Candida Kefyr

Pathogenicity

Candida kefyr, from the Candida species, has emerged to be a very opportunistic pathogen. It has proven to be so in subjects affected with Hematologic malignancies. A retrospective study on the epidemiology of Candida kefyr was conducted within a time span of 6 years (2004-2010) in the John Hopkins Hospital. Upon observation it was found that 83 of the patients under invigilation were infected with C. kefyr and 9.6% of them had invasive Candidiasis. Over the course of this study, it was found that the incidences of infection caused by this pathogen had increased rapidly. In 2010 alone, C. kefyr was held responsible for being the cause of 16.7% Candidiasis. Especially during the summers patients suffering from myelogenic leukemia, who underwent induction chemotherapy, were found to be at a greater risk for infection from C. kefyr. This condition was absolved with administration of Azole and/or amphotericin B.

 

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Effect of Candidiasis in Neonates Caused by Candida Kefyr

Recent findings link the overuse of antibiotics to the systemic infections caused by Candida in neonates. Term babies with underlying problems associated with the GIT or urinary tract are known to be more at risk for being infected by Candida. A particular case of a neonate who was detected to have vesico-ureteral-reflex grade V, underwent surgery and later developed urosepsis. A urine analysis revealed the presence of Candida kefyr colonization. As previously sufficient data was unavailable about this species of Candida, the neonate was initially treated with liposomal amphotericin B. with further investigation through antibiogram, liposomal amphotericin B was replaced by fluconazole. Although it didn’t benefit the neonate initially even after switching to fluconazole, it did take further treatment and complete recovery was observed after a period of 3 months under treatment with systemic fluconazole.

This case report was evident in suggesting that it is of great importance that we come across the pathogenicity and the sensitivities related with the non albicans species of Candida, as without sufficient evidence and data of the particular species of Candida might and will pose a threat in treating patients with co-occurring diseases or disorders.

 

Below is a Picture of Candida Kefyr under Microscope:

Candida Kefyr under Microscope
Candida Kefyr under Microscope
 

Role of Candida kefyr as a pathogen in Neutropenic Leukemia Patients suffering from nosocomial bloodstream infections:



Patients undergoing stem cell transplantation or the ones having hematological malignancies are prone to get infected by Candida kefyr. This type of infection often leads to Nosocomial Candidemia. In this particular case three different patients suffering from neutropenic leukemia were kept under observation. The Bactec 9240 system along with ID32C- a yeast identification system besides having isolates from gram, stained cultures were used to identify the infections caused by Candida kefyr. The first two patients were recorded to have developed fever after being administered the chemotherapy. In both the cases, presence of C. kefyr was detected, in 3 different blood cultures for patient one and 2 in case of the second patient. In patient one, it was from the mouth washings and the central venous catheter. Hepatic lesions were observed in the second patient while the first one had pulmonary infiltrates. Upon treatment with capsofungin and amphotericin B for the second and the first patient respectively, the blood culture results came back negative.

In case of the third patient fever was a common effect, and the presence of C. kefyr was detected in 2 mouth washings, blood cultures, on the central venous catheter and 3 specimens of stool. The patient was also found to have Candida arthritis. Treatment with fluconazole and amphotericin B was brought in to effect immediately but even with hematopoietic regeneration, the persistence of Candidemia was still observed. Right after that liposomal amphotericin B, fluconazole, nystatin and capsofungin was administered and the patient recovered soon. All three patients recovered only after the problem with leukopenia was resolved.

This case study shows that C. kefyr can be expected to have quite an effect on patients with neutropenic leukemia, and have been found in invasive devices and blood cultures. The patients got the chance to fully recover once the leukopenia was dealt with, so it is fair to say, that the co-occurring disease had to be treated with proper care taken, to check the colonization of Candida kefyr.

 

Candida Kefyr as a causal agent of Pneumonia in pediatric patients

A 13 year old male patient was admitted for suffering from hepatosplenomegaly and respiratory distress. The patient had suffered from 2 episodes of hemoptysis as well as shortness of breath for 3 months. Upon further investigation starting from sputum sample collection, a 10% KOH smear test, gram stain test, the presence of C. kefyr was detected. Upon treatment with fluconazole, the patient recovered from respiratory distress and no other episode of hemoptysis was witnessed.

This report concluded that C. kefyr is suspected to act as a pathogen in causing pneumonia in patients with hematological malignancies and further studies on its pathogenicity is crucial to detect its effects correctly for better treatment.

 

References:

– Epidemiology of Candida kefyr – Journal of Clinical Microbiology – 2014 – By Simon F. Dufresne, Kieren A. Marr and Emily Sydnor
http://jcm.asm.org/content/52/6/1830.full
 
– Candidiasis caused by Candida kefyr– BMC Infectious Diseases Journal Impact – 2012 – By Stefan Weichert, Konrad Reinshagen and Katrin Zahn
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3342153/
 
– Candida kefyr as an Emerging Pathogen – Clinical Infectious Diseases Journal – 2005 – By Christoph W. M. Reuter , Michael A. Morgan and Franz-Christoph Bange
http://cid.oxfordjournals.org/content/41/9/1365.full
 
– Pneumonia caused by Candida kefyr – International Research Journal of Medical Sciences – 2013 – By Dinkar A, Bhattacharyya S and Kumar D
http://www.isca.in/MEDI_SCI/Archive/v1/i1/4.ISCA-IRJMedS-2013-002.pdf
 
– The Yeasts: A Taxonomic Study
Book by: Cletus Kurtzman and ‎J.W. Fell and ‎Teun Boekhout – Published: 2011
 
– Mosby’s Dictionary of Medicine
Book by: Mosby – Published: 2016
 
– Catalogue of Yeasts
Book by: S. C. Jong and ‎M. J. Edwards – Published: 1990
 

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