title: In situ management and molecular analysis of candidaemia related to a totally implantable vascular access in a cystic fibrosis patient.
abstract: We describe a case of candidaemia in a paediatric cystic fibrosis (CF) patient with a totally implantable vascular access (TIVA). Serial quantitative blood cultures during therapy with amphotericin B delivered via the catheter suggested that the patient was responding to therapy. The TIVA was finally removed because of persistent fever, but its culture remained sterile. Randomly amplified polymorphic DNA (RAPD) analysis of Candida albicans from various anatomical sites showed that the patient's sputum was the most likely source of TIVA contamination. Investigation of TIVA-related candidaemia by molecular analysis could guide rational antifungal chemoprophylaxis of TIVA-related candidaemia.
authors.affiliation: Service de Microbiologie, Hôpital Robert Debré, Paris, France.
authors.forename: S P
authors.initials: SP
authors.lastname: Bonacorsi
authors.forename: A
authors.initials: A
authors.lastname: Munck
authors.forename: M
authors.initials: M
authors.lastname: Gerardin
authors.forename: C
authors.initials: C
authors.lastname: Doit
authors.forename: N
authors.initials: N
authors.lastname: Brahimi
authors.forename: J
authors.initials: J
authors.lastname: Navarro
authors.forename: E
authors.initials: E
authors.lastname: Bingen
mesh_terms: D000666:Amphotericin B / Q000627:therapeutic use; D002177:Candidiasis / Q000175:diagnosis / Q000188:drug therapy*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D002648:Child; D003550:Cystic Fibrosis / Q000150:complications*; D004271:DNA, Fungal / Q000032:analysis; D005260:Female; D016469:Fungemia / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans
chemical_list: D004271:DNA, Fungal; D000666:Amphotericin B