Usefulness of McRAPD for typing and importance of biofilm production in a case of nosocomial ventriculoperitoneal shunt infection caused by Candida lusitaniae

Abstract

A case report of ventriculoperitoneal shunt infection caused by Candida lusitaniae in a 6-year-old patient with cerebral astrocytoma and obstructive hydrocephalus is presented briefly with emphasis on the course of antifungal treatment. Seven isolates recovered subsequently from the cerebrospinal fluid were studied retrospectively. To confirm identity, isolates were typed using pulsed-field gel electrophoresis and melting curve of random amplified polymorphic DNA (McRAPD). Further, the ability to form biofilm and its susceptibility to systemic antifungals were evaluated. Using McRAPD, identity of C. lusitaniae isolates showing slight microevolutionary changes in karyotypes was undoubtedly confirmed; successful application of numerical interpretation of McRAPD for typing is demonstrated here for the first time. The strain was also recognized as a strong biofilm producer. Moreover, minimum biofilm inhibitory concentrations were very high, in contrast to low antifungal minimum inhibitory concentrations of isolates. It can be concluded that McRAPD seems to be a simple and reliable method not only for identification but also for typing of yeasts. A ventriculoperitoneal shunt colonized by C. lusitaniae was revealed as the source of this nosocomial infection, and the ability of the strain to form biofilm on its surface likely caused treatment failure.

Smoothie Drinks: Possible Source of Resistant and Biofilm-Forming Microorganisms

“…Candida spp. yeasts are generally known for considerable biofilm activity, which increases their virulent behaviour [ 61 , 62 ]. In this respect, the species Candida albicans is most often discussed in the literature [ 63 ].…”

The Potential of High Resolution Melting Analysis (Hrma) to Streamline, Facilitate and Enrich Routine Diagnostics in Medical Microbiology

“…Owing to the principle of RAPD, its interlaboratory reproducibility will always be limited however although it can outdo conventional techniques in several aspects when optimized carefully 5 . It should also be noted, that because of the digital data obtained in melting analysis the McRAPD approach can be used for automated strain typing, as demonstrated by Hamal et al 26 . For those who do not want to spend too much time with optimization and who also resign on typing for epidemiological purposes, specific amplification targeting yeast ITS1 and ITS2 regions should be very useful 27 .…”

“…McRAPD may be usefull mainly in such species where other molecular typing schemes are not easily available or are laborious, e.g. for serovars of Leptospira as demonstrated by Tulsiani et al 39 , or for less frequently occurring yeasts as demonstrated by Hamal et al 26 in the emerging pathogenic yeast C. lusitaniae. Comparison of McRAPD with MLST data in five Gram-negative bacterial species showed that McRAPD could be used to rapidly identify major clones of these species, including multidrug-resistant and particularly virulent clones 21 .…”

McRAPD unlike MALDI-TOF MS is a suitable candidate for routine discrimination of new Haemophilus influenzae strain acquisition in chronic obstructive pulmonary disease (COPD) and cystic fibrosis

“…to our previous experience. Melting analysis of RAPD, termed McRAPD, was first used by our group for purposes of yeast species identification 19 , but later proved to be useful for strain typing in several other settings 17,[20][21][22] . In this study, McRAPD provided excellent results that were in full accordance with the results of MLST, which is considered the gold standard for microbial typing.…”