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.
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.
Hamal
Petr
P
Department of Microbiology, University Hospital and Faculty of Medicine, Palacky University Olomouc, Czech Republic. petr.hamal@fnol.cz
Ostransky
Jiri
J
Dendis
Milos
M
Horváth
Radek
R
Ruzicka
Filip
F
Buchta
Vladimir
V
Vejsova
Marcela
M
Sauer
Pavel
P
Hejnar
Petr
P
Raclavsky
Vladislav
V
D000328:Adult; D000935:Antifungal Agents / Q000494:pharmacology*; D001393:Azoles / Q000494:pharmacology*; D018441:Biofilms; D025141:Drug Resistance, Fungal; D004696:Endocarditis / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D008297:Male; D009181:Mycoses / Q000188:drug therapy* / Q000382:microbiology; D010843:Pichia / Q000187:drug effects / Q000302:isolation & purification / Q000472:pathogenicity* / Q000502:physiology
D000935:Antifungal Agents; D001393:Azoles