Review of Candida dubliniensis at a Pediatric Hospital

Abstract

Background:Candida dubliniensis is a worldwide fungal opportunistic pathogen, closely related to C. albicans. Originally identified in patients infected with HIV in Dublin, Ireland, C. dubliniensis has emerged as a pathogen in other immunocompromised individuals, including patients receiving chemotherapy and transplant recipients. Pediatric epidemiological data for this organism are limited. Methods: We report a descriptive review of C. dubliniensis isolates recovered between January 2018 and June 2019 at a large tertiary-care pediatric institution in Columbus, Ohio. Results:C. dubliniensis was identified in 48 patients in the 18-month review period. In total, 67 positive cultures were collected in these patients with the following distribution of sources: 44 sputum (66%), 11 bronchoalveloar lavage fluid (16%), 4 blood (6%), 3 wounds (4%), 2 esophageal (3%), 2 peritoneal fluid (3%), and 1 vaginal (1%). Of the 48 patients in whom C. dubliniensis was identified, 35 (73%) were patients with cystic fibrosis. Also, 8 patients (17%) were considered to have clinical infections and received antifungal therapy: 3 patients with pneumonia, 2 patients with esophagitis, 1 patient with peritonitis, 1 patient with catheter-related bloodstream infection, and 1 patient with disseminated candidiasis. The remaining 40 patients (83%) were considered colonized. Conclusions: We report a descriptive series over 18 months of clinical isolates with C. dubliniensis recovery at a pediatric institution. Most isolates were identified as colonizing strains in patients with cystic fibrosis. C. dubliniensis was a rare cause of invasive disease in our institution, with only 8 cases identified.

Funding: None

Disclosures: None