Candida lipolytica Bloodstream Infection in an Adult Patient with COVID-19 and Alcohol Use Disorder: A Unique Case and a Systematic Review of the Literature

Simonetti, Omar; Zerbato, Verena; Sincovich, Sara; Cosimi, Lavinia; Zorat, Francesca; Costantino, Venera; Santolo, Manuela Di; Busetti, Marina; Bella, Stefano Di; Principe, Luigi; Luzzati, Roberto

doi:10.3390/antibiotics12040691

Cited by 4 publications

(3 citation statements)

References 29 publications

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“…Stavrou et al [91] demonstrated that among twenty-seven Y. lipolytica isolates, 74.1% were resistant to echinocandins. In contrast, Yu et al [93] have not reported resistance strains of Y. lipolytica in their retrospective study, and the use of echinocandins in bloodstream infections due to Y. lipolytica had a favourable outcome [98]. Based on the literature, no data regarding the resistance mechanism for echinocandins are described for the S. ciferrii complex as well as for Y. lipolytica, but elevated echinocandin MICs have been associated with several single amino acid substitutions caused by mutations in specific "hot spot" regions of the well-conserved target genes FKS1 of Y. lipolytica [99].…”

Section: Treatment and Resistancementioning

confidence: 88%

Stephanoascus ciferrii Complex: The Current State of Infections and Drug Resistance in Humans

Cosio,

Pica,

Fontana

et al. 2024

JoF

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In recent years, the incidence of fungal infections in humans has increased dramatically, accompanied by an expansion in the number of species implicated as etiological agents, especially environmental fungi never involved before in human infection. Among fungal pathogens, Candida species are the most common opportunistic fungi that can cause local and systemic infections, especially in immunocompromised individuals. Candida albicans (C. albicans) is the most common causative agent of mucosal and healthcare-associated systemic infections. However, during recent decades, there has been a worrying increase in the number of emerging multi-drug-resistant non-albicans Candida (NAC) species, i.e., C. glabrata, C. parapsilosis, C. tropicalis, C. krusei, C. auris, and C. ciferrii. In particular, Candida ciferrii, also known as Stephanoascus ciferrii or Trichomonascus ciferrii, is a heterothallic ascomycete yeast-like fungus that has received attention in recent decades as a cause of local and systemic fungal diseases. Today, the new definition of the S. ciferrii complex, which consists of S. ciferrii, Candida allociferrii, and Candida mucifera, was proposed after sequencing the 18S rRNA gene. Currently, the S. ciferrii complex is mostly associated with non-severe ear and eye infections, although a few cases of severe candidemia have been reported in immunocompromised individuals. Low susceptibility to currently available antifungal drugs is a rising concern, especially in NAC species. In this regard, a high rate of resistance to azoles and more recently also to echinocandins has emerged in the S. ciferrii complex. This review focuses on epidemiological, biological, and clinical aspects of the S. ciferrii complex, including its pathogenicity and drug resistance.

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Section: Treatment and Resistancementioning

confidence: 88%

Stephanoascus ciferrii Complex: The Current State of Infections and Drug Resistance in Humans

Cosio,

Pica,

Fontana

et al. 2024

JoF

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“…but the methods for species identification are not well described and the cases were also associated with predisposing factors in the patients, but they were not specified. Simonetti et al (2023) report a case of fungaemia caused by Y. lipolytica in a patient with predisposition factors, COVID-19 infection and a history of alcohol syndrome. The literature update did not identify any new information that would change the QPS status of Y. lipolytica.…”

Section: Yarrowia Lipolyticamentioning

confidence: 99%

Update of the list of qualified presumption of safety (QPS) recommended microbiological agents intentionally added to food or feed as notified to EFSA 19: Suitability of taxonomic units notified to EFSA until September 2023

Koutsoumanis,

Allende,

Alvarez‐Ordóñez

et al. 2024

EFS2

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The qualified presumption of safety (QPS) process was developed to provide a safety assessment approach for microorganisms intended for use in food or feed chains. The QPS approach is based on an assessment of published data for each taxonomic unit (TU), with respect to its taxonomic identity, the body of relevant knowledge and safety concerns. Safety concerns identified for a TU are, where possible, confirmed at the species/strain or product level and reflected by ‘qualifications’. In the period covered by this Statement, no new information was found that would change the status of previously recommended QPS TUs. Of 71 microorganisms notified to EFSA between April and September 2023 (30 as feed additives, 22 as food enzymes or additives, 7 as novel foods and 12 from plant protection products [PPP]), 61 were not evaluated because: 26 were filamentous fungi, 1 was Enterococcus faecium, 5 were Escherichia coli, 1 was a bacteriophage (all excluded from the QPS evaluation) and 28 were TUs that already have a QPS status. The other 10 notifications belonged to 9 TUs which were evaluated for a possible QPS status: Ensifer adhaerens and Heyndrickxia faecalis did not get the QPS recommendation due to the limited body of knowledge about their occurrence in the food and/or feed chains and Burkholderia ubonensis also due to its ability to generate biologically active compounds with antimicrobial activity; Klebsiella pneumoniae, Serratia marcescens and Pseudomonas putida due to safety concerns. K. pneumoniae is excluded from future QPS evaluations. Chlamydomonas reinhardtii is recommended for QPS status with the qualification ‘for production purposes only’; Clostridium tyrobutyricum is recommended for QPS status with the qualification ‘absence of genetic determinants for toxigenic activity’; Candida oleophila has been added as a synonym of Yarrowia lipolytica. The Panel clarifies the extension of the QPS status for genetically modified strains.

