Transient Fungemia Caused by an Amphotericin B-Resistant Isolate of
            <i>Candida haemulonii</i>

Rodero, L; Cuenca‐Estrella, Manuel; Córdoba, Susana; Cahn, Pedro; Davel, Graciela; Kaufman, Sara; Guelfand, Liliana; Rodríguez-Tudela, Juan Luis

doi:10.1128/jcm.40.6.2266-2269.2002

Cited by 64 publications

(74 citation statements)

References 16 publications

(21 reference statements)

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“…Of the non-albicans Candida species isolated infrequently, C. lusitaniae and C. haemulonii are resistant to amphotericin B (17,20,31). Although C. inconspicua and C. norvegensis are also fluconazole-resistant species, there is little information on their identification, diagnosis, medication, or pathogenicity.…”

Section: Discussionmentioning

confidence: 99%

Fluconazole‐Resistant Pathogens Candida inconspicua and C. norvegensis: DNA Sequence Diversity of the rRNA Intergenic Spacer Region, Antifungal Drug Susceptibility, and Extracellular Enzyme Production

Sugita

Takeo

Ohkusu

et al. 2004

Microbiology and Immunology

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The opportunistic fungal pathogens Candida inconspicua and C. norvegensis are very rarely isolated from patients and are resistant to fluconazole. We collected 38 strains of the two microorganisms isolated from Europe and Japan, and compared the polymorphism of the rRNA intergenic spacer (IGS) and internal transcribed spacer (ITS) regions, antifungal drug susceptibility, and extracellular enzyme production as a potential virulence factor. While the IGS sequences of C. norvegensis were not very divergent (more than 96.7% sequence similarity among the strains), those of C. inconspicua showed remarkable diversity, and were divided into four genotypes with three subtypes. In the ITS region, no variation was found in either species. Since the sequence similarity of the two species is approximately 70% at the ITS region, they are closely related phylogenetically. Fluconazole resistance was reconfirmed for the two microorganisms but they were susceptible to micafungin and amphotericin B. No strain of either species secreted aspartyl proteinase or phospholipase B. These results provide basal information for accurate identification, which is of benefit to global molecular epidemiological studies and facilitates our understanding of the medical mycological characteristics of C. inconspicua and C. norvegensis.

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Section: Discussionmentioning

confidence: 99%

Fluconazole‐Resistant Pathogens Candida inconspicua and C. norvegensis: DNA Sequence Diversity of the rRNA Intergenic Spacer Region, Antifungal Drug Susceptibility, and Extracellular Enzyme Production

Sugita

Takeo

Ohkusu

et al. 2004

Microbiology and Immunology

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“…haemulonii complex often exhibits antifungal resistance, with clinical failure associated with in vitro resistance to amphotericin B and reduced susceptibility to azoles (6,7,9,10,(13)(14)(15). Moreover, C. haemulonii isolates with resistance to echinocandins have been reported (11).…”

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confidence: 99%

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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“…Despite more than 40 years of clinical use, resistance to amphotericin B is very rare. Only C. lusitaniae, C. haemulonii, and Trichosporon asahii have reduced sensitivity to this drug (2,9,11,16). Although C. pseudohaemulonii and the two types of C. haemulonii are resistant to both amphotericin B and azole agents, they are very susceptible to 5-FC and micafungin.…”

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confidence: 99%

Candida pseudohaemulonii Sp. Nov., an Amphotericin B‐ and Azole‐Resistant Yeast Species, Isolated from the Blood of a Patient from Thailand

Sugita

Takashima

Poonwan

et al. 2006

Microbiology and Immunology

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Candida haemulonii (types I and II) is rarely isolated from clinical specimens. We isolated a strain that is phylogenetically close to C. haemulonii from the blood of a Thai patient, and named it C. pseudohaemulonii sp. nov. (CBS 10099T=JCM 12453T=DMST 17134T). The new species and C. haemulonii types I and II were resistant to amphotericin B and azole agents but were susceptible to a 1,3‐β‐D‐glucan synthetase inhibitor, micafungin, and 5‐flucytosine. The species were easily distinguished using an ID32 yeast identification kit. The taxonomic description of C. pseudohaemulonii sp. nov. is presented.

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Transient Fungemia Caused by an Amphotericin B-Resistant Isolate of Candida haemulonii

Cited by 64 publications

References 16 publications

Fluconazole‐Resistant Pathogens Candida inconspicua and C. norvegensis: DNA Sequence Diversity of the rRNA Intergenic Spacer Region, Antifungal Drug Susceptibility, and Extracellular Enzyme Production

Fluconazole‐Resistant Pathogens Candida inconspicua and C. norvegensis: DNA Sequence Diversity of the rRNA Intergenic Spacer Region, Antifungal Drug Susceptibility, and Extracellular Enzyme Production

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

Candida pseudohaemulonii Sp. Nov., an Amphotericin B‐ and Azole‐Resistant Yeast Species, Isolated from the Blood of a Patient from Thailand

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