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.