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Kawasaki K, Sawai T, Inadomi Y, Morimitsu S, Ikeda T, Yoshioka S, Matsuo N, Kadota J, Yanagihara K, Mukae H. Central venous access Port-Related blood stream infection caused by Cyberlindnera fabianii: A case report and literature review. J Infect Chemother 2025; 31:102662. [PMID: 40057275 DOI: 10.1016/j.jiac.2025.102662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 02/05/2025] [Accepted: 02/20/2025] [Indexed: 03/16/2025]
Abstract
Cyberlindnera fabianii, an ascomycetous yeast, is a rare human pathogen. Here, we describe the first reported case of central venous (CV) access port-related blood-stream infection caused by C. fabianii. An 80-year-old Asian man presented to our department with a mass in the pancreas. A diagnosis of pancreatic cancer (cT4N0M0, cStage III) was made. A catheter with CV access port was inserted, and anticancer chemotherapy and radiotherapy was initiated. One year after the first visit, he was urgently admitted to our hospital due to recurrent hematemesis. On day 37, organism cultures of the blood and catheter tip were positive for Candida pelliculosa by the BD PHOENIX™ 100 system. On the basis of these findings, CV port-related blood-stream infection caused by C. pelliculosa was diagnosed, and treatment with micafungin (MCFG) was initiated. On day 51, the blood culture converted to negative. On day 65, MCFG was stopped. The cultured strain was sent to reference laboratory where Cyberlindnera fabianii was identified by MALDI-TOF mass spectrometry and direct sequencing of the internally transcribed spacer region. The present case report describes the first known case of CV access port-related blood-stream infection caused by C. fabianii. MCFG was successfully used to treat the fungemia caused by C. fabianii. Although the incidence of uncommon yeast species causing human infections has gradually increased in recent years, conventional biochemical methods may offer limited usefulness for identifying these rare organisms. Accordingly, MALDI-TOF mass spectrometry or molecular assays may be required to identify these uncommon fungal species.
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Affiliation(s)
- Koichi Kawasaki
- Department of Respiratory Medicine, Nagasaki Harbor Medical Center, 6-39 Shinchi-machi, Nagasaki, Japan
| | - Toyomitsu Sawai
- Department of Respiratory Medicine, Nagasaki Harbor Medical Center, 6-39 Shinchi-machi, Nagasaki, Japan.
| | - Yudai Inadomi
- Department of Respiratory Medicine, Nagasaki Harbor Medical Center, 6-39 Shinchi-machi, Nagasaki, Japan
| | - Shun Morimitsu
- Department of Respiratory Medicine, Nagasaki Harbor Medical Center, 6-39 Shinchi-machi, Nagasaki, Japan
| | - Tomonari Ikeda
- Department of Gastroenterology, Nagasaki Harbor Medical Center, 6-39 Shinchi-machi, Nagasaki, Japan
| | - Sumako Yoshioka
- Department of Respiratory Medicine, Nagasaki Harbor Medical Center, 6-39 Shinchi-machi, Nagasaki, Japan
| | - Nobuko Matsuo
- Department of Respiratory Medicine, Nagasaki Harbor Medical Center, 6-39 Shinchi-machi, Nagasaki, Japan
| | - Junichi Kadota
- Department of Respiratory Medicine, Nagasaki Harbor Medical Center, 6-39 Shinchi-machi, Nagasaki, Japan
| | - Katsunori Yanagihara
- Department of Laboratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto-machi, Nagasaki, Japan
| | - Hiroshi Mukae
- Second Department of Internal Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto-machi, Nagasaki, Japan
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Mpakosi A, Cholevas V, Meletiadis J, Theodoraki M, Sokou R. Neonatal Fungemia by Non-Candida Rare Opportunistic Yeasts: A Systematic Review of Literature. Int J Mol Sci 2024; 25:9266. [PMID: 39273215 PMCID: PMC11395034 DOI: 10.3390/ijms25179266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2024] [Revised: 08/23/2024] [Accepted: 08/24/2024] [Indexed: 09/15/2024] Open
Abstract
