Recovery of Candida dubliniensis from non-human immunodeficiency virus-infected patients in Israel

Candida dubliniensis is a recently discovered yeast species principally ass ociated with carriage and disease in the oral cavities of human immunodefic iency virus (HIV)-infected individuals. To date the majority of isolates of this species have been identified in Europe and North America. In this stu dy, fire Candida isolates recovered from separate HIV-negative hospitalized patients in Jerusalem! Israel, Here presumptively identified as C. dublini ensis on the basis of their dark green coloration when grown on CHROMagar C andida medium. Their identification nas confirmed by a variety of technique s, including carbohydrate assimilation profiles, absence of growth at 45 de grees C, positive reaction with C. dubliniensis-specific antibodies as dete rmined by indirect immunofluorescence analysis, and positive amplification with C. dubliniensis-specific: PCR primers. All five strains were shown to be susceptible to a range of antifungal agents, including fluconazole, One of the five isolates was recovered from urine specimens, while the remainin g four were recovered from upper respiratory tract and oral samples, While none of the patients was HIV positive, all were receiving broad-spectrum an tibacterials at the time isolates of C. dubliniensis were obtained from cli nical specimens. This study describes the first isolates of C. dubliniensis from the Middle East and confirms that this yeast can be associated with c arriage and infection in the absence of HIV infection.