A case of endocarditis caused by the yeast Pichia fabianii with biofilm production and developed in vitro resistance to azoles in the course of antifungal treatment

Authors

HAMAL Petr OSTRANSKY Jiří DENDIS Miloš HORVÁTH Radek RŮŽIČKA Filip BUCHTA Vladimír VEJŠOVÁ Marcela SAUER Pavel HEJNAR Petr RACLAVSKÝ Vladislav

Year of publication 2008
Type Article in Periodical
Magazine / Source Medical Mycology
MU Faculty or unit

Faculty of Medicine

Citation
Field Microbiology, virology
Keywords INFECTIVE ENDOCARDITIS; HANSENULA-ANOMALA; CROSS-RESISTANCE; CANDIDA; IDENTIFICATION; FUNGEMIA; THERAPY; VORICONAZOLE; CASPOFUNGIN; DIAGNOSIS
Description Pichia fabianii, a yeast rarely causing human infections, was isolated from the blood of a patient with aortic valve endocarditis. The isolates were initially identified biochemically as Candida pelliculosa, but based on direct sequencing of the ITS2 region of rRNA, they were subsequently reidentified as P. fabianii. Antifungal therapy with fluconazole and later with voriconazole led to the development of resistant variants which had high MIC values to both antifungals. Strong biofilm formation by this yeast could also have played a role in the development of its resistance and allowed for its persistence on the infected valve during antifungal therapy. To our knowledge, this is the first published case of endocarditis and the fourth human infection caused by this yeast species.

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