Candida dubliniensis at a cancer center

Candida dubliniensis, a germ tube-positive yeast first described and identi fied as a cause of oral candidiasis in patients with acquired immunodeficie ncy syndrome in Europe in 1995, has an expanding clinical and geographic di stribution that appears to be similar to that of the other germ tube-positi ve yeast, Candida albicans. This study determined the frequency, clinical s pectrum, drug susceptibility profile, and suitable methods for identificati on of this emerging pathogen at a cancer center in 1998 and 1999. Twenty-tw o isolates were recovered from 16 patients with solid-organ or hematologic malignancies or acquired immunodeficiency syndrome. Two patients with cance r had invasive infection, and 14 were colonized with fungus or had superfic ial fungal infection. All isolates produced germ tubes and chlamydospores a t 37 degreesC, did not grow at 45 degreesC, and gave negative reactions wit h D-xylose and alpha -methyl-D-glucoside in the API 20 C AUX and ID 32 C ye ast identification systems. Phenotypic identification was confirmed by mole cular beacon probe technology. All isolates were susceptible to the antifun gal drugs amphotericin B, 5-fluorocytosine, fluconazole, itraconazole, and ketoconazole.