Fungal colonization poses a significant risk for neonates, leading to invasive infections such as fungemia. While Candida species are the most commonly identified pathogens, other rare yeasts are increasingly reported, complicating diagnosis and treatment due to limited data on antifungal pharmacokinetics. These emerging yeasts, often opportunistic, underscore the critical need for early diagnosis and targeted therapy in neonates. This systematic review aims to comprehensively analyze all published cases of neonatal fungemia caused by rare opportunistic yeasts, examining geographical distribution, species involved, risk factors, treatment approaches, and outcomes. Searching two databases (PubMed and SCOPUS), 89 relevant studies with a total of 342 cases were identified in the 42-year period; 62% of the cases occurred in Asia. Pichia anomala (31%), Kodamaea ohmeri (16%) and Malassezia furfur (15%) dominated. Low birth weight, the use of central catheters, prematurity, and the use of antibiotics were the main risk factors (98%, 76%, 66%, and 65%, respectively). 22% of the cases had a fatal outcome (80% in Asia). The highest mortality rates were reported in Trichosporon beigelii and Trichosporon asahii cases, followed by Dirkmeia churashimamensis cases (80%, 71%, and 42% respectively). Low birth weight, the use of central catheters, the use of antibiotics, and prematurity were the main risk factors in fatal cases (84%, 74%, 70%, and 67%, respectively). 38% of the neonates received fluconazole for treatment but 46% of them, died. Moreover, the rare yeasts of this review showed high MICs to fluconazole and this should be taken into account when planning prophylactic or therapeutic strategies with this drug. In conclusion, neonatal fungemia by rare yeasts is a life-threatening and difficult-to-treat infection, often underestimated and misdiagnosed.
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Affiliation(s)
- Alexandra Mpakosi
- Department of Microbiology, General Hospital of Nikaia “Agios Panteleimon”, 18454 Piraeus, Greece
| | | | - Joseph Meletiadis
- Clinical Microbiology Laboratory, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece;
| | - Martha Theodoraki
- Neonatal Intensive Care Unit, General Hospital of Nikaia “Agios Panteleimon”, 18454 Piraeus, Greece;
| | - Rozeta Sokou
- Neonatal Intensive Care Unit, General Hospital of Nikaia “Agios Panteleimon”, 18454 Piraeus, Greece;
- Neonatal Department, Aretaieio Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
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3
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Sariguzel FM, Unuvar GK, Kucukoglu O, Parkan OM, Koc AN. Identification, molecular characterization, and antifungal susceptibility of Cyberlindnera fabianii strains isolated from urinary tract. J Mycol Med 2023; 33:101429. [PMID: 37683563 DOI: 10.1016/j.mycmed.2023.101429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 08/17/2023] [Accepted: 08/21/2023] [Indexed: 09/10/2023]
Abstract
OBJECTIVES Cyberlindnera fabianii is an opportunistic pathogen isolated from clinical specimens. It can be incorrectly identified as Candida utulis by phenotypic methods. This study aimed to accurately identify Cy.fabianii strains isolated from the urinary tract, and to determine their molecular characterization and antifungal susceptibilities as well. METHODS Twenty-nine yeast strains isolated from urinary tract samples were studied. Strains were identified by phenotypically, sequence analysis and MALDI-TOF MS. Sequence analysis using different gene regions (ITS1-2,D1/D2,EF-1-alpha) in ribosomal DNA was performed for the molecular analysis. Phylogenetic analysis was done by the neighbor-joining method. Antifungal susceptibilities of strains were determined for nine antifungals by reference broth microdilution and the Sensititre YeastOne broth microdilution method (SensititreTMYeastOneTMAST Plate, Thermo Fisher Scientific™,USA) according to CLSI M60-Ed2 recommendations. RESULTS All strains were identified as C.utulis phenotypically by conventional methods, however all strains were identified as Cy.fabianii by sequence analysis and MALDI-TOF MS. It was observed that the gene regions examined in terms of determining evolutionary relatedness did not show intraspecies nucleotide variations. In all strains, the MIC50/MIC90 values for fluconazole were higher than the other antifungals tested. CONCLUSION Cy.fabianii should be considered in fluconazole-resistant urinary tract yeast infections. Although conventional phenotypical methods were insufficient to identify Cy.fabianii, it could be correctly identified with sequence analysis using different gene regions (ITS1-2,D1/D2,EF-1-alpha) in ribosomal DNA and MALDI-TOF MS.
