Mycopathologia. 2010 Jun;169(6):457-9. doi: 10.1007/s11046-010-9278-5. Epub 2010 Feb 5.
Isolation of Candida non-albicans yeasts as commensals or pathogens from hospitalised hosts is acquiring increasing importance, due to the frequent drug resistance expressed by such organisms.Particularly, the recover of antifungal resistant C. guilliermondii is of worrisome concern, even if recovered as a saprophyte, since commensal yeasts may behave as reservoirs for resistance elements;furthermore, they may enter the bloodstream after chemotherapy-related mucosal damage has developed,thus causing life-threatening and difficult-to-treat fungemias. This communication deals with the unusual isolation of a pan-azole resistant C. guilliermondii strain from a leukaemic patient with silent candiduria and emphasizes the importance of monitoring less recurring species within the nosocomial setting to better understand fungal epidemiology within the wards and face the spread of resistance determinants. Also, we highlight the controversial significance of silent candiduria, clinical relevance of which should be investigated case by case, to exclude and/or prevent candiduria as well as renal impairment.
由于这些生物体经常表现出耐药性,因此从住院宿主中分离非白念珠菌念珠菌作为共生菌或病原体变得越来越重要。特别是,即使作为腐生物回收,抗真菌耐药的 C. guilliermondii 的回收也令人担忧,因为共生酵母可能是耐药元件的储库;此外,它们可能在化疗相关的粘膜损伤发展后进入血液,从而导致危及生命且难以治疗的真菌感染。本通讯涉及从患有无症状念珠菌尿的白血病患者中分离出一种泛唑类耐药 C. guilliermondii 菌株的不寻常情况,并强调了在医院环境中监测较少出现的物种的重要性,以更好地了解病房内的真菌流行病学并应对耐药决定因素的传播。此外,我们强调了无症状念珠菌尿的争议意义,应逐例调查其临床相关性,以排除和/或预防念珠菌尿以及肾功能损害。