5% of C. dubliniensis isolates, 7 of which occurred between 2008–2010. Of note was the diagnosis of C. dubliniensis candidemia in 14 patients, 11 of them occurring between 2008–2010. None of the bloodstream isolate was resistant to fluconazole, while a solitary isolate showed increased MIC to 5-flucytosine (>32 µg/ml) and belonged to genotype 4. A review of literature since 1999 revealed 28 additional cases of C. dubliniensis candidemia, and 167 isolates identified from blood cultures since 1982. In conclusion, this study highlights a greater role of C. dubliniensis in bloodstream infections than hitherto recognized.
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Affiliation(s)
- Ziauddin Khan
- Department of Microbiology, Faculty of Medicine, Kuwait University, Safat, Kuwait.
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Ahmad S, Khan ZU, Joseph L, Asadzadeh M, Theyyathel A. Genotypic heterogeneity and molecular basis of 5-flucytosine resistance among Candida dubliniensis isolates recovered from clinical specimens in Kuwait. Med Mycol 2011; 50:244-51. [PMID: 21895416 DOI: 10.3109/13693786.2011.597446] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
There is a paucity of information about genotypic heterogeneity among Candida dubliniensis isolates recovered from different geographic regions. This study explored genotypic heterogeneity among 103 C. dubliniensis strains obtained over a six-year period from clinical specimens in Kuwait. Genotype assignment was based on amplification with genotype-specific primers and sequencing of rDNA. Susceptibility to 5-flucytosine was determined by means of the Etest. DNA sequencing of cytosine deaminase was performed to determine the molecular basis of resistance to 5-flucytosine. DNA sequencing of rDNA identified seven different genotypes, i.e., 68 (66%) isolates were found to belong to genotype 1, 25 to genotype 4, six to genotype 5 and one each to genotypes 6-9. Strains of genotype 2 or genotype 3 were not detected. All isolates of genotype 4 but none of other genotypes were resistant to 5-flucytosine and the resistant strains all contained S29L mutation. Isolates of all other genotypes contained wild-type codon 29 in cytosine deaminase. A simple, PCR-RFLP-based method has been developed to facilitate rapid detection of S29L mutation in cytosine deaminase. A noteworthy observation of our study is the identification of five new genotypes of C. dubliniensis isolates, recovered from oral/respiratory specimens from patients of Middle Eastern origin. Furthermore, all 5-flucytosine resistant C. dubliniensis isolates in Kuwait belonged to genotype 4 only.
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Affiliation(s)
- Suhail Ahmad
- Department of Microbiology, Kuwait University, Kuwait
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Medovarská I, Bystrický S, Kossaczká Z, Machová E. Importance of α- and β/α-linked mannooligosaccharides in antibody response against C. dubliniensis. Glycoconj J 2010; 27:697-702. [PMID: 21110087 DOI: 10.1007/s10719-010-9314-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2010] [Revised: 10/27/2010] [Accepted: 11/10/2010] [Indexed: 10/18/2022]
Abstract
A conjugate of C. dubliniensis cell-wall mannan and human serum albumin (HSA) induced significant level of anti-mannan IgGs in sera of immunized rabbits, whereas mannan alone was not immunogenic. Binding affinities of anti-mannan IgGs induced by the conjugate were evaluated by inhibition ELISA (iELISA) using mannooligosaccharides (dimer-octamer), derived from the side chains of C. dubliniensis mannan, as the inhibitors. Inhibition power of the mannooligosaccharides increased exponentially with their size, with dimer being the weakest (IC(50) = 4 mmol/L) and heptamer/octamer the strongest inhibitors (IC(50) = 0.01 mmol/L). In addition, the mannooligosaccharides proved effective as inhibitors against antiserum obtained from rabbits immunized with C. dubliniensis heat-killed cells, demonstrating a high correlation in the IC(50) values with anti-conjugate serum (Pearson's correlation coefficient r = 0.98; P < 0.01). These findings suggest that a) the mannooligosaccharides comprising the side chains of C. dubliniensis mannan may represent relevant points of interaction with host immune system during infection and b) anti-mannan antibodies induced by the two antigens (the mannan conjugate and the yeast) are of similar specificities.
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Affiliation(s)
- Izabela Medovarská
- Institute of Chemistry, Slovak Academy of Sciences, Dúbravská cesta 9, 845 38, Bratislava, Slovak Republic.