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Affiliation(s)
- Fatma Mutlu Sariguzel
- Department of Medical Microbiology, Faculty of Medicine, Erciyes University, Kayseri 38030, Turkey.
| | - Gamze Kalin Unuvar
- Department of Infection Diseases, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Osman Kucukoglu
- Department of Medical Microbiology, Faculty of Medicine, Erciyes University, Kayseri 38030, Turkey
| | - Omur Mustafa Parkan
- Department of Medical Microbiology, Faculty of Medicine, Erciyes University, Kayseri 38030, Turkey
| | - Ayse Nedret Koc
- Department of Medical Microbiology, Faculty of Medicine, Erciyes University, Kayseri 38030, Turkey
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4
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Invasive fungal infections in neonates: a review. Pediatr Res 2022; 91:404-412. [PMID: 34880444 DOI: 10.1038/s41390-021-01842-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 09/16/2021] [Accepted: 10/28/2021] [Indexed: 12/15/2022]
Abstract
Invasive fungal infections remain the leading causes of morbidity and mortality in neonates, especially preterm and very low birth weight infants. Most invasive fungal infections are due to Candida or Aspergillus species, and other fungi are increasingly reported and described. Appropriate identification and treatment are required to augment activity and reduce the toxicity of antifungal drugs. Successful use of antifungals in the vulnerable neonatal population is important for both prevention and treatment of infection. Strategies for prevention, including prophylactic antifungal therapy as well as reducing exposure to modifiable risk factors, like limiting antibiotic exposure, discontinuation of central catheters, and hand hygiene are key techniques to prevent and decrease rates of invasive fungal infections. In conclusion, this is a review of the most common causes, prevention strategies, prophylaxis, and treatment of invasive fungal infections in neonates.
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Willaert RG, Kayacan Y, Devreese B. The Flo Adhesin Family. Pathogens 2021; 10:pathogens10111397. [PMID: 34832553 PMCID: PMC8621652 DOI: 10.3390/pathogens10111397] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 10/11/2021] [Accepted: 10/25/2021] [Indexed: 12/14/2022] Open
Abstract
The first step in the infection of fungal pathogens in humans is the adhesion of the pathogen to host tissue cells or abiotic surfaces such as catheters and implants. One of the main players involved in this are the expressed cell wall adhesins. Here, we review the Flo adhesin family and their involvement in the adhesion of these yeasts during human infections. Firstly, we redefined the Flo adhesin family based on the domain architectures that are present in the Flo adhesins and their functions, and set up a new classification of Flo adhesins. Next, the structure, function, and adhesion mechanisms of the Flo adhesins whose structure has been solved are discussed in detail. Finally, we identified from Pfam database datamining yeasts that could express Flo adhesins and are encountered in human infections and their adhesin architectures. These yeasts are discussed in relation to their adhesion characteristics and involvement in infections.
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Affiliation(s)
- Ronnie G. Willaert
- Research Group Structural Biology Brussels (SBB), Vrije Universiteit Brussel (VUB), 1050 Brussels, Belgium;
- Alliance Research Group VUB-UGent NanoMicrobiology (NAMI), 1050 Brussels, Belgium;
- International Joint Research Group VUB-EPFL NanoBiotechnology & NanoMedicine (NANO), Vrije Universiteit Brussel (VUB), 1050 Brussels, Belgium
- Correspondence: ; Tel.: +32-2629-1846
| | - Yeseren Kayacan
- Research Group Structural Biology Brussels (SBB), Vrije Universiteit Brussel (VUB), 1050 Brussels, Belgium;
- Alliance Research Group VUB-UGent NanoMicrobiology (NAMI), 1050 Brussels, Belgium;
- International Joint Research Group VUB-EPFL NanoBiotechnology & NanoMedicine (NANO), Vrije Universiteit Brussel (VUB), 1050 Brussels, Belgium
- Ecole Polytechnique Fédérale de Lausanne, 1015 Lausanne, Switzerland
| | - Bart Devreese
- Alliance Research Group VUB-UGent NanoMicrobiology (NAMI), 1050 Brussels, Belgium;
- International Joint Research Group VUB-EPFL NanoBiotechnology & NanoMedicine (NANO), Vrije Universiteit Brussel (VUB), 1050 Brussels, Belgium
- Ecole Polytechnique Fédérale de Lausanne, 1015 Lausanne, Switzerland
- Laboratory for Microbiology, Gent University (UGent), 9000 Gent, Belgium
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Park JH, Oh J, Sang H, Shrestha B, Lee H, Koo J, Cho SI, Choi JS, Lee MH, Kim J, Sung GH. Identification and Antifungal Susceptibility Profiles of Cyberlindnera fabianii in Korea. MYCOBIOLOGY 2019; 47:449-456. [PMID: 32010466 PMCID: PMC6968713 DOI: 10.1080/12298093.2019.1651592] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 06/30/2019] [Accepted: 07/31/2019] [Indexed: 06/10/2023]
Abstract
Invasive fungal infections caused by Cyberlindnera fabianii have recently increased. However, biochemical kits such as API 20 C AUX and Vitek-2C have misidentified this species as other Candida spp. such as C. pelliculosa or C. utilis due to no information of Cy. fabianii in yeast database. During our 2016-2017 surveys, eleven isolates of Cy. fabianii were obtained in International St. Mary's Hospital in Korea. Here, we describe its morphological and molecular characteristics and tested its antifungal susceptibility against nine antifungal agents. The sequences of the ITS region and the D1/D2 region of LSU revealed 100% identity with the sequences of Cy. fabianii. In comparison with the results from MALDI-TOF mass spectrometry, we found that Cy. fabianii can be distinguished from other species. In antifungal susceptibility test, voriconazole and echinocandins exhibited good antifungal activities against the majority of Cy. fabianii isolates despite the absence of standard criteria.
