Volume 22, Number 3—March 2016
Letter
Candida haemulonii Complex Species, Brazil, January 2010–March 2015
João Nobrega de Almeida
, João Guilherme Pontes Lima Assy, Anna S. Levin, Gilda M.B. Del Negro, Mauro C. Giudice, Marcela Pullice Tringoni, Danilo Yamamoto Thomaz, Adriana Lopes Motta, Edson Abdala, Ligia Camara Pierroti, Tania Strabelli, Ana Lucia Munhoz, Flávia Rossi, and Gil Benard
, João Guilherme Pontes Lima Assy, Anna S. Levin, Gilda M.B. Del Negro, Mauro C. Giudice, Marcela Pullice Tringoni, Danilo Yamamoto Thomaz, Adriana Lopes Motta, Edson Abdala, Ligia Camara Pierroti, Tania Strabelli, Ana Lucia Munhoz, Flávia Rossi, and Gil Benard
Table
Demographic, clinical, and microbiological features of patients whose cultures were positive for C. haemulonii. var. vulerna, and C. duobushaemulonii, January 2010–March 2015, Brazil*
| Characteristic | Candida haemulonii, n = 14 | Candida haemulonii var. vulnera, n = 8 | Candida duobushaemulonii, n = 9 |
|---|---|---|---|
| Mean age, y (range) | 42 (0–85) | 46 (16–78) | 49 (0–85) |
| Sex, F/M | 8/6 | 6/2 | 4/5 |
| Mean hospitalization, d (range) | 20 (0–140) | 28 (0–78) | 26 (0–67) |
| ICU-acquired, % | 2 (14) | 1 (12) | 4 (44) |
| Polymicrobial culture, % |
4 (28) |
5 (62) |
4 (44) |
| Underlying conditions, % | |||
| Malignancy† | 3 (21) | 3 (37) | 2 (22) |
| Solid organ transplant | 2 (14) | ND | ND |
| Systemic lupus erythematosus | ND | 1 (12) | ND |
| Diabetes mellitus | 4 (28) | 2 (25) | 6 (66) |
| Vascular diseases |
3 (21) |
3 (37) |
4 (44) |
| Risk factors | |||
| Previous antimicrobial drug therapy | 12 (85) | 6 (75) | 8 (89) |
| Previous antifungal drug therapy | 6 (42) | 2 (25) | 3 (33) |
| Chronic lower-extremity infected wounds | 3 (21) | 4 (50) | 4 (44) |
| Candidemia |
4 (28) |
3 (37) |
1 (11) |
| Antifungal susceptibility testing | |||
| Amphotericin B | |||
| GM, μg/mL (range) | 1.56 (1–4) | 1 (0.5–2) | 4 (2–8) |
| MIC90 | 4 | 2 | 8 |
| Fluconazole | |||
| GM, μg/mL (range) | 8.4 (1–64) | 17.4 (2–>64) | 10.07 (0.25–>64) |
| MIC90 | 64 | 64 | 64 |
| Voriconazole | |||
| GM, μg/mL (range) | 1.9 (0.25–>16) | 1.53 (0.125–>16) | 1.07 (0.125–>16) |
| MIC90 | 16 | 16 | 16 |
| Caspofungin | |||
| GM, μg/mL (range) | 0.12 (0.125–0.5) | 0.26 (0.125–0.5) | 0.22 (0.06–16) |
| MIC90 | 0.25 | 0.5 | 16 |
| Anidulafungin | |||
| GM, μg/mL (range) | 0.015 (<0.015–0.015) | 0.016 (<0.015–0.03) | 0.06 (<0.015–0.5) |
| MIC90 | 0.015 | 0.03 | 0.5 |
*Values are no. (%) patients except as indicated. ND, no data; GM, geometric mean; MIC90, concentration that inhibits 90% of isolates.
†Solid tumors (n = 5) and hematologic malignancies (n = 3).
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