title: Persistent Candida conglobata bloodstream infection in a preterm neonate successfully treated by combination therapy with amphotericin B and caspofungin.
abstract: Fungemia due to uncommon/rare Candida species is an emerging problem of global clinical significance. Here, we describe a case of Candida conglobata bloodstream infection in a preterm neonate. The diagnosis was established by repeated isolation of C. conglobata in blood cultures and by detection of rDNA of the fungus in serum samples. The identity of the isolate as C. conglobata was confirmed by sequencing of ITS region and D1/D2 domains of rDNA. Despite initial treatment with a liposomal amphotericin B (AmBisome) for 7 days, the blood culture remained positive. The neonate was successfully treated by combination therapy with caspofungin for 25 days. To the best of our knowledge, this is the first proven report unequivocally proving the etiologic role of C. conglobata in bloodstream infection.
authors.affiliation: Department of Microbiology, Faculty of Medicine, Kuwait University, Safat, Kuwait; Microbiology Unit, Maternity Hospital, Safat, Kuwait.
authors.forename: N
authors.initials: N
authors.lastname: Al-Sweih
authors.affiliation: Department of Microbiology, Faculty of Medicine, Kuwait University, Safat, Kuwait.
authors.forename: S
authors.initials: S
authors.lastname: Ahmad
authors.affiliation: Microbiology Unit, Maternity Hospital, Safat, Kuwait.
authors.forename: S
authors.initials: S
authors.lastname: Khan
authors.affiliation: Department of Microbiology, Faculty of Medicine, Kuwait University, Safat, Kuwait; Mycology Reference Laboratory, Microbiology Unit, Mubarak Al-Kabeer Hospital, Safat, Kuwait. Electronic address: zkhan@hsc.edu.kw.
authors.forename: Z
authors.initials: Z
authors.lastname: Khan
authors.affiliation: Department of Microbiology, Faculty of Medicine, Kuwait University, Safat, Kuwait.
authors.forename: L
authors.initials: L
authors.lastname: Joseph
authors.affiliation: Mycology Reference Laboratory, Microbiology Unit, Mubarak Al-Kabeer Hospital, Safat, Kuwait.
authors.forename: S
authors.initials: S
authors.lastname: Vayalil
authors.affiliation: Department of Microbiology, Faculty of Medicine, Kuwait University, Safat, Kuwait.
authors.forename: R
authors.initials: R
authors.lastname: Chandy
mesh_terms: D000666:Amphotericin B / Q000008:administration & dosage*; D000935:Antifungal Agents / Q000008:administration & dosage; D058387:Candidemia / Q000188:drug therapy*; D002177:Candidiasis / Q000188:drug therapy* / Q000382:microbiology; D000077336:Caspofungin; D055499:Catheter-Related Infections / Q000188:drug therapy / Q000382:microbiology; D004359:Drug Therapy, Combination; D054714:Echinocandins / Q000008:administration & dosage*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000188:drug therapy* / Q000382:microbiology; D055666:Lipopeptides / Q000008:administration & dosage*; D008297:Male; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D000666:Amphotericin B; D000077336:Caspofungin
keywords: Candida conglobata; Combination therapy; Fungemia; Kuwait