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Affiliation(s)
- Ji-Hyun Park
- Translational Research Division, Biomedical Institute of Mycological Resource, International St. Mary’s Hospital and College of Medicine, Catholic Kwandong University, Incheon, Korea
| | - Junsang Oh
- Translational Research Division, Biomedical Institute of Mycological Resource, International St. Mary’s Hospital and College of Medicine, Catholic Kwandong University, Incheon, Korea
| | - Hyunkyu Sang
- Translational Research Division, Biomedical Institute of Mycological Resource, International St. Mary’s Hospital and College of Medicine, Catholic Kwandong University, Incheon, Korea
| | - Bhushan Shrestha
- Translational Research Division, Biomedical Institute of Mycological Resource, International St. Mary’s Hospital and College of Medicine, Catholic Kwandong University, Incheon, Korea
| | - Hyeyoung Lee
- Department of Laboratory Medicine, International St. Mary’s Hospital and College of Medicine, Catholic Kwandong University, Incheon, Korea
| | - Jehyun Koo
- Department of Laboratory Medicine, International St. Mary’s Hospital and College of Medicine, Catholic Kwandong University, Incheon, Korea
| | - Sung-Il Cho
- Department of Laboratory Medicine, International St. Mary’s Hospital and College of Medicine, Catholic Kwandong University, Incheon, Korea
| | - Ji Seon Choi
- Department of Laboratory Medicine, International St. Mary’s Hospital and College of Medicine, Catholic Kwandong University, Incheon, Korea
| | - Min-Ha Lee
- Department of Laboratory Medicine, International St. Mary’s Hospital and College of Medicine, Catholic Kwandong University, Incheon, Korea
| | - Jayoung Kim
- Department of Laboratory Medicine, International St. Mary’s Hospital and College of Medicine, Catholic Kwandong University, Incheon, Korea
| | - Gi-Ho Sung
- Translational Research Division, Biomedical Institute of Mycological Resource, International St. Mary’s Hospital and College of Medicine, Catholic Kwandong University, Incheon, Korea
- Department of Microbiology, College of Medicine, Catholic Kwandong University, Gangneung-si, Korea
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7
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Desai M, Nitta B, Dhanani H, Djurkovic S, Katugaha S. Multiple organ dysfunction syndrome and death secondary to Cyberlindnera fabianii. Med Mycol Case Rep 2019; 26:1-4. [PMID: 31508299 PMCID: PMC6722395 DOI: 10.1016/j.mmcr.2019.07.004] [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: 05/23/2019] [Accepted: 07/04/2019] [Indexed: 11/19/2022] Open
Abstract
Cyberlindnera fabianii is a yeast present in soil rarely associated with invasive infection. Due to advanced diagnostic and therapeutic techniques, pathogenicity is increasingly recognized. A 37-year-old male with B cell lymphoma on rituximab developed multiple organ dysfunction syndrome secondary to C. fabianii bacteremia. Specialized species identification techniques were required after failure of standard methods. Despite extracroporeal membrane oxygenation (ECMO) the patient died on day 26 after admission.
