First identification of Candida dubliniensis in the Brest University Hospital (France)

Results of a six month survey. Since the discovery of Candida dubliniensis, this species has been found in many countries and especially in the oral c avities of human immunodeficiency virus-infected individuals. One hundred a nd ninety-six hospitalized patients have been included in a prospective sur vey which was conducted in the Brest University Hospital from January until June 2000 and 419 samples, of which 200 from the 121 immunodeficiency viru s-infected individuals, were analyzed. Samples were spread on CHROMagar Can dida((R)) and Sabouraud dextrose agar and incubated at 37 degreesC and 45 d egreesC. An electrophoretic karyotyping was performed on strains which had not grown at 45 degreesC and presented a green color on CHROMagar Candida(( R)). The strains, which presented at least 8 chromosome-sized bands with at least one band less than 1 Mb in size, were suspected to be C. dubliniensi s and therefore further analyzed. Chlamydospore production was tested on RA T((R)) and Staib's agar media and the substrate assimilation profiles were determined by using the API20C AUX((R)) and ID 32C((R)) strips and the ID-Y ST card of the VITEK2 system((R)). Finally a hybridation technique was used . Four hundred and nineteen yeasts were isolated from the 419 samples. But while 70 of these 419 yeasts did not grow at 45 degreesC and presented a gr een color on CHROMagar Candida((R)) only 8 had an electrophoretic pattern w hich could tally with C. dublinensis: eight chromosome-sized bands with at least one band less than 1 Mb in size by pulse field electrophoresis. These 8 strains produced chlamydospores on RAT medium((R)), but only 4 C, dublin ensis strains were confirmed (2% of the 196 patients) which represents 3.3% of the 121 immunodeficiency virus-infected patients. While the presence of C. dublinensis has demonstrated its low prevalence in our study, this can be explained by the methodology we followed. Therefore to enhance the isola tion of this species in daily laboratory practice, Staib's agar and the ID 32C((R)) strips or the VITEK 2((R)) should be recommended.