INVASIVE CANDIDA-GUILLIERMONDII INFECTION - IN-VITRO SUSCEPTIBILITY STUDIES AND MOLECULAR ANALYSIS

Candida guilliermondii is rarely isolated from humans. We describe a c ase of disseminated C. guilliermondii with associated purulent pericar ditis, despite high-dose amphotericin B (AmB), in a 19-year-old female with aplastic anemia who underwent BMT. In vitro susceptibility studi es of the 13 clinical isolates, two control strains and one environmen tal isolate revealed a minimum inhibitory concentration (MIC) range of (0.19-1.56 mu g/ml) for AmB and (1.25-10 mu g/ml) for fluconazole. Pu lsed-field gradient gel electrophoresis was performed to evaluate poss ible similarities between strains. This case is significant for severa l reasons, the high degree and prolonged duration of fungemia despite high-dose AmB and concomitant flucytosine, the change in in vitro susc eptibility during therapy, the initial misidentification of the yeast isolate, and the invasiveness of the organism. The poor response to th erapy may have been due to the severe and sustained neutropenia and th e high MICs of C. guilliermondii to AmB.