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Pasligh J, Radecke C, Fleischhacker M, Ruhnke M. Comparison of phenotypic methods for the identification of Candida dubliniensis. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2010; 43:147-54. [PMID: 20457432 DOI: 10.1016/s1684-1182(10)60023-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2008] [Revised: 10/08/2008] [Accepted: 11/07/2008] [Indexed: 10/19/2022]
Abstract
BACKGROUND/PURPOSE Mixed infections caused by different Candida species are the rule rather than the exception. The discrimination between the two closely related species Candida albicans and Candida dubliniensis is not trivial. Therefore, there is a need for fast, reliable, and inexpensive methods with high specificity for the identification and differentiation of these two Candida species, which are frequently detected in the oral cavities of patients with a human immunodeficiency virus infection. METHODS We applied several phenotypic identification methods (growth on Rice-agar, Bird-seed agar, CHROMagar Candida, API ID 32C; growth at 42 degrees C and 45 degrees C) and compared them with genotyping by arbitrarily primed-polymerase chain reaction. RESULTS A sensitivity of 44% for the identification of C. dubliniensis was achieved for growth on Rice-agar, 97% for discrimination on Bird-seed agar, 95% with the assimilation profile index API ID 32C, and 97% when grown at 45 degrees C. We found two API codes not described for C. dubliniensis so far. Additionally, 88% of our C. dubliniensis isolates assimilated palatinose, in contrast to the 1% described in the API reference manual. CONCLUSION According to our results, cultivation of Candida isolates on Bird-seed agar after screening on CHROMagar Candida is a very sensitive, simple, and cost-effective method for discriminating C. dubliniensis from C. albicans in routine practice.
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Affiliation(s)
- Julia Pasligh
- Division of Oncology, Department of Medicine, Charité Universitätsmedizin Berlin, Charité Campus Mitte, Berlin, Germany
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14
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Coleman DC, Moran GP, McManus BA, Sullivan DJ. Mechanisms of antifungal drug resistance in Candida dubliniensis. Future Microbiol 2010; 5:935-49. [PMID: 20521937 DOI: 10.2217/fmb.10.51] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Candida dubliniensis was first described in 1995 and is the most closely related species to the predominant human fungal pathogen Candida albicans. C. dubliniensis is significantly less prevalent and less pathogenic than C. albicans and is primarily associated with infections in HIV-infected individuals and other immunocompromised cohorts. The population structure of C. dubliniensis consists of three well-defined major clades and is significantly less diverse than C. albicans. The majority of C. dubliniensis isolates are susceptible to antifungal drugs commonly used to treat Candida infections. To date only two major patterns of antifungal drug resistance have been identified and the molecular mechanisms of these are very similar to the resistance mechanisms that have been described previously in C. albicans. However, significant differences are evident in the predominant antifungal drug mechanisms employed by C. dubliniensis, differences that reflect its more clonal nature, its lower prevalence and characteristics of its genome, the complete sequence of which has only recently been determined.
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Affiliation(s)
- David C Coleman
- Microbiology Research Unit, Division of Oral Biosciences, Dublin Dental School & Hospital, University of Dublin, Trinity College Dublin, Dublin 2, Republic of Ireland.
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Mandviwala T, Shinde R, Kalra A, Sobel JD, Akins RA. High-throughput identification and quantification of Candida species using high resolution derivative melt analysis of panfungal amplicons. J Mol Diagn 2009; 12:91-101. [PMID: 20007848 DOI: 10.2353/jmoldx.2010.090085] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Fungal infections pose unique challenges to molecular diagnostics; fungal molecular diagnostics consequently lags behind bacterial and viral counterparts. Nevertheless, fungal infections are often life-threatening, and early detection and identification of species is crucial to successful intervention. A high throughput PCR-based method is needed that is independent of culture, is sensitive to the level of one fungal cell per milliliter of blood or other tissue types, and is capable of detecting species and resistance mutations. We introduce the use of high resolution melt analysis, in combination with more sensitive, inclusive, and appropriately positioned panfungal primers, to address these needs. PCR-based amplification of the variable internal transcribed regions of the rDNA genes generates an amplicon whose sequence melts with a shape that is characteristic and therefore diagnostic of the species. Simple analysis of the differences between test and reference melt curves generates a single number that calls the species. Early indications suggest that high resolution melt analysis can distinguish all eight major species of Candida of clinical significance without interference from excess human DNA. Candida species, including mixed and novel species, can be identified directly in vaginal samples. This tool can potentially detect, count, and identify fungi in hundreds of samples per day without further manipulation, costs, or delays, offering a major step forward in fungal molecular diagnostics.
