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Donor Derived Candida stellimalicola in a Clinical Specimen: Preservation Fluid Contamination During Pancreas Procurement

Abstract

We report here a case of possible donor-derived Candida stellimalicola infection after pancreas transplantation. Candida stellimalicola, an environmental non-filamentous yeast, was isolated from both the peritoneal fluid of the graft donor and the preservation fluid of the transplanted pancreas. Interestingly, this strain exhibited high minimum inhibitory concentrations to azoles. These results justified the use of echinocandins as therapy instead of fluconazole. This switch permitted a favorable outcome. To our knowledge, this is the first report of C. stellimalicola from clinical samples and therefore the first reported case of a possible human infection. This case report highlights the need for standardized microbiological procedures in solid organ transplant settings. Moreover, it underlines the importance of using molecular identification technique when routine techniques do not allow successful identification of the pathogen. It is of utmost importance to determine sensitivity profile, even in the absence of species-level identification, because resistance to fluconazole is not uncommon, especially in emergent species.

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Acknowledgements

The authors would like to thank Dr A. L. Bienvenu, M. Fernandes and A. Gaudin. They also thank the Biofidal staff for sequencing.

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Correspondence to Damien Dupont.

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The authors have no relevant conflicts of interest.

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Dupont, D., Huguenin, A., Tisserand, E. et al. Donor Derived Candida stellimalicola in a Clinical Specimen: Preservation Fluid Contamination During Pancreas Procurement. Mycopathologia 183, 573–577 (2018). https://doi.org/10.1007/s11046-017-0171-3

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Keywords

  • Candida stellimalicola
  • Infection
  • Transplant recipient
  • Azole resistance
  • Emerging pathogen