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Affiliation(s)
- Mehul Desai
- INOVA Fairfax Medical Campus, 3300 Gallows Rd, Fairfax, VA, 22042, United States
| | - Bradley Nitta
- INOVA Fairfax Medical Campus, 3300 Gallows Rd, Fairfax, VA, 22042, United States
| | - Hussain Dhanani
- INOVA Fairfax Medical Campus, 3300 Gallows Rd, Fairfax, VA, 22042, United States
| | - Svetolik Djurkovic
- INOVA Fairfax Medical Campus, 3300 Gallows Rd, Fairfax, VA, 22042, United States
| | - Shalika Katugaha
- INOVA Fairfax Medical Campus, 3300 Gallows Rd, Fairfax, VA, 22042, United States
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8
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Al-Sweih N, Ahmad S, Khan S, Joseph L, Asadzadeh M, Khan Z. Cyberlindnera fabianii
fungaemia outbreak in preterm neonates in Kuwait and literature review. Mycoses 2018; 62:51-61. [DOI: 10.1111/myc.12846] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 08/28/2018] [Accepted: 08/29/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Noura Al-Sweih
- Department of Microbiology; Faculty of Medicine; Kuwait University; Safat Kuwait
- Microbiology Department; Maternity Hospital; Shuwaikh Kuwait
| | - Suhail Ahmad
- Department of Microbiology; Faculty of Medicine; Kuwait University; Safat Kuwait
| | - Seema Khan
- Microbiology Department; Maternity Hospital; Shuwaikh Kuwait
| | - Leena Joseph
- Department of Microbiology; Faculty of Medicine; Kuwait University; Safat Kuwait
| | - Mohammad Asadzadeh
- Department of Microbiology; Faculty of Medicine; Kuwait University; Safat Kuwait
| | - Ziauddin Khan
- Department of Microbiology; Faculty of Medicine; Kuwait University; Safat Kuwait
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9
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Hof H, Amann V, Tauber C, Paulun A. Peritonitis in a neonate due to Cyberlindnera fabianii, an ascomycetic yeast. Infection 2017; 45:921-924. [PMID: 28825212 DOI: 10.1007/s15010-017-1062-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Accepted: 08/15/2017] [Indexed: 11/26/2022]
Abstract
The ascomycetous yeast Cyberlindera fabianii is not only present in the environment, but is also occasionally pathogenic. Especially, neonates seem to be prone to infection. Here, we describe a case of peritoneal infection of a neonate after congenital heart surgery. The correct identification of this peculiar species is made by MALDI-TOF and especially by molecular biology methods, whereas the standard biochemical identification methods fail.The neonate with a hypoplastic left heart syndrome had a Norwood palliation followed by transient ECMO therapy for 3 days. The patient developed a renal insufficiency, so that peritoneal dialysis was initiated. After a few days, a peritoneal infection due to C. fabianii emerged. The proper source of this rare and particular yeast remains obscure. In spite of a reasonable antimycotic therapy, the patient developed a capillary leak syndrome and died finally in septic shock with multiorgan failure. One reason is probably that the yeast population, which was highly susceptible to all common antimycotic drugs at the beginning of therapy with fluconazole (and for a short period with caspofungin and liposomal amphotericin B), became rapidly resistant.
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Affiliation(s)
- H Hof
- MVZ Labor Limbach, Im Breitspiel 16, 69126, Heidelberg, Germany.