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Affiliation(s)
- Tasneem Mandviwala
- Department of Biochemistry and Molecular Biology, Wayne State University School of Medicine, Detroit, Michigan, USA
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Szabo Z, Borbely A, Kardos G, Somogyvari F, Kemény-Beke A, Asztalos L, Rozgonyi F, Majoros L. In vitro efficacy of amphotericin B, 5-fluorocytosine, fluconazole, voriconazole and posaconazole against Candida dubliniensis isolates using time-kill methodology. Mycoses 2009; 53:196-9. [PMID: 19761489 DOI: 10.1111/j.1439-0507.2009.01705.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Candida dubliniensis is a recently described yeast that causes infections in mucosal surfaces as well as sterile body sites. Candida dubliniensis develops resistance to fluconazole (FLC) more rapidly than the closely related species C. albicans. The killing activity of amphotericin B (AMB), 5-fluorocytosine (5FC), FLC, voriconazole (VRC) and posaconazole (POS) was determined against six C. dubliniensis clinical isolates, identified using molecular biological methods and C. dubliniensis CD36 reference strain. Minimum inhibitory concentrations (MICs) were determined using the Clinical and Laboratory Standards Institute standard procedure. Time-kill assays were performed using RPMI-1640 as test media over a 48-h period. AMB proved to be fungicidal at >or=0.5 microg ml(-1) against all clinical isolates after 48 h. 5FC was only fungicidal at 32-64x MIC (4-8 microg ml(-1)) against all C. dubliniensis isolates. FLC, VRC and POS were fungistatic; decrease in colony number was observed only at the highest concentrations tested (8, 4 and 4 microg ml(-1), respectively). Triazoles invariably showed fungistatic effect at concentrations attainable in the serum. In clinical situations when a fungicidal antifungal is desirable, AMB may be used.
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Affiliation(s)
- Z Szabo
- Department of Medical Microbiology, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary
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Wellinghausen N, Moericke A, Bundschuh S, Friedrich W, Schulz AS, Gatz SA. Multifocal osteomyelitis caused by Candida dubliniensis. J Med Microbiol 2009; 58:386-390. [PMID: 19208893 DOI: 10.1099/jmm.0.003970-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Candida dubliniensis is an emerging fungal pathogen, especially in immunodeficient patients. We report what is to the best of our knowledge the first case of multifocal osteomyelitis following disseminated infection in a patient after haematopoietic stem cell transplantation. PFGE for typing of C. dubliniensis was developed and the necessity of long-term antifungal therapy is discussed.
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Affiliation(s)
- Nele Wellinghausen
- Institute of Medical Microbiology and Hygiene, University Hospital of Ulm, Ulm, Germany
| | - Angelika Moericke
- Institute of Medical Microbiology and Hygiene, University Hospital of Ulm, Ulm, Germany
| | - Silke Bundschuh
- University Hospital for Children's and Adolescent Medicine, Ulm, Germany
| | - Wilhelm Friedrich
- University Hospital for Children's and Adolescent Medicine, Ulm, Germany
| | - Ansgar S Schulz
- University Hospital for Children's and Adolescent Medicine, Ulm, Germany
| | - Susanne A Gatz
- University Hospital for Children's and Adolescent Medicine, Ulm, Germany
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18
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Khlif M, Sellami A, Sellami H, Makni F, Ayadi A. [Candida dubliniensis: Identification methods and epidemiologic implication]. ACTA ACUST UNITED AC 2008; 59:166-72. [PMID: 19046828 DOI: 10.1016/j.patbio.2008.09.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2008] [Accepted: 09/18/2008] [Indexed: 10/21/2022]
Abstract
Candida dubliniensis was recently described (1995) associated with oral candidiasis in HIV-positive patients. This organism is very closely related to the pathogenic human yeast, Candida albicans, and share a great number of phenotypic and genotypic characters. This great similarity limits the discrimination between these two species. Several phenotypic and molecular methods were developed. The phenotypic methods are simply used in routine discrimination between these two species and depend on the growth at high temperature, sugar assimilation, growth on special mediums and chlamydospore production…; but these methods are insensitive in discrimination between these two species. The molecular biology methods are highly reliable and able to confirm rapidly the identification of this species. In this article, we will review the various studies run out concerning the methods deployed for the identification of C. dubliniensis as well as the epidemiological implication of this new pathogen.