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“…Since three cases of eye infection caused by Y. lipolytica were reported in France in 1976, more than 30 relevant pathogenic studies and case reports have been published ( 4 – 12 ). Recently, Y. lipolytica has been reported to cause nosocomial outbreaks, foodborne infections, breakthrough fungemia, and catheter-related infections that may be complicated by septic shock in immunocompromised patients and even those co-infected with severe acute respiratory syndrome coronavirus 2 ( 4 , 9 – 11 , 13 ).…”

Section: Introductionmentioning

confidence: 99%

Antifungal susceptibility profile and local epidemiological cut-off values of Yarrowia ( Candida ) lipolytica : an emergent and rare opportunistic yeast

Yu,

Liu,

Guo

et al. 2024

Microbiol Spectr

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The antifungal susceptibility profile and epidemiological cut-off values (ECOFFs) of Yarrowia lipolytica , a rare opportunistic yeast, remain unclear. We conducted a comprehensive multi-method study on clinical isolates from various central hospitals, based on the China Hospital Invasive Fungal Surveillance Network (2009–2022). Our objective was to evaluate the antifungal susceptibility of Y. lipolytica , establish its local ECOFFs (L-ECOFFs), and compare the performance of the ATB FUNGUS 3 (ATB), Sensititre YeastOne (SYO), and minimum inhibitory concentration (MIC) test strip (MTS) with that of the broth microdilution (BMD) method. L-ECOFFs were established using ECOFFinder, and we examined ERG11 mutations to assess the reliability of the L-ECOFFs. The L-ECOFF for fluconazole was 8 µg/mL. Non-wild-type isolates of antifungal drugs, such as flucytosine and azoles, were exclusively isolated from patients. Additionally, we detected that four strains with the ERG11 A395T mutation (azole MIC >L-ECOFF) may be associated with the exposure to azole drugs. For azoles, ATB showed the highest essential agreement with the BMD (98.18%–100%), followed by SYO (85.45%–100%). However, ATB could not detect susceptibility to echinocandins, while SYO exhibited the highest agreement (98.18%–100%) in detecting echinocandin susceptibility. Our findings indicate that acquired azole cross-resistance has emerged despite Y. lipolytica infections being rare. This research provides crucial antifungal susceptibility data and establishes the initial L-ECOFFs for Y. lipolytica . The SYO is recommended as the optimal laboratory antifungal susceptibility testing method for Y. lipolytica , followed by ATB, whereas the use of MTS requires caution. We hope that this study will facilitate improved clinical management of Y. lipolytica infections. IMPORTANCE Yarrowia lipolytica , also known as Candida lipolytica , is an emerging opportunistic “rare pathogenic yeast”. Due to the limited data on its antifungal susceptibility, the clinical treatments become challenging. Based on the China Hospital Invasive Fungal Surveillance Network (2009–2022), we conducted a comprehensive multi-method study on clinical isolates from various central hospitals. This study is currently the largest study carried out to assess the antifungal susceptibility of Y. lipolytica . It is also the first to establish local epidemiological cut-off values (L-ECOFFs), identify its ERG11 mutations, and assess the consistency between the three prevalent commercial antifungal susceptibility testing methods and the broth microdilution method. We recommend the Sensititre YeastOne as the best option for antifungal susceptibility testing for Y. lipolytica , followed by the ATB FUNGUS 3. Nevertheless, practitioners should use the MIC test strip with discretion.

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Candida lipolytica Bloodstream Infection in an Adult Patient with COVID-19 and Alcohol Use Disorder: A Unique Case and a Systematic Review of the Literature

Cited by 4 publications

References 29 publications

Stephanoascus ciferrii Complex: The Current State of Infections and Drug Resistance in Humans

Stephanoascus ciferrii Complex: The Current State of Infections and Drug Resistance in Humans

Update of the list of qualified presumption of safety (QPS) recommended microbiological agents intentionally added to food or feed as notified to EFSA 19: Suitability of taxonomic units notified to EFSA until September 2023

Antifungal susceptibility profile and local epidemiological cut-off values of Yarrowia ( Candida ) lipolytica : an emergent and rare opportunistic yeast

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