<i>Candida haemulonii</i>Complex Species, Brazil, January 2010–March 2015

Jn, de Almeida; Jg, Assy; Levin, Anna S.; Negro, G. Del; Mc, Giudice; Mp, Tringoni; Dy, Thomaz; Al, Motta; Abdala, Edson; Lc, Pierroti; Strabelli, Tânia Mara Varejão; Al, Munhoz; Rossi, Flávia; Benard, Gil

doi:10.3201/eid2203.151610

Cited by 45 publications

(60 citation statements)

References 9 publications

(10 reference statements)

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“…In vitro antifungal susceptibility results in the present study showed that all C. haemulonii complex isolates had high MICs for fluconazole and amphotericin B and that C. duobushaemulonii isolates had 2-fold higher amphotericin B MICs than those of the C. haemulonii species, as previously reported (22). In vitro resistance to these agents has been associated with clinical treatment failure and fatal outcome (6,7,10,(13)(14)(15).…”

Section: Discussionsupporting

confidence: 70%

“…We therefore determined the proportion of C. haemulonii complex isolates among clinical strains cultured from patients with IFDs in China and their antifungal susceptibilities by the broth microdilution method. Overall, during the 5-year CHIF-NET study, C. haemulonii complex isolates represented 0.3% (31/9,673) of all yeast isolates, which was higher than the rate noted in the ARTEMIS study but similar to the rate found in Brazil (21,22). The identification and differentiation of C. haemulonii complex isolates relies on molecular methods, so it is difficult to compare the proportions because laboratories differ in the extent to which they identify uncommon Candida species to the species level; of laboratories that do identify to the species level, different methodologies are often used (8,9).…”

Section: Discussioncontrasting

confidence: 38%

“…We recommend that C. haemulonii complex isolates with high MICs to fluconazole be assessed for susceptibility to the other azoles. Echinocandins demonstrated excellent in vitro potency against the isolates (9,22). In the present study, our in vitro antifungal susceptibility data showed that MICs to echinocandins were low, indicating that there may be better treatment options.…”

Section: Discussionmentioning

confidence: 71%

“…In 2012, Cendejas-Bueno et al (8) proposed a reclassification of the C. haemulonii complex based on molecular methods; this taxonomic reclassification has prompted many laboratories to reexamine their culture collections for these species. To date, most of the C. haemulonii complex isolates identified by ITS sequencing were reported in Brazil (5,8,9,22), including 12 isolates and 31 isolates from two reports of a local national epidemiology study (9,22). We therefore determined the proportion of C. haemulonii complex isolates among clinical strains cultured from patients with IFDs in China and their antifungal susceptibilities by the broth microdilution method.…”

Section: Discussionmentioning

confidence: 99%

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Identification and Antifungal Susceptibility Profiles of Candida haemulonii Species Complex Clinical Isolates from a Multicenter Study in China

et al. 2016

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c Candida haemulonii complex (Candida haemulonii, Candida haemulonii var. vulnera, and Candida duobushaemulonii) consists of emerging pathogens. Thirty-one isolates from 14 hospitals in China were studied for their species classification and antifungal susceptibilities. Performances of molecular (i.e., ribosomal DNA [rDNA] internal transcribed spacer [ITS] sequencing, D1/D2 sequencing, and ITS sequencer-based capillary gel electrophoresis [SCGE]) and phenotypic identification methods in species identification were compared. Twenty-six (83.9%) of 31 isolates were identified as C. haemulonii and 5 isolates were identified as C. duobushaemulonii by ITS sequencing as the reference method; results obtained by D1/D2 sequencing and ITS SCGE were concordant with those obtained by ITS sequencing for all (100%) of the isolates. All 31 isolates were identified as C. haemulonii by the Vitek matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) system (bioMérieux, France), whereas the Bruker MS system (Bruker Daltoniks, Germany) correctly provided species identification for 77.4% and 100% of isolates using cutoff scores for species of >2.0 and >1.70, respectively. The Vitek 2 compact (bioMérieux) only identified 9 (29%) of 31 isolates. All isolates showed high MICs for amphotericin B (range, 2 to >8 g/ml) and fluconazole (>128 g/ml) but low MICs (<0.5 g/ml) for the echinocandins. Our results reinforce the need for MALDI-TOF MS and/or molecular differentiation of species within the C. haemulonii complex. The multiresistant antifungal susceptibility profile of these isolates represents a challenge to therapy. Candida species remain the most common fungal pathogens worldwide, and invasive candidiasis (IC) is associated with high mortality and excess hospital costs, particularly in seriously ill and immunocompromised patients (1). Although four species, namely, Candida albicans, C. glabrata, C. parapsilosis, and C. tropicalis are the most often encountered, previously uncommon or emerging novel Candida species are becoming more recognized (2, 3).One such emerging pathogen is Candida haemulonii complex, which has been described to cause human infection, including peritonitis (4); neonatal candidemia, including case clusters (5); catheter-related candidemia (6); and osteitis (7). Members of this species complex can be divided into three genotypically distinguishable species: C. haemulonii, C. haemulonii var. vulnera, and C. duobushaemulonii (8). Their differentiation relies on molecular methods with good discrimination to the species and varietal or intraspecies levels, such as sequence analysis of the ribosomal DNA (rDNA) internal transcribed spacer (ITS) genes. The use of ITS sequencing (considered the reference method) together with matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) may provide improved discrimination of members of this complex for reference spectra that are contained within the used MS database (8, 9). In contrast, phenotypic identi...