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Affiliation(s)
- M Khlif
- Laboratoire de biologie moléculaire, parasitaire et fongique, faculté de médecine de Sfax, avenue Magida-Boulila, 3029 Sfax, Tunisie
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19
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de Loreto ÉS, Pozzatti P, Alves Scheid L, Santurio D, Morais Santurio J, Alves SH. Differentiation of Candida dubliniensis from Candida albicans on rosemary extract agar and oregano extract agar. J Clin Lab Anal 2008; 22:172-7. [PMID: 18484650 PMCID: PMC6649199 DOI: 10.1002/jcla.20237] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2007] [Accepted: 02/21/2008] [Indexed: 11/07/2022] Open
Abstract
Candida dubliniensis is a recently described pathogenic species which shares many phenotypic features with Candida albicans and therefore, may be misidentified in microbiological laboratories. Because molecular methods can be onerous and unfeasible in routine mycological laboratories with restricted budgets such as those in developing countries, phenotypic techniques have been encouraged in the development of differential media for the presumptive identification of these species. We examined the colony morphology and chlamydospore production of 30 C. dubliniensis isolates and 100 C. albicans isolates on two new proposed media: rosemary (Rosmarinus officinalis) extract agar (REA) and oregano (Origanum vulgare) extract agar (OEA). These substrates are traditionally used as spices and medicinal herbs. In both of these media, all C. dubliniensis isolates (100%) showed rough colonies with peripheral hyphal fringes and abundant chlamydospores after 24 to 48 hr of incubation at 25 degrees C. In contrast, under the same conditions, all isolates of C. albicans (100%) showed smooth colonies without hyphal fringes or chlamydospores. In conclusion, REA and OEA offer a simple, rapid, and inexpensive screening media for the differentiation of C. albicans and C. dubliniensis.
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Affiliation(s)
- Érico Silva de Loreto
- Departamento de Microbiologia e Parasitologia, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
| | - Patrícia Pozzatti
- Departamento de Microbiologia e Parasitologia, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
| | - Liliane Alves Scheid
- Departamento de Microbiologia e Parasitologia, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
| | - Deise Santurio
- Departamento de Microbiologia e Parasitologia, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
| | - Janio Morais Santurio
- Departamento de Microbiologia e Parasitologia, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
| | - Sydney Hartz Alves
- Departamento de Microbiologia e Parasitologia, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
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Paugam A, Baixench MT, Viguié C. [An update on Candida dubliniensis]. Med Mal Infect 2007; 38:1-7. [PMID: 18065177 DOI: 10.1016/j.medmal.2007.10.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2007] [Accepted: 10/07/2007] [Indexed: 11/17/2022]
Abstract
Eleven years ago, Irish authors, using molecular biology, demonstrated the existence of Candida dubliniensis, a new species of Candida close to Candida albicans. Initially isolated from AIDS patients with oral candidiasis, this species was detected, even in immunocompetent patients. Recently, with new, easy to implement identification tests (latex, immunochromatography), numerous epidemiological studies were undertaken. In most studies, C. dubliniensis was most often identified in the oral cavity. In the absence of HIV infection, the proportion C. dubliniensis/C. albicans ranged from 1 to 5% but it increased to 15-20% in case of HIV infection. It should be stressed that, from an experimental point of view, the acquisition of a secondary resistance to fluconazole is more quickly obtained with C. dubliniensis that with C. albicans, this resistance remains exceptionally observed in clinical observations.
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Affiliation(s)
- A Paugam
- Laboratoire de parasitologie-mycologie, groupe hospitalier Cochin-Saint-Vincent-de-Paul, Assistance publique-Hôpitaux de Paris, université Paris-Descartes, Paris, France.
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21
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Sullivan DJ, Moran GP, Coleman DC. Candida dubliniensis: ten years on. FEMS Microbiol Lett 2005; 253:9-17. [PMID: 16213674 DOI: 10.1016/j.femsle.2005.09.015] [Citation(s) in RCA: 89] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2005] [Revised: 09/09/2005] [Accepted: 09/09/2005] [Indexed: 11/17/2022] Open
Abstract
Candida dubliniensis was first described as a novel species in 1995. This organism is very closely related to the important human yeast pathogen, Candida albicans. However, despite the very close phylogenetic relationship between C. albicans and C. dubliniensis and the fact that they share a large number of phenotypic traits, epidemiological and virulence model data indicate that the former is a far more successful pathogen. In order to investigate the molecular basis of the lower virulence of C. dubliniensis recent comparative genomic hybridisation studies have revealed the absence and divergence of specific genes implicated in candidal virulence. Data from the C. dubliniensis genome sequencing project will allow a complete comparison between the genomes of the two species to be performed and thus enhance our understanding of candidal virulence and how virulence has evolved in Candida species.
