<i>Candida bracarensis</i>
            Detected among Isolates of
            <i>Candida glabrata</i>
            by Peptide Nucleic Acid Fluorescence In Situ Hybridization: Susceptibility Data and Documentation of Presumed Infection

Candida palmioleophila has previously been misidentified as C. famata or C. guilliermondii. We have investigated traditional and modern identification methods for the identification of this and related species. Forty-one clinical isolates previously identified as C. famata or C. guilliermondii and 8 reference strains were included. Color development on CHROMagar, growth temperature ranges, micromorphologies, carbon assimilation (ID32C), matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) profiles, and susceptibility profiles (mica-and anidulafungin and itra-, vori-, posa-, and fluconazole MICs were determined by EUCAST method EDef 7.1, and caspofungin MICs were determined by Etest) were determined, and results were compared to those of molecular identification (ITS1 and ITS2 sequencing). The following five different species were identified among the clinical isolates by sequencing, but no C. famata isolates were found: C. guilliermondii (22 isolates), C. palmioleophila (8 isolates), C. fermentati (6 isolates), C. lusitaniae (3 isolates), and C. intermedia (2 isolates). C. palmioleophila developed a distinct scintillating color of turquoise to rose, grew at 40°C, and failed to produce pseudohyphae within 14 days. The ID32C profile for 7/9 C. palmioleophila isolates was 5367352315, and all were unable to hydrolyze esculin (Esc). The six related species were well discriminated by MALDI-TOF MS. The susceptibility pattern for C. palmioleophila was unique, as the echinocandin MICs were low (range, 0.008 to 0.125 g/ml) and fluconazole MICs were high (range, 8 to >16 g/ml). Correct identification of C. palmioleophila is important due to its unique susceptibility profile. Identification is possible yet laborious with conventional techniques, whereas MALDI-TOF MS easily separated the related species.

mentioning

confidence: 75%

Candida palmioleophila: Characterization of a Previously Overlooked Pathogen and Its Unique Susceptibility Profile in Comparison with Five Related Species

Jensen

Arendrup

2011

“…Despite the analysis of 1,598 C. glabrata isolates from 28 countries, our data indicate that C. nivariensis and C. bracarensis isolates make up only a very small percentage of the C. glabrata clinical isolates from global surveillance. Other published data indicate that they may be more locally or regionally prevalent (3,4). Colony color on CHROMagar may be a very good way to rule C. nivariensis and C. bracarensis isolates in or rule out among C. glabrata clinical isolates.…”

mentioning

confidence: 99%

“…Out of the 1,598 tested by C. glabrata-specific PCR, 1,595 were positive, including 11 of the 14 that were white on CHROMagar. All 14 of the isolates that were white on CHROMagar were analyzed by peptide nucleic acid fluorescence in situ hybridization (PNA-FISH) first with a probe that recognized C. glabrata and the two closely related species and then with probes specific for C. nivariensis or C. bracarensis (3,9). The 11 isolates white on CHROMagar that were also C. glabrata PCR positive were also confirmed to be C. glabrata by PNA-FISH.…”

mentioning

confidence: 99%

Identification of Candida nivariensis and Candida bracarensis in a Large Global Collection of Candida glabrata Isolates: Comparison to the Literature

Lockhart

Messer

Gherna³

et al. 2009

Self Cite

“…The current prevalence of this organism is based on retesting of C. glabrata isolates (3,7). This approach may possibly underestimate the current prevalence of C. bracarensis, since our two C. bracarensis isolates were initially not identified as C. glabrata.…”

mentioning

confidence: 99%

Candida bracarensis Bloodstream Infection in an Immunocompromised Patient

Warren

McTaggart²,

Richardson

et al. 2010

Candida bracarensis is a recently described Candida species which is phenotypically similar to Candida glabrata. A case of C. bracarensis bloodstream infection in a bone marrow transplant patient is described and confirms this organism as an opportunistic human pathogen. The organism can be distinguished from C. glabrata by its white color on CHROMagar and by DNA sequence analysis using D1/D2 and internal transcribed spacer (ITS) primers. CASE REPORTA 50-year-old male underwent a matched related-donor bone marrow transplant after a diagnosis of chronic lymphocytic leukemia made 7 years previously. The patient's posttransplant course was complicated by significant graft-versushost disease (GVHD) of the skin, liver, and bowel. Four months after transplant, the GVHD necessitated admission to hospital and he was treated with cyclosporine and corticosteroids. In hospital, he had multiple infectious complications, including herpes simplex virus mucositis and cytomegalovirus viremia, treated with antiviral therapy. Seven weeks after admission to hospital, the patient developed respiratory failure and sepsis, which necessitated transfer to the intensive care unit (ICU). Klebsiella pneumoniae was cultured from both the urine and the blood, and Staphylococcus aureus was cultured from bronchoalveolar lavage fluid. He was treated with appropriate antibiotic therapy.Three weeks after admission to the ICU, two blood cultures became positive, and yeast cells were seen on the Gram stain. After 24 h of growth, small white colonies were seen on blood and chocolate agar media. A wet prep showed budding yeast cells, and a germ tube test was negative. On Saboraud's agar, colonies appeared white and creamy. On cornmeal agar, hyphae or pseudohyphae were not observed microscopically. Both isolates produced white colonies on BBL CHROMagar (BD diagnostics, Maryland). Biochemically, the isolates were positive for the rapid trehalose assay (Remel, Lenexa, KS) and positive for assimilation of lysine and glucose (Table 1). Identification using the API 20C AUX system (bioMérieux, Inc., NC) showed a low-percentage identity match with C. glabrata (Ͻ50%). Thus, molecular analysis was applied to further characterize these strains.Both isolates were negative as determined by a C. glabrataspecific PCR, with gel electrophoresis endpoint detection using primers targeting the internal transcribed spacer (ITS) region and PCR conditions described previously (8) ( Table 1). The ITS1-5.8S-ITS2 region and the D1/D2 region of 26S ribosomal DNA (nucleotides 63 to 642) were amplified and sequenced. PCRs were conducted using the Phire Hot Start DNA polymerase kit (New England Biolabs, Massachusetts) according to the manufacturer's instructions and using the following amplification conditions: 98°C for 30 s, followed by 35 cycles of 98°C for 5 s, annealing temperature (see below) for 5 s, and 72°C for 20 s, followed by a final extension of 72°C for 1 min. The ITS region was amplified using the primers ITS-1 (5Ј-TCCGTAG GTGAACCTGCGG-3Ј) and ITS-4 (5Ј-TCCTCCGCTTA...