Epidemiological study of a large cluster of fungaemia cases due to Kodamaea ohmeri in an Indian tertiary care centre. (4th September 2013)

• Record Type: Journal Article
• Authors: Chakrabarti, A.; Rudramurthy, S. M.; Kale, P.; Hariprasath, P.; Dhaliwal, M.; Singhi, S.; Rao, K. L. N.; Roilides, E.
• Is Part Of: Clinical microbiology and infection. Volume 20:Number 2(2014:Feb.)
• Page Start: O83
• Page End: O89
• Publication Date: 2013-09-04
• Subjects: Medical microbiology -- Periodicals; Diagnostic microbiology -- Periodicals; Communicable diseases -- Periodicals; Infection -- Periodicals; 616.01
• DOI: 10.1111/1469-0691.12337
• Languages: English
• ISSNs: 1198-743X

Abstract

<abstract abstract-type="main" id="clm12337-abs-0001"> <title>Abstract</title> <p>While performing molecular confirmation of phenotypically identified <italic>Candida tropicalis</italic> isolates, we re‐identified a few isolates as <italic>Kodamaea ohmeri</italic>. This led us to the present epidemiological investigation of <italic>K. ohmeri</italic> fungaemia cases. All phenotypically identified <italic>C. tropicalis</italic> blood isolates during October 2008 through to December 2009 at our advanced paediatric centre were included for molecular identification by sequencing of the internal transcribed spacer and D1/D2 regions of rDNA. After identifying a large cluster <italic>K. ohmeri</italic> fungaemia cases, a case–control study was carried out retrospectively to analyse potential risk factors for <italic>K. ohmeri</italic> fungaemia. Molecular typing of the isolates was performed using a fluorescent amplified fragment length polymorphism (FAFLP) technique. The antifungal susceptibility testing was performed as per the M27‐A3 protocol of CLSI. Thirty‐eight (25.7%) of 148 phenotypically identified <italic>C. tropicalis</italic> isolates were confirmed as <italic>K. ohmeri</italic> by sequencing and FAFLP. By case–control analysis, piperacillin‐tazobactam was significantly associated with the <italic>K. ohmeri</italic> fungaemia. The FAFLP analysis showed that all <italic>K. ohmeri</italic> isolates had >92% similarity. The azoles and echinocandins had good <italic>in vitro</italic> activity against <italic>K. ohmeri</italic>, though 86.8% of the isolates had MIC of 1 mg/L for amphotericin B. The response to antifungal therapy could be evaluated in 27 patients and 70.4% of patients recovered after antifungal therapy. The present study reports the largest cluster of <italic>K. ohmeri</italic> fungaemia from a single centre. The study also stresses the need for accurate identification of clinical yeast isolates.</p> </abstract>