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Affiliation(s)
- Derek J Sullivan
- Microbiology Research Unit, Division of Oral Biosciences, Dublin Dental School and Hospital, University of Dublin, Trinity College, Dublin 2, Ireland.
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22
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Al Mosaid A, Sullivan DJ, Polacheck I, Shaheen FA, Soliman O, Al Hedaithy S, Al Thawad S, Kabadaya M, Coleman DC. Novel 5-flucytosine-resistant clade of Candida dubliniensis from Saudi Arabia and Egypt identified by Cd25 fingerprinting. J Clin Microbiol 2005; 43:4026-36. [PMID: 16081946 PMCID: PMC1233943 DOI: 10.1128/jcm.43.8.4026-4036.2005] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
DNA fingerprinting of Candida dubliniensis isolates using the species-specific probe Cd25 previously showed that this species consists of two distinct groups, termed Cd25 group I and Cd25 group II. The present study investigated the population structure of 30 C. dubliniensis oral isolates from Saudi Arabia and Egypt using Cd25 fingerprinting and rRNA gene internal transcribed spacer region-based genotyping. Cd25 fingerprinting analysis of these isolates revealed two distinct populations, the first of which consisted of 10 closely related genotype 1 isolates (average similarity coefficient [S(AB)] value, 0.86). The second population of 20 isolates was much more heterogeneous (average S(AB) value, 0.35) and consisted of two distinct subpopulations, one of which consisted of genotype 3 isolates (n = 13) and the other of genotype 4 isolates (n = 7). A mixed dendrogram generated from the fingerprint data from the 30 Saudi Arabian and Egyptian isolates, 5 Israeli isolates, and 51 previously characterized international isolates (32 of Cd25 group I and 19 of Cd25 group II) revealed the presence of three distinct main clades. The first corresponded to the previously described Cd25 group I and contained all the Saudi Arabian, Egyptian, and Israeli genotype 1 isolates mixed with international isolates. The second clade corresponded to the previously described Cd25 group II and contained three Israeli isolates, one genotype 2 isolate, one genotype 3 isolate, and a genotype 4 variant isolate, which were mixed with international isolates. The third clade has not been described before and consisted solely of the 20 Saudi Arabian and Egyptian genotype 3 and 4 isolates identified in this study and a previously described genotype 4 Israeli isolate. All 20 Cd25 group III isolates exhibited high-level resistance to 5-flucytosine (MIC > or = 128 microg/ml), whereas all Cd25 group I and Cd25 group II isolates tested (10 Saudi Arabian and Egyptian, 16 Israeli, and 24 international) were susceptible to 5-flucytosine (MIC < or = 0.125 microg/ml). The results of this study show for the first time the presence of a novel 5-flucytosine-resistant clade of C. dubliniensis (Cd25 group III) that is predominant among isolates from Saudi Arabia and Egypt and absent from a previously characterized international collection of 98 isolates from 15 countries.
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Affiliation(s)
- Asmaa Al Mosaid
- Microbiology Research Division, Dublin Dental School and Hospital, Trinity College, University of Dublin, Dublin 2, Republic of Ireland, Department of Clinical Microbiology and Infectious Diseases, The Hebrew University-Hadassah Medical Center, Jerusalem, Israel, Jeddah Kidney Center, King Fahad Hospital, Jeddah, Saudi Arabia, National Cancer Institute, Cairo, Egypt, Medical Mycology Unit, Department of Pathology, College of Medicine, King Khalid University Hospital, Riyadh, Saudi Arabia, Microbiology Laboratory, Department of Pathology & Laboratory Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Derek J. Sullivan
- Microbiology Research Division, Dublin Dental School and Hospital, Trinity College, University of Dublin, Dublin 2, Republic of Ireland, Department of Clinical Microbiology and Infectious Diseases, The Hebrew University-Hadassah Medical Center, Jerusalem, Israel, Jeddah Kidney Center, King Fahad Hospital, Jeddah, Saudi Arabia, National Cancer Institute, Cairo, Egypt, Medical Mycology Unit, Department of Pathology, College of Medicine, King Khalid University Hospital, Riyadh, Saudi Arabia, Microbiology Laboratory, Department of Pathology & Laboratory Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Itzhack Polacheck
