Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Letter to the Editor
  • Published:

Candida kefyr fungal enteritis following autologous BMT

Bone Marrow Transplantation volume 47, pages 465–466 (2012)Cite this article

Candida kefyr, previously known as Candida pseudotropicalis, is an opportunistic species that can be isolated from dairy products, and most commonly results in superficial rather than systemic infections in humans.1 More recently, it has been identified as a pathogen causing oesophagitis as well as disseminated infections in the immunosuppressed, where it has been isolated from blood cultures.2, 3, 4 We report C. kefyr as the causative pathogen in a case of fungal enteritis, diagnosed both by histology and nucleic acid sequencing, and describe its possible emerging role as a pathogen in patients with haematological malignancies.

In the absence of unfixed specimens, DNA was extracted from formalin-fixed jejunal tissue using previously published TaKaRa DEXPAT method (TaKaRa, Madison, WI, USA).5 Amplification and sequencing of the 18S ribosomal RNA gene was performed using pan-fungal primers described by Einsele et al.6 The PCR of 18S ribosomal RNA resulted in a 429-bp fragment, which was compared against sequences in the GenBank database. The fragment shared 100% sequence homology with Kluyveromyces marxianus (teleomorph of C. kefyr) partial 18S ribosomal RNA gene (E-value=0.0, indicating a highly statistically significant species identification).

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

References

  1. Valderrama MJ, de Siloniz MI, Gonzalo P, Peinado JM . A differential medium for the isolation of Kluyveromyces marxianus and Kluyveromyces lactis from dairy products. J Food Prot 1999; 62: 189–193.

    Article  CAS  Google Scholar 

  2. Listemann H, Schulz KD, Wasmuth R, Begemann F, Meigel W . Oesophagitis caused by Candida kefyr. Mycoses 1998; 41: 343–344.

    Article  CAS  Google Scholar 

  3. Peter Z, Zala J, Szabo O, Telegdy L, Horvath Z, Makara M et al. Fungal colonization of the esophagus in alcoholic liver disease. Z Gastroenterol 2000; 38: 821–825.

    Article  CAS  Google Scholar 

  4. Reuter CW, Morgan MA, Bange FC, Gunzer F, Eder M, Hertenstein B et al. Candida kefyr as an emerging pathogen causing nosocomial bloodstream infections in neutropenic leukemia patients. Clin Infect Dis 2005; 41: 1365–1366.

    Article  Google Scholar 

  5. Paterson PJ, Seaton S, McLaughlin J, Kibbler CC . Development of molecular methods for the identification of Aspergillus and emerging moulds in paraffin wax embedded tissue sections. Mol Pathol 2003; 56: 368–370.

    Article  CAS  Google Scholar 

  6. Einsele H, Hebart H, Roller G, Loffler J, Rothenhofer I, Muller CA et al. Detection and identification of fungal pathogens in blood by using molecular probes. J Clin Microbiol 1997; 35: 1353–1360.

    CAS  PubMed  PubMed Central  Google Scholar 

  7. Richardson M, Lass-Florl C . Changing epidemiology of systemic fungal infections. Clin Microbiol Infect 2008; 14 (Suppl 4): 5–24.

    Article  Google Scholar 

  8. Sendid B, Lacroix C, Bougnoux ME . Is Candida kefyr an emerging pathogen in patients with oncohematological diseases? Clin Infect Dis 2006; 43: 666–667.

    Article  Google Scholar 

  9. Ozcelik B, Kaynak F, Cesur S, Sipahi B, Sultan N . In vitro activities of voriconazole as a triazole derivative and caspofungin as an echinocandin were compared with those of some antifungal agents against Candida species isolated from clinical specimens. Jpn J Infect Dis 2007; 60: 302–304.

    CAS  PubMed  Google Scholar 

  10. Pfaller MA, Diekema DJ, Messer SA, Boyken L, Hollis RJ, Jones RN . In vitro activities of voriconazole, posaconazole, and four licensed systemic antifungal agents against Candida species infrequently isolated from blood. J Clin Microbiol 2003; 41: 78–83.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

We would like to thank Dr Darius Armstrong-James and Dr Michael Petrou (Hammersmith Hospital, Department of Infectious Disease and Immunity) for reviewing the fungal morphology from the histological specimens. We also thank Rebecca Gorton (Royal Free Hospital, Department of Microbiology) who kindly extracted fungal DNA from the histological specimens.

Author information

Authors and Affiliations

  1. Department of Haematology, UCLH NHS Foundation Trust, London, UK

    S Direkze, M Mansour & K S Peggs

  2. Department of Histopathology, UCLH NHS Foundation Trust, London, UK

    M Rodriguez-Justo

  3. Department of Immunity and Infection, Royal Free Hospital, London, UK

    C Kibbler & V Gant

Authors
  1. S Direkze
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M Mansour
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M Rodriguez-Justo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. C Kibbler
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. V Gant
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. K S Peggs
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S Direkze.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Direkze, S., Mansour, M., Rodriguez-Justo, M. et al. Candida kefyr fungal enteritis following autologous BMT. Bone Marrow Transplant 47, 465–466 (2012). https://doi.org/10.1038/bmt.2011.112

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/bmt.2011.112

This article is cited by

Search

Advanced search

Quick links