| | - V Amann
- Paediatric Cardiac Intensive Care Unit, German Paediatric Heart Center, Asklepios Klinik St. Augustin GmbH, Arnold-Janssen Str. 29, 53757, Sankt Augustin, Germany
| | - C Tauber
- MVZ Labor Limbach, Im Breitspiel 16, 69126, Heidelberg, Germany
| | - A Paulun
- Paediatric Cardiac Intensive Care Unit, German Paediatric Heart Center, Asklepios Klinik St. Augustin GmbH, Arnold-Janssen Str. 29, 53757, Sankt Augustin, Germany
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10
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Fernández-Ruiz M, Guinea J, Puig-Asensio M, Zaragoza Ó, Almirante B, Cuenca-Estrella M, Aguado JM. Fungemia due to rare opportunistic yeasts: data from a population-based surveillance in Spain. Med Mycol 2016; 55:125-136. [DOI: 10.1093/mmy/myw055] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 02/22/2016] [Accepted: 05/15/2016] [Indexed: 12/18/2022] Open
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11
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Katagiri S, Gotoh M, Tone K, Akahane D, Ito Y, Ohyashiki K, Makimura K. Fatal Cyberlindnera fabianii fungemia in a patient with mixed phenotype acute leukemia after umbilical cord blood transplantation. Int J Hematol 2016; 103:592-5. [DOI: 10.1007/s12185-016-1953-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 01/29/2016] [Accepted: 02/03/2016] [Indexed: 10/22/2022]
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12
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Svobodova L, Bednarova D, Ruzicka F, Chrenkova V, Dobias R, Mallatova N, Buchta V, Kocmanova I, Olisarova P, Stromerova N, Thongsri Y, Hamal P. High frequency of Candida fabianii among clinical isolates biochemically identified as Candida pelliculosa and Candida utilis. Mycoses 2016; 59:241-246. [PMID: 26763103 DOI: 10.1111/myc.12454] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 12/03/2015] [Accepted: 12/04/2015] [Indexed: 11/28/2022]
Abstract
Clinical yeast isolates belonging to Candida pelliculosa, Candida utilis and Candida fabianii are difficult to distinguish in a routine mycology laboratory using common biochemical tests. The aims of this study were to determine the prevalence of C. pelliculosa, C. utilis and C. fabianii in clinical samples and to compare their minimum inhibitory concentrations (MICs) to systemic antifungals. Two hundred and forty-eight clinical yeast isolates obtained from eight large hospitals in the Czech Republic were included in this study. Identification was performed biochemically using ID 32C kit and by MALDI-TOF MS. MICs were determined using colorimetric broth dilution Sensititre YeastOne panels. From a total number of 248 isolates, 175 were identified as C. pelliculosa and 73 as C. utilis using the biochemical kit. In contrast, MALDI-TOF MS identified 222 isolates as C. fabianii, 20 as C. pelliculosa and 6 as C. utilis. The highest mean MICs were found in C. fabianii and, regardless of the studied species, in isolates from blood cultures and central venous catheters. MALDI-TOF MS revealed C. fabianii to be most prevalent in clinical samples as compared with the other studied species. Higher MIC values in C. fabianii support the importance of correct identification of this species.
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Affiliation(s)
- L Svobodova
- Department of Microbiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Olomouc, Czech Republic
| | - D Bednarova
- Research & Development Department, GeneProof a.s., Brno, Czech Republic
| | - F Ruzicka
- Department of Microbiology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - V Chrenkova
- Department of Medical Microbiology, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague, Czech Republic
| | - R Dobias
- Laboratory of Clinical Mycology, Public Health Institute Ostrava, Ostrava, Czech Republic
| | - N Mallatova
- Laboratory of Parasitology and Mycology, Ceske Budejovice Hospital, Ceske Budejovice, Czech Republic
| | - V Buchta
- Department of Clinical Microbiology, Faculty of Medicine and University Hospital, Charles University, Hradec Kralove, Czech Republic
| | - I Kocmanova
- Department of Clinical Microbiology, University Hospital Brno, Brno, Czech Republic
| | - P Olisarova
- Mycology Laboratory, Clinical Microbiology and ATB Centre, Institute of Medical Biochemistry and Laboratory Diagnostics of the General University Hospital and of the First Faculty of Medicine of Charles University in Prague, Prague, Czech Republic
| | - N Stromerova
- State Veterinary Institute Olomouc, Olomouc, Czech Republic
| | - Y Thongsri
- Cellular and Molecular Immunology Research Unit (CMIRU), Department of Medical Technology, Faculty of Allied Health Science, Naresuan University, Phitsanulok, Thailand
| | - P Hamal
- Department of Microbiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Olomouc, Czech Republic
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Primer caso de infección fúngica invasora por Candida fabianii en un paciente pediátrico no neonatal. Rev Iberoam Micol 2016; 33:48-50. [DOI: 10.1016/j.riam.2015.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Revised: 01/12/2015] [Accepted: 06/08/2015] [Indexed: 11/20/2022] Open
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First Report of Ventriculoperitoneal Shunt Infection due to Cyberlindnera fabianii. Case Rep Infect Dis 2015; 2015:630816. [PMID: 26618013 PMCID: PMC4649088 DOI: 10.1155/2015/630816] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 10/19/2015] [Indexed: 11/24/2022] Open
Abstract
Fungal infections in the central nervous system (CNS) are associated with significant morbidity and death. Transient fungemia in immunocompetent patients without any other risk factors for fungemia has been suggested as a possible mechanism that may lead to serious fungal ventriculoperitoneal (VP) shunt infections, but evidence is lacking. The clinical spectrum, diagnosis, and optimal therapy of Cyberlindnera fabianii infections remain to be determined. We describe the first case of CNS infection due to C. fabianii that occurred in an immunocompetent adult with a VP shunt. Spontaneous translocation with yeast that is not part of the normal gastrointestinal flora in the setting of ingestion of multiple servings of a fermentation product was the likely source from which Cyberlindnera fabianii gained entrance into the VP shunt system, causing meningitis in this patient. The authors conclude that, in view of the high morbidity associated with yeast infection of the CNS, long-term antifungal therapy should be strongly considered in cases where the VP shunt cannot be completely removed. Transient fungemia may lead to invasive disease in an immunocompetent host with VP shunt, even in the absence of any other risk factors for fungemia and even after remote placement of the VP shunt.