- Microbiology Research Division, Dublin Dental School and Hospital, Trinity College, University of Dublin, Dublin 2, Republic of Ireland, Department of Clinical Microbiology and Infectious Diseases, The Hebrew University-Hadassah Medical Center, Jerusalem, Israel, Jeddah Kidney Center, King Fahad Hospital, Jeddah, Saudi Arabia, National Cancer Institute, Cairo, Egypt, Medical Mycology Unit, Department of Pathology, College of Medicine, King Khalid University Hospital, Riyadh, Saudi Arabia, Microbiology Laboratory, Department of Pathology & Laboratory Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Faisal A. Shaheen
- Microbiology Research Division, Dublin Dental School and Hospital, Trinity College, University of Dublin, Dublin 2, Republic of Ireland, Department of Clinical Microbiology and Infectious Diseases, The Hebrew University-Hadassah Medical Center, Jerusalem, Israel, Jeddah Kidney Center, King Fahad Hospital, Jeddah, Saudi Arabia, National Cancer Institute, Cairo, Egypt, Medical Mycology Unit, Department of Pathology, College of Medicine, King Khalid University Hospital, Riyadh, Saudi Arabia, Microbiology Laboratory, Department of Pathology & Laboratory Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Osama Soliman
- Microbiology Research Division, Dublin Dental School and Hospital, Trinity College, University of Dublin, Dublin 2, Republic of Ireland, Department of Clinical Microbiology and Infectious Diseases, The Hebrew University-Hadassah Medical Center, Jerusalem, Israel, Jeddah Kidney Center, King Fahad Hospital, Jeddah, Saudi Arabia, National Cancer Institute, Cairo, Egypt, Medical Mycology Unit, Department of Pathology, College of Medicine, King Khalid University Hospital, Riyadh, Saudi Arabia, Microbiology Laboratory, Department of Pathology & Laboratory Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Saleh Al Hedaithy
- Microbiology Research Division, Dublin Dental School and Hospital, Trinity College, University of Dublin, Dublin 2, Republic of Ireland, Department of Clinical Microbiology and Infectious Diseases, The Hebrew University-Hadassah Medical Center, Jerusalem, Israel, Jeddah Kidney Center, King Fahad Hospital, Jeddah, Saudi Arabia, National Cancer Institute, Cairo, Egypt, Medical Mycology Unit, Department of Pathology, College of Medicine, King Khalid University Hospital, Riyadh, Saudi Arabia, Microbiology Laboratory, Department of Pathology & Laboratory Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Sahar Al Thawad
- Microbiology Research Division, Dublin Dental School and Hospital, Trinity College, University of Dublin, Dublin 2, Republic of Ireland, Department of Clinical Microbiology and Infectious Diseases, The Hebrew University-Hadassah Medical Center, Jerusalem, Israel, Jeddah Kidney Center, King Fahad Hospital, Jeddah, Saudi Arabia, National Cancer Institute, Cairo, Egypt, Medical Mycology Unit, Department of Pathology, College of Medicine, King Khalid University Hospital, Riyadh, Saudi Arabia, Microbiology Laboratory, Department of Pathology & Laboratory Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Motaz Kabadaya
- Microbiology Research Division, Dublin Dental School and Hospital, Trinity College, University of Dublin, Dublin 2, Republic of Ireland, Department of Clinical Microbiology and Infectious Diseases, The Hebrew University-Hadassah Medical Center, Jerusalem, Israel, Jeddah Kidney Center, King Fahad Hospital, Jeddah, Saudi Arabia, National Cancer Institute, Cairo, Egypt, Medical Mycology Unit, Department of Pathology, College of Medicine, King Khalid University Hospital, Riyadh, Saudi Arabia, Microbiology Laboratory, Department of Pathology & Laboratory Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - David C. Coleman
- Microbiology Research Division, Dublin Dental School and Hospital, Trinity College, University of Dublin, Dublin 2, Republic of Ireland, Department of Clinical Microbiology and Infectious Diseases, The Hebrew University-Hadassah Medical Center, Jerusalem, Israel, Jeddah Kidney Center, King Fahad Hospital, Jeddah, Saudi Arabia, National Cancer Institute, Cairo, Egypt, Medical Mycology Unit, Department of Pathology, College of Medicine, King Khalid University Hospital, Riyadh, Saudi Arabia, Microbiology Laboratory, Department of Pathology & Laboratory Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
- Corresponding author. Mailing address: Microbiology Research Division, Dublin Dental School and Hospital, University of Dublin, Trinity College, Lincoln Place, Dublin 2, Republic of Ireland. Phone: (353) 1 6127276. Fax: (353) 1 6127295. E-mail:
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