656. Yarrowia lipolytica as Normal Human Flora: a Case Series of 24 Patients with Positive Cultures and No Attributable Disease
Session: Abstracts: Mycology
Friday, October 22, 2010
Background:

Yarrowia lipolytica, previously named Candida lipolytica, is a dimorphic yeast that has been reported as a human colonizer and weak human pathogen.  Most clinical reports involve catheter associated fungemia which clears with removal of the catheter alone, or without catheter removal and addition of intravenous amphotericin B.  No fatalities or poor outcomes have been associated with infection by this organism.  Colonization has been previously noted in samples from the oral cavity, lung, and vagina. 

Methods:

We cultured Y. lipolytica from laboratory specimens of 24 patients over a 10 year period.  We send all surgical specimens for culture and report speciation of yeast when possible, which may explain the frequency of isolates seen at our institution. 

Results:

Seventeen of the 24 patients grew Y. lipolytica from lung tissue after resection of a lung mass suspicious for malignancy.  Only two of these specimens were positive for malignancy and the majority of samples grew additional bacterial isolates.  Other specimens that grew Y. lipolytica included a stool sample, duodenal mass, breast tissue, a mesenteric mass, and two cutaneous nodules.  Only one bronchoalveolar lavage sample grew the organism, and it did not grow from sputum.  None of our 24 patients were found to have associated fungemia.  No patients had evidence that Y. lipolytica was responsible for active disease, and no patients with positive cultures developed disease from Y. lipolytica during their hospitalization.  Antifungal therapy was not initiated for any of these positive cultures.

Conclusion:

These findings suggest that Y. lipolytica should be considered normal human flora, especially of the adult respiratory tract.  Given its prevalence in distal lung tissue, rather than more proximal sputum specimens or bronchoalveolar lavage, the organism may be present as a distal airway saprophyte with little clinical significance.  Clinicians should recognize the benign nature of this organism and formulate their treatment strategies accordingly.   


Subject Category: M. Mycology including clinical and basic studies of fungal infections

Speakers:
Rachel Franck, MD , Infectious Disease, University of South Florida, Tampa, FL
Aliyah Baluch, MD , University of South Florida, Tampa, FL
Ramon Sandin, MD , Hematopathology and Laboratory Medicine, Moffitt Cancer Center, Tampa, FL
John Greene, MD , Infectious Disease, Moffitt Cancer Center, Tampa, FL

Disclosures:

R. Franck, None

A. Baluch, None

R. Sandin, None

J. Greene, None

See more of: Mycology
See more of: Abstracts

Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 21 with the exception of research findings presented at IDSA press conferences.

 
 
   
 

Copyright IDSA 2009 Infectious Diseases Society of America 1300 Wilson Boulevard, Suite 300 Arlington, VA 22209 info@idsociety.org