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Jindal N, Arora S, Dhuria N, Arora D. Cyberlindnera (Pichia) fabianii infection in a neutropenic child: importance of molecular identification. JMM Case Rep 2015. [DOI: 10.1099/jmmcr.0.000033] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Neerja Jindal
- Department of Microbiology, Guru Gobind Singh Medical College & Hospital, Faridkot, India
| | - Shilpa Arora
- Department of Microbiology, Guru Gobind Singh Medical College & Hospital, Faridkot, India
| | - Nitika Dhuria
- Department of Microbiology, Guru Gobind Singh Medical College & Hospital, Faridkot, India
| | - Deepak Arora
- Department of Microbiology, Guru Gobind Singh Medical College & Hospital, Faridkot, India
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Mlinarić-Missoni E, Hatvani L, Kocsubé S, Vágvölgyi C, Škarić I, Lukić-Grlić A. Cyberlindnera fabianii in the neonatal and paediatric intensive care unit: case reports. JMM Case Rep 2015. [DOI: 10.1099/jmmcr.0.000032] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
| | - Lóránt Hatvani
- Department of Microbiology, Faculty of Science and Informatics, University of Szeged, Szeged, Hungary
| | - Sándor Kocsubé
- Department of Microbiology, Faculty of Science and Informatics, University of Szeged, Szeged, Hungary
| | - Csaba Vágvölgyi
- Department of Microbiology, Faculty of Science and Informatics, University of Szeged, Szeged, Hungary
| | | | - Amarela Lukić-Grlić
- Department of Medical Microbiology and Parasitology, University of Zagreb Medical School, Zagreb, Croatia
- Children's Hospital Zagreb, Zagreb, Croatia
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17
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Genome Sequence of the Yeast Cyberlindnera fabianii (Hansenula fabianii). GENOME ANNOUNCEMENTS 2014; 2:2/4/e00638-14. [PMID: 25103752 PMCID: PMC4125763 DOI: 10.1128/genomea.00638-14] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The yeast Cyberlindnera fabianii is used in wastewater treatment, fermentation of alcoholic beverages, and has caused blood infections. To assist in the accurate identification of this species, and to determine the genetic basis for properties involved in fermentation and water treatment, we sequenced and annotated the genome of C. fabianii (YJS4271).
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18
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Hundalani S, Pammi M. Invasive fungal infections in newborns and current management strategies. Expert Rev Anti Infect Ther 2014; 11:709-21. [DOI: 10.1586/14787210.2013.811925] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Yun JW, Park KS, Ki CS, Lee NY. Catheter-related bloodstream infection by Lindnera fabianii in a neutropenic patient. J Med Microbiol 2013; 62:922-925. [PMID: 23475905 DOI: 10.1099/jmm.0.048306-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Lindnera (Pichia) fabianii (Candida fabianii teleomorph) is a yeast species that is an uncommon cause of invasive human infections. This report describes what we believe to be the first human case of a catheter-related L. fabianii bloodstream infection in a neutropenic patient. The Clinical and Laboratory Standards Institute guidelines do not offer antifungal breakpoints in this neutropenic case and empirical chemotherapy was considered. Sharing our experience, we will discuss the choice of an effective antifungal agent in this uncommon clinical situation.
