Candida bracarensis Bloodstream Infection in an Immunocompromised Patient

Department of Laboratory Medicine and Pathobiology, University of Toronto, and Division of Microbiology, Hospital for Sick Children, Toronto, Ontario, Canada.
Journal of clinical microbiology (Impact Factor: 3.99). 09/2010; 48(12):4677-9. DOI: 10.1128/JCM.01447-10
Source: PubMed


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. Copyright © 2010, American Society for Microbiology. All Rights Reserved.

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    • "On the basis of key reports and previous clinical work, we selected a set of universal reference primers to amplify 16S rDNA and identify previously “difficult-to-identify” bacteria in clinical settings. In addition, the ITS region (especially ITS2) is heavily used for the identification of fungi [12]. The identification of standard strains and common clinical isolates by PCR and sequencing in this study demonstrates that this method is consistent with conventional laboratory methods. "
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    ABSTRACT: Clinical microbiology laboratories have to accurately identify clinical microbes. However, some isolates are difficult to identify by the automated biochemical text platforms, which are called "difficult-to-identify" microbes in this study. Therefore, the ability of 16S ribosomal DNA (16S rDNA) and internal transcribed spacer 2 (ITS2) sequencing to identify these "difficult-to-identify" bacteria and fungi was assessed in this study. Samples obtained from a teaching hospital over the past three years were examined. The 16S rDNA of four standard strains, 18 clinical common isolates, and 47 "difficult-to-identify" clinical bacteria were amplified by PCR and sequenced. The ITS2 of eight standard strains and 31 "difficult-to-identify" clinical fungi were also amplified by PCR and sequenced. The sequences of 16S rDNA and ITS2 were compared to reference data available in GenBank by using the BLASTN program. These microbes were identified according to the percentage of similarity to reference sequences of strains in GenBank. The results from molecular sequencing methods correlated well with automated microbiological identification systems for common clinical isolates. Sequencing results of the standard strains were consistent with their known phenotype. Overall, 47 "difficult-to-identify" clinical bacteria were identified as 35 genera or species by sequence analysis (with 10 of these identified isolates first reported in clinical specimens in China and two first identified in the international literature). 31 "difficult-to-identify" clinical fungi tested could be identified as 15 genera or species by sequence analysis (with two of these first reported in China). Our results show the importance of 16S rDNA and internal ITS2 sequencing for the molecular identification of "difficult-to-identify" bacteria and fungi. The development of this method with advantages of convenience, availability, and cost-effectiveness will make it worth extending into clinical practice in developing countries.
    Annals of Clinical Microbiology and Antimicrobials 01/2014; 13(1):1. DOI:10.1186/1476-0711-13-1 · 2.19 Impact Factor
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    ABSTRACT: Increases in susceptible patient populations and advances in identification methods have resulted in the continued recognition of novel yeasts as agents of human infection. Most of these agents are members of the well-recognized genera Candida, Cryptococcus, Trichosporon, and Rhodotorula. Some of these agents are “cryptic species,” members of species complexes, and may not be detectable using classical carbohydrate assimilation-based methods of yeast identification. Such species require DNA- or MALDI-based methods for correct identification, although sporadic isolates may not routinely require delineation to the individual species level. The coming end of the fungal taxonomy rules requiring separate names for sexual and asexual forms of the same fungus will hopefully allow greater clarity, as names for medically important yeast can now be based on the needs of the medical mycology community and the common goal of better communication between laboratory and clinician.
    Current Fungal Infection Reports 09/2012; 6(3). DOI:10.1007/s12281-012-0094-x
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    ABSTRACT: Background Candida nivariensis and C. bracarensis have been recently identified as emerging yeast pathogens which are phenotypically indistinguishable from C. glabrata. However, there is little data on the prevalence and antifungal susceptibilities of these species. Objective This study investigated the occurrence of C. nivariensis and C. bracarensis in a culture collection of 185 C. glabrata isolates at a Malaysian teaching hospital. Methods C. nivariensis was discriminated from C. glabrata using a PCR assay as described by Enache-Angoulvant et al. (J Clin Microbiol 49:3375–9, 2011). The identity of the isolates was confirmed by sequence analysis of the D1D2 domain and internal transcribed spacer region of the yeasts. The isolates were cultured on Chromogenic CHROMagar Candida ® agar (Difco, USA), and their biochemical and enzymic profiles were determined. Antifungal susceptibilities of the isolates against amphotericin B, fluconazole, voriconazole and caspofungin were determined using E tests. Clotrimazole MICs were determined using a microbroth dilution method. Results There was a low prevalence (1.1 %) of C. nivariensis in our culture collection of C. glabrata. C. nivariensis was isolated from a blood culture and vaginal swab of two patients. C. nivariensis grew as white colonies on Chromogenic agar and demonstrated few positive reactions using biochemical tests. Enzymatic profiles of the C. nivariensis isolates were similar to that of C. glabrata. The isolates were susceptible to amphotericin B, fluconazole, voriconazole and caspofungin. Clotrimazole resistance is suspected in one isolate. Conclusion This study reports for the first time the emergence of C. nivariensis in our clinical setting.
    Mycopathologia 07/2014; 178(3-4). DOI:10.1007/s11046-014-9778-9 · 1.53 Impact Factor
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