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Recurrent candidaemia in a neonate with Hirschsprung’s disease: fluconazole resistance and genetic relatedness of eight Candida tropicalis isolates

Chong, Pei Pei and Chieng, David Ching-Soo and Low, Lee Yean and Hafeez, Asma and Shamsudin, Mariana Nor and Seow, Heng Fong and Ng, Kee Peng (2006) Recurrent candidaemia in a neonate with Hirschsprung’s disease: fluconazole resistance and genetic relatedness of eight Candida tropicalis isolates. Journal of Medical Microbiology, 55 (4). pp. 423-428. ISSN 0022-2615

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Abstract

The incidence of candidaemia among immunocompromised patients in Malaysia is increasing at an alarming rate. Isolation of clinical strains that are resistant to fluconazole has also risen markedly. We report here the repeated isolation of Candida tropicalis from the blood of a neonatal patient with Hirschsprung's disease. In vitro fluconazole susceptibility tests of the eight isolates obtained at different time points showed that seven of the isolates were resistant and one isolate was scored as susceptible dose-dependent. Random amplification of polymorphic DNA fingerprinting of the isolates using three primers and subsequent phylogenetic analysis revealed that these isolates were highly similar strains having minor genetic divergence, with a mean pairwise similarity coefficient of 0·893±0·041. The source of the infectious agent was thought to be the central venous catheter, as culture of its tip produced fluconazole-resistant C. tropicalis. This study demonstrates the utility of applying molecular epidemiology techniques to complement traditional mycological culture and drug susceptibility tests for accurate and appropriate management of recurrent candidaemia and highlights the need for newer antifungals that can combat the emergence of fluconazole-resistant C. tropicalis strains.

Item Type: Article
Uncontrolled Keywords: ResPubID16885. recurrent candidemia, fluconazole resistance
Subjects: Faculty/School/Research Centre/Department > School of Biomedical and Health Sciences
FOR Classification > 1112 Oncology and Carcinogenesis
SEO Classification > 970111 Expanding Knowledge in the Medical and Health Sciences
Depositing User: VUIR
Date Deposited: 20 May 2011 06:53
Last Modified: 29 Jan 2015 22:09
URI: http://vuir.vu.edu.au/id/eprint/2918
DOI: 10.1099/jmm.0.46045-0
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Citations in Scopus: 11 - View on Scopus

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