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Section: Discussionsupporting

confidence: 70%

Section: Discussioncontrasting

confidence: 38%

Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 99%

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Identification and Antifungal Susceptibility Profiles of Candida haemulonii Species Complex Clinical Isolates from a Multicenter Study in China

et al. 2016

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“…Entre estas se encuentra C. haemulonii, cuyo primer aislamiento clínico fue en 1984 en un paciente con falla renal 5 y desde ahí, se han reportado casos en pacientes con infección del torrente sanguíneo asociada a catéteres intravasculares, 6 nutrición parenteral, 7 infecciones de hueso y tejido blando. 8 En un estudio descriptivo por aislamientos de C. haemulonii en pacientes de cinco hospitales de Brasil durante cinco años, reportan 31 pacientes con infección, uno de ellos correspondía a líquido peritoneal. 8 Se encuentra un único reporte de caso publicado en el año 2014, en el cual un paciente diabético cursa con peritonitis por C. haemulonii, tratado con voriconazol y fallece al tercer día.…”

Section: Introductionunclassified

Candida haemulonii: causa infrecuente de peritonitis asociada a diálisis peritoneal

Bravo

Larrarte

Quiñonez

et al. 2017

Infect

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Cómo citar este artículo: J. Bravo, et al. Candida haemulonii: causa infrecuente de peritonitis asociada a diálisis peritoneal. Infectio 2018; 22(1): 58-60 ResumenLa peritonitis fúngica es la responsable del 3 a 6% de los casos de peritonitis asociada a diálisis. Es causa importante de morbimortalidad y de falla de la técnica. El microorganismo aislado con mayor frecuencia es la Candida albicans. Sin embargo, en los últimos años la incidencia de nuevos casos asociados a Candida no albicans y otros hongos, ha aumentado. De estas especies patógenas, Candida haemulonii es causal de infecciones humanas, siendo inusual en pacientes en diá-lisis, encontrándose un caso reportado en la literatura de peritonitis asociado a diálisis. C. haemulonii supone ciertos retos diagnósticos ya que es un complejo de tres especies que requieren métodos moleculares de laboratorio para su diferenciación. Adicionalmente, tiene un perfil de multirresistencia a los antimicóticos que constituye para el clínico, un reto en el oportuno tratamiento de estos pacientes. A continuación, se describe un caso de peritonitis asociado a diálisis peritoneal por C. haemulonii. Palabras clave: Candida haemulonii, peritonitis, diálisis peritoneal, infección en diálisis Candida haemulonii, peritonitis, peritoneal dialysis, dialysis infectionsCandida haemulonii: an infrequent cause of dialysis related peritonitis. AbstractFungal peritonitis represents 3 to 6% of peritonitis in dialysis patients. It is an important cause of morbidity, mortality and technique failure. The most frequently isolated microorganism is Candida albicans; however, in recent years there are an increasing number of cases of non Candida albicans and other fungal peritonitis. Candida haemulonii causes human infections, but it is unusual in dialysis patients. There is one reported case of peritonitis in a dialysis patient. C. haemulonii generates certain diagnostic and therapeutic challenges because it is a complex of three species that can only be differentiated by specialized molecular methods and additionally, has a multidrug resistance profile. We describe the case of a dialysis patient with C. haemulonii peritonitis. REPORTE DE CASO IntroducciónLa peritonitis es una de las complicaciones más frecuentes en los pacientes en diálisis peritoneal, contribuyendo al 18% de mortalidad relacionada con infección.1 La peritonitis fún-gica es poco frecuente pero tiene complicaciones serias, con mortalidad del 15-50% y alto riesgo de falla de técnica por desarrollo de adherencias, esclerosis y falla de la membrana. 2Es responsable del 3 al 6% de las peritonitis y generalmente es causada por Candida albicans.3-4 También se han documentado casos por C. parapsilopsis, C. glabrata, C. tropicalis, C. krusei y de hongos filamentosos como Aspergillus spp y Penicillium spp, entre otros. 3En los últimos años se han identificado especies de Candida con menor susceptibilidad a los azoles. Entre estas se encuentra C. haemulonii, cuyo primer aislamiento clínico fue en 1984 en un paciente con falla renal 5 y ...

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Difference Between the Profiles Presented by Yeasts that Colonize the Vaginal Mucosa or Cause Primary or Recurrent Candidiasis

et al. 2021

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Candida haemuloniiComplex Species, Brazil, January 2010–March 2015

Cited by 45 publications

References 9 publications

Identification and Antifungal Susceptibility Profiles of Candida haemulonii Species Complex Clinical Isolates from a Multicenter Study in China

Identification and Antifungal Susceptibility Profiles of Candida haemulonii Species Complex Clinical Isolates from a Multicenter Study in China

Candida haemulonii: causa infrecuente de peritonitis asociada a diálisis peritoneal

Difference Between the Profiles Presented by Yeasts that Colonize the Vaginal Mucosa or Cause Primary or Recurrent Candidiasis

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