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.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
De Pauw B, Walsh TJ, Donnelly JP, Stevens DA, Edwards JE, Calandra T, et al. Revised definitions of invasive fungal disease from the European organization for research and treatment of cancer/invasive fungal infections cooperative group and the national institute of allergy and infectious diseases mycoses study group (EORTC/MSG) consensus group. Clin Infect Dis. 2008;46:1813–21.
Silveira FP, Husain S. Fungal infections in solid organ transplantation. Med Mycol. 2007;45:305–20.
Neofytos D, Fishman JA, Horn D, Anaissie E, Chang C-H, Olyaei A, et al. Epidemiology and outcome of invasive fungal infections in solid organ transplant recipients. Transpl Infect Dis. 2010;12:220–9.
Singh N, Huprikar S, Burdette SD, Morris MI, Blair JE, Wheat LJ, et al. Donor-derived fungal infections in organ transplant recipients: guidelines of the American society of transplantation, infectious diseases community of practice†. Am J Transplant. 2012;12:2414–28.
Hibberd PL, Rubin RH. Clinical aspects of fungal infection in organ transplant recipients. Clin Infect Dis. 1994;19(Suppl 1):S33–40.
Pappas PG, Alexander BD, Andes DR, Hadley S, Kauffman CA, Freifeld A, et al. Invasive fungal infections among organ transplant recipients: results of the transplant-associated infection surveillance network (TRANSNET). Clin Infect Dis. 2010;50:1101–11.
Herrero-Martínez JM, Lumbreras C, Manrique A, San-Juan R, García-Reyne A, López-Medrano F, et al. Epidemiology, risk factors and impact on long-term pancreatic function of infection following pancreas-kidney transplantation. Clin Microbiol Infect. 2013;19:1132–9.
Shoham S, Marr KA. Invasive fungal infections in solid organ transplant recipients. Future Microbiol. 2012;7:639–55.
Albano L, Bretagne S, Mamzer-Bruneel M-F, Kacso I, Desnos-Ollivier M, Guerrini P, et al. Evidence that graft-site candidiasis after kidney transplantation is acquired during organ recovery: a multicenter study in France. Clin Infect Dis. 2009;48:194–202.
Mai H, Champion L, Ouali N, Hertig A, Peraldi M-N, Glotz D, et al. Candida albicans arteritis transmitted by conservative liquid after renal transplantation: a report of four cases and review of the literature. Transplantation. 2006;82:1163–7.
Bassetti M, Salvalaggio PRO, Topal J, Lorber MI, Friedman AL, Andriole VT, et al. Incidence, timing and site of infections among pancreas transplant recipients. J Hosp Infect. 2004;56:184–90.
Fischer SA, Lu K. AST infectious diseases community of practice. Screening of donor and recipient in solid organ transplantation. Am J Transplant. 2013;13(Suppl 4):9–21.
Société Française de Microbiologie, Contrôles microbiologiques des liquides de conservation d'organes. In: REMIC: Société Française de Microbiologie Ed; 2015. pp 407–10.
Botterel F, Foulet F, Legrand P, Soria A-M, Farrugia C, Grimbert P, et al. Yeast contamination of kidney, liver and cardiac preservation solutions before graft: need for standardisation of microbial evaluation. J Hosp Infect. 2010;76:52–5.
Matignon M, Botterel F, Audard V, Dunogue B, Dahan K, Lang P, et al. Outcome of renal transplantation in eight patients with Candida sp. contamination of preservation fluid. Am J Transplant. 2008;8:697–700.
Suzuki M, Nakase T, Komagata K. Candida stellimalicola, a new species of anamorphic yeast isolated from star apple in Thailand. J Gen Appl Microbiol. 1994;40:115–21.
Charron G, Leducq J-B, Bertin C, Dubé AK, Landry CR. Exploring the northern limit of the distribution of Saccharomyces cerevisiae and Saccharomyces paradoxus in North America. FEMS Yeast Res. 2014;14:281–8.
Kurtzman CP, Robnett CJ, Basehoar-Powers E. Phylogenetic relationships among species of Pichia, Issatchenkia and Williopsis determined from multigene sequence analysis, and the proposal of Barnettozyma gen. nov., Lindnera gen. nov. and Wickerhamomyces gen. nov. FEMS Yeast Res. 2008;8:939–54.
Freitas LFD, Barbosa R, Sampaio JP, Lachance M-A, Rosa CA. Starmera pilosocereana sp. nov., a yeast isolated from necrotic tissue of cacti in a sandy coastal dune ecosystem. Int J Syst Evol Microbiol. 2015;65:4474–8.
Daniel H-M, Vrancken G, Takrama JF, Camu N, De Vos P, De Vuyst L. Yeast diversity of Ghanaian cocoa bean heap fermentations. FEMS Yeast Res. 2009;9:774–83.
Suzuki M, Nakase T, Daengsubha W, Chaowsangket M, Suyanandana P, Komagata K. Identification of yeasts isolated from fermented foods and related materials in Thailand. J Gen Appl Microbiol. 1987;33:205–19.
Barata A, Malfeito-Ferreira M, Loureiro V. Changes in sour rotten grape berry microbiota during ripening and wine fermentation. Int J Food Microbiol. 2012;154:152–61.
Marklein G, Josten M, Klanke U, Müller E, Horré R, Maier T, et al. Matrix-assisted laser desorption ionization-time of flight mass spectrometry for fast and reliable identification of clinical yeast isolates. J Clin Microbiol. 2009;47:2912–7.
The authors would like to thank Dr A. L. Bienvenu, M. Fernandes and A. Gaudin. They also thank the Biofidal staff for sequencing.
Conflict of interest
The authors have no relevant conflicts of interest.
About this article
Cite this article
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
- Candida stellimalicola
- Transplant recipient
- Azole resistance
- Emerging pathogen