Abstract
Rare fungal pathogens are emerging as agents of invasive fungal infections. We analyzed 13 cases of fungal infections caused by Kazachstania (Arxiozyma) spp. in Strasbourg University Hospital, Strasbourg, France. Among the cases, 4 patients had proven fungal disease (3 cases of invasive fungal disease and 1 mucocutaneous infection) and 9 were colonized by Kazachstania (Arxiozyma) spp. Candida albicans was also isolated from 11 of the 13 patients. None of the patients with proven invasive fungal disease met host criteria, but most had underlying diseases. All strains were identified as K. telluris by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, and 3 were confirmed as K. bovina by internal transcribed spacer sequencing. For all tested strains, the MICs for fluconazole were >2 μg/mL. Emergence of this rare fungal infection might be explained by the increasing number of patients with immunocompromised conditions and gastroesophageal diseases.
Highlights
In support of improving patient care, this activity has been planned and implemented by Medscape, LLC and Emerging Infectious Diseases
We report a case series of fungal infections caused by Kazachstania (Arxiozyma) spp. and classify them as invasive infections, mucocutaneous infections, or colonizations
Because mass spectrometry cannot distinguish between the species of the K. telluris complex, we identified the strains involved in IFIs, and stored in our laboratory, by internal transcribed spacer (ITS) sequencing and confirmed them as K. bovina
Summary
In support of improving patient care, this activity has been planned and implemented by Medscape, LLC and Emerging Infectious Diseases. To participate in this journal CME activity: (1) review the learning objectives and author disclosures; (2) study the education content; (3) take the post-test with a 75% minimum passing score and complete the evaluation at http://www.medscape.org/journal/eid; and (4) view/print certificate. Disclosures: Charlotte Kaeuffer, MD; Mathieu Baldacini, MD; Tiffany Ruge, MD; Yvon Ruch, MD; Yves-Jean Zhu, BS; Manon De Cian, MD; Guillaume Philouze, MD; Philippe Bachellier, MD; Julie Denis, PharmD; Nicolas Lefebvre, MD; Francis Schneider, MD, PhD; Yves Hansmann, MD; Valérie Letscher-Bru, PhD; and Marcela Sabou, MD, PhD, have disclosed no relevant financial relationships.
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