Case Report
A 40-day-old girl candidate for heart surgery was admitted to Children’s
Medical Center in Tehran, Iran after diagnosis of congenital heart
disease. She was treated with some related medicines and also
sulfacetamide sodium ophthalmic solution in order to prevention and
treatment of bacterial eye infections such as conjunctivitis. At the
twelfth day of surgery and admitting in CICU, presented a discharge from
left eye. Physical examination showed an eyelid swelling and
erythematous conjunctiva with mucopurulent discharge from the left eye.
Microbiological investigations were performed by culturing of purulent
ocular discharge on blood agar, MacConkey agar and sabouraud dextrose
agar (SDA), which yielded yeast in pure cultures and were reported asCandida sp. by performing the germ tube test (Reynolds-Braude
Phenomenon). These isolates were subsequently cultured on CHROMagar
Candida medium for purification and primary identification, and
identified as C. parapsilosis . Also, the PCR-restriction fragment
length polymorphism (PCR-RFLP) assay was described for rapid
confirmation of identification.
DNA of yeast isolate was extracted using the boiling method (8).
Briefly, three-four colonies of overnight culture were transferred to a
1.5 ml tube containing 50 μl of sterile distilled water and placed in
boiling water for 20 min, centrifuged for 10 min at 5000 r.p.m., and the
supernatant was transferred to a new microtube and used as DNA template.
and the ITS1-5.8S-ITS2 region was PCR-amplified (9). The PCR product was
sequenced, and based on the sequence queries in the NCBI and ISHAM
barcoding databases, the isolate was identified as Candidametapsilosis . In vitro susceptibility of the isolate to
amphotericin B, fluconazole, Itraconazole, voriconazole, clotrimazole,
nystatin, terbinafine, 5-fluorocytosine, caspofungin, anidulafungin and
micafungin was tested according to M27-A3 standard approach of clinical
and laboratory standards institute (CLSI) (10), and the minimum
inhibitory concentrations were 0.5, 2, 0.125, 0.015, 0.015, 1, 0.015,
0.063, 0.125, 8 and 8 μg/mL, respectively.
Written informed consent was obtained from the next of kin of the
patient for the publication of any data included in this article.