title: Intravenous Catheter-Associated Candidemia due to Candida membranaefaciens: The First Iranian Case.
abstract: The incidence of candidemia due to the uncommon non-albicans Candida species appears to be increasing, and certain species such as Candida (C.) membranaefaciens have been reported in some clinical researches. Vascular catheters are considered the likely culprit for the sudden emergence of hospital-acquired candidemia. The identification of C. membranaefaciens can be problematic in clinical practice owing to its phenotypic resemblance to C. guilliermondii. We report the first case of C. membranaefaciens in Iran, which occurred in a 70-year-old woman, who had coronary artery bypass grafting (CABG). We isolated germ-tube negative yeast from both blood culture and central venous catheter (CVC) tip culture on brain-heart infusion agar, Sabouraud dextrose agar plates, and biphasic brain-heart infusion media bottle; it developed smooth, pink colonies on CHROMagar Candida. By using the polymerase chain reaction and sequencing of theinternal transcribed spacer region of rDNA, we identified C. membranaefaciens. After the removal of the CVC and initiation of Fluconazole treatment, the patient's condition gradually improved and she was discharged from the hospital. The early detection of organisms in the catheter, removal of the catheter, and treatment with anti-fungal antibiotics have an important role in controlling disease and preventing septicemia after CABG. As C. membranaefaciens is an opportunistic Candida species, both clinicians and microbiologists should be aware of the factors that confer fast diagnosis and appropriate treatment.
authors.affiliation: Department of Medical Mycology and Parasitology, and Invasive Fungi Research Center (IFRC), Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Seyed Reza
authors.initials: SR
authors.lastname: Aghili
authors.affiliation: Department of Medical Mycology and Parasitology, and Invasive Fungi Research Center (IFRC), Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Tahereh
authors.initials: T
authors.lastname: Shokohi
authors.affiliation: Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad Ali
authors.initials: MA
authors.lastname: Boroumand
authors.affiliation: Student Research Committee , Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Shirinsadat
authors.initials: S
authors.lastname: Hashemi Fesharaki
authors.affiliation: Department of Sciences, Seddigheh Tahereh Branch, Farhangian University, Sari, Iran .
authors.forename: Bahar
authors.initials: B
authors.lastname: Salmanian
keywords: Candidemia; Catheter-related infections; Coronary artery bypass; Cross infection; Polymerase chain reaction