Candida Utilis Causing Neonatal Candidemia - A Case Report and Literature Review

Summary Nosocomial bloodstream candidaemia is a life‐threatening fungal infection with high morbidity and mortality, especially among paediatric patients undergoing intensive immunosuppressive therapy. Limited data on the epidemiology of candidaemia and susceptibility profiles are available for Iran. To characterise candidaemia epidemiology, comorbidity risk factors, species distribution, and antifungal susceptibility profiles among paediatric patients in Iran. This observational cross‐sectional study enrolled 26 189 patients <18 years old at three reference paediatric hospitals in Mazandaran and Tehran over 2 years. Blood samples from patients with suspected fungal bloodstream infection were analysed using the BACTEC culture system. Fungal isolates were identified using matrix‐assisted laser desorption ionisation time‐of‐flight mass spectrometry (MALDI‐TOF) and DNA sequencing. Antifungal susceptibility testing was performed using the Clinical and Laboratory Standards Institute broth microdilution guideline. We observed 109 episodes of nosocomial candidaemia in paediatric patients with or without immunosuppressive therapy. The most common healthcare‐associated factor was central vascular catheter use (97%). The all‐cause mortality rate was 40%, of which 48% was attributable to candidaemia. While Candida albicans was the most frequent causative agent (49%), emerging and uncommon Candida species were also isolated. Candidaemia mortality by non‐albicans Candida species was significantly higher than that by C. albicans (P < .05). All fluconazole‐resistant species were non‐albicans Candida species. Uncommon Candida species with reduced susceptibility to antifungals are emerging as major agents of nosocomial candidaemia in high‐risk paediatric patients in Iran. Appropriate source control, antifungal regimens and improved antifungal stewardship are warranted for managing and decreasing the burden of nosocomial candidaemia.

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Epidemiological features of nosocomial candidaemia in neonates, infants and children: A multicentre study in Iran

Ahangarkani

Shokohi

Rezai

et al. 2020

“…34,35 Candida utilis was the second most common (40.8%) yeast isolated in the present study, contrary to previous reports from our centre where this species was reported at a rate of 0.5%-0.7% from paediatric candidaemia cases. 9,33 There are very few reports of C. utilis candidaemia in literature, 36,37 and the reason for the rise in incidence of C. utilis candidaemia at our centre is unclear. As the majority (95%) of W. anomalus and C. utilis isolates were susceptible to all antifungal agents tested, antifungal drug pressure could not explain their emergence and warrants a systematic epidemiology study.…”

Section: Discussionmentioning

confidence: 94%

Fungaemia due to rare yeasts in paediatric intensive care units: A prospective study

Kaur

Rudramurthy

Jayashree

et al. 2021

Fungaemia due to yeast is a major cause of morbidity, mortality and increased healthcare costs in critically ill patients in intensive care units (ICUs). [1][2][3][4] The overuse of antibiotics, multiple invasive procedures and compromise in infection control contribute to the rise of fungaemia in ICUs. 2 While majority of the epidemiological studies covered adult patients in ICUs, the limited studies in paediatric ICUs

“…Only a few studies have reported invasive infection due to C. utilis (reviewed in Table ). Two surveys reported four cases concerning neonates hospitalised in intensive care unit with several risk factors (central venous catheter (CVC), parenteral nutrition, antibiotic therapy and mostly surgical procedure) . One case involved a 68‐year‐old patient suffering from Alzheimer's disease admitted with neurological issues and chronic fever, but with neither neutropoenia nor CVC .…”

Section: Discussionmentioning

confidence: 99%

Candida utilis fungaemia following endoscopic intervention on ureteral stent in a kidney transplant recipient: Case report and a review of the literature

Gaisne

Jeddi

Morio

et al. 2018

Infection due to species other than Candida albicans is increasing among solid organ transplant recipients. Candida utilis, commonly used in the food industry, is considered as a low-virulence yeast. We report the first case of C. utilis fungaemia involving a solid organ transplant recipient. The infection was triggered by the withdrawal of a ureteral stent and was successfully treated with intravenous micafungin. We also propose a review of all reported cases of infection caused by C. utilis.