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Affiliation(s)
- Jae Won Yun
- Department of Laboratory Medicine & Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyung Sun Park
- Department of Laboratory Medicine & Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Chang-Seok Ki
- Department of Laboratory Medicine & Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Nam Yong Lee
- Department of Laboratory Medicine & Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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20
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Wu Y, Wang J, Li W, Jia H, Che J, Lu J, Liu L, Cheng Y. Pichia fabianii blood infection in a premature infant in China: case report. BMC Res Notes 2013; 6:77. [PMID: 23510524 PMCID: PMC3599298 DOI: 10.1186/1756-0500-6-77] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Accepted: 02/27/2013] [Indexed: 11/17/2022] Open
Abstract
Background Invasive fungal infections caused by uncommon fungi have increased in recent years. Hospitalized low-birth-weight infants are at high risk for neonatal fungal infections. Pichia fabianii is a rare pathogen causing blood infection, which has reportedly caused only 4 cases of fungemia and 1 case of endocarditis worldwide. Here, we describe the first case of a P. fabianii blood infection in a premature infant in China. Case presentation On July 28th, a low-birth-weight (LBW, 1760 g) female infant born at 33+4 weeks of gestation was admitted to the pediatric intensive care unit with mild neonatal asphyxia. Until August 2nd, a mechanical respirator was used to assist respiration under the Continuous Positive Airway Pressure (CPAP) model. The baby had an increased body temperature and a fever. To prevent infection, Ceftriaxone Sodium (CS) was administered intravenously for three days, after which Cefepime was administered until August 13th. Chest X-rays showed suspected plaque-like shadows in the right lung. Blood cultures twice tested positive for fungal infection caused by Candida pelliculosa (recognized as Pichia fabianii later), which is first mis-identified by commercial kit. Hence, intravenous fluconazole was administered. However, cultures of other body fluids (e.g., urine, feces and sputum) tested negative for fungal infection. Routine tests and biochemistry of cerebrospinal fluid (CSF) were normal. Latex agglutination of Cryptococcus neoformans and fungi cultures in the CSF were also negative. After 14 days of intravenous fluconazole, blood was re-cultured, the result of which was negative. On August 30th, intravenous fluconazole was suspended. On Sep 3rd, the infant left the hospital in good health. Conclusions This is the first case of a blood infection caused by P. fabianii in a LBW premature female infant in China. Risk factors for fungal infection include premature birth, as well as mechanical invasive operation and antibacterial drug usage. Whether such risk factors necessitate prophylactic use of antifungal drugs is an important question that has yet to be fully addressed. Additionally, the pathogen P. fabianii collected in this study was resistant to amphotericin B (AMB) and itraconazole (ITR). With the exception of the azole-resistant endocarditis case, all other cases have not demonstrated such a resistance. Finally, commercial biochemical methods used in routine practice are limited in their ability to identify P. fabianii. Molecular genetic based methods are imperative for identification of uncommon fungal species from disseminated infections.
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Affiliation(s)
- Yuan Wu
- Department of Hospital Acquired Infection Control and Prevention, National, Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, State Key Laboratory for Infectious Disease Prevention and Control, Beijing, China
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21
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Gabriel F, Noel T, Accoceberry I. Lindnera (Pichia) fabianii blood infection after mesenteric ischemia. Med Mycol 2011; 50:310-4. [PMID: 21671831 DOI: 10.3109/13693786.2011.587455] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Lindnera (Pichia) fabianii (teleomorph of Candida fabianii) is a yeast species rarely involved in human infections. This report describes the first known human case of a Lindnera fabianii blood infection after mesenteric ischemia. The 53-year-old patient was hospitalized in the intensive care unit after a suicide attempt and was suffering from a mesenteric ischemia and acute renal failure. Lindnera fabianii was recovered from an oropharyngeal swab, then isolated from stool and urine samples before the diagnosis of the blood infection. Caspofungin intravenous treatment was associated with a successful outcome. Final unequivocal identification of the strain was done by sequencing the internal transcribed spacer (ITS) region, and regions of 18S rDNA gene and of the translation elongation factor-1α gene. Until our work, the genomic databases did not contain the complete ITS region of L. fabianii as a single nucleotide sequence (encompassing ITS1, the 5.8S rDNA and ITS2), and misidentification with other yeast species, e.g., Lindnera (Pichia) mississippiensis, could have occurred. Our work demonstrates that the usual DNA barcoding method based on sequencing of the ITS region may fail to provide the correct identification of some taxa, and that partial sequencing of the EF1α gene may be much more effective for the accurate delineation and molecular identification of new emerging opportunistic yeast pathogens.
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