title: 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.
abstract: 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.
authors.affiliation: Department of Microbiology, University Hospital and Faculty of Medicine, Palacky University Olomouc, Czech Republic. petr.hamal@fnol.cz
authors.forename: Petr
authors.initials: P
authors.lastname: Hamal
authors.forename: Jiri
authors.initials: J
authors.lastname: Ostransky
authors.forename: Milos
authors.initials: M
authors.lastname: Dendis
authors.forename: Radek
authors.initials: R
authors.lastname: Horváth
authors.forename: Filip
authors.initials: F
authors.lastname: Ruzicka
authors.forename: Vladimir
authors.initials: V
authors.lastname: Buchta
authors.forename: Marcela
authors.initials: M
authors.lastname: Vejsova
authors.forename: Pavel
authors.initials: P
authors.lastname: Sauer
authors.forename: Petr
authors.initials: P
authors.lastname: Hejnar
authors.forename: Vladislav
authors.initials: V
authors.lastname: Raclavsky
mesh_terms: 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
chemical_list: D000935:Antifungal Agents; D001393:Azoles