Epidemiology of Candida dubliniensis in Central Kentucky
C. dubliniensis is an uncommon Candida species first identified as causing candidiasis in HIV patients and later found in the oral cavities of patients with diabetes mellitus and cystic fibrosis. During the validation of the Bruker MALDI-TOF system at a tertiary care hospital in Central Kentucky, a more than 5-fold increase in the number of C. dubliniensis isolates was noted. Since little is known of the epidemiology of this yeast in the US, this epidemiologic study was initiated.
This was an IRB approved, retrospective chart review study. This study included all of the patients from whom Candidaspecies were isolated from clinical specimens over a one-year period (Jan - Dec 2012). Data were also collected using a SUNQUEST Epi report to determine the base-line prevalence of yeasts for 2009 and 2011.
Candida species were isolated from a total of 2039 patients from Jan- -Dec 2012. C. dubliniensis was isolated from 56 patients in 2012, compared to only 9 and 11 patients during 2009 and 2011 respectively. The majority (79%) of 2012 isolates of C. dubliniensiswas isolated from oral/respiratory specimens with 7% being cultured from urine, 5% from stool, 5% from blood and 4% from other specimen types.
In contrast, C. albicanswas isolated from 1129 patients, representing the predominant yeast for 2012. Forty-five percent were cultured from oral/respiratory sources, 27% from urine, 7% from stool, 3% from blood and 18 % from other specimen types.
During 2012, the distribution of Candida species isolated from clinical specimens was 55% C. albicans, 25% C. glabrata, 8% C. tropicalis, 9% other yeast with C. dubliniensisrepresenting less than 3% of all yeast isolates detected.
C. dubliniensis is more likely to be associated with specimens collected through the mouth (oral/respiratory tract) when compared with C. albicans (p<0.001) and may reflect colonization rather than disease. Although the prevalence of C. dubliniensis was only 2.7% , this amounted to a 5-fold increase in the number of isolates detected This is likely reflective of improved screening and diagnostic accuracy of the MALDI-TOF instrument during the 2012 validation period, rather than an actual emergence of the organism in Central Kentucky.
G. Caldwell, None
C. Mcdonald, None
J. Ribes, None