A RARE FUNGAL INFECTION: REPORT OF 17 SAPROCHAETE CAPITATA CASES

Serkan Aydemir^{1, *}, Sümeyye Karabıyık¹, Çiğdem Arabacı², Aysun Kaya³, Funda Şimşek¹, Mustafa Taner Yıldırmak¹

¹Department of Infectious Diseases and Clinical Microbiology, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul - ²Department of Medical Microbiology, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul - ³Department of Medical Microbiology, University of Health Sciences Hamidiye Faculty of  Medicine, Istanbul, Turkey

Introduction: Saprochaete capitata is a rare cause of invasive fungal infection. Patients with hematological malignancies and those with severe neutropenia are at high risk. It has been generally reported as case reports or small case series in the literature. Here, we report 17 cases of Saprochaete capitata infection detected in our center over a five-year period.

Materials and Methods: Culture results were evaluated retrospectively between 2014 and 2019. Blood samples were cultured in BACTEC 9240 (Becton Dickinson, Diagnostic Instrument System, Sparks, USA) fully automated blood culture system. Yeast colonies were identified as Saprochaete capitata by Phoenix™-100 (Becton Dickinson, Diagnostic Instrument System, Sparks, USA) automated system. Antifungal susceptibility of isolates was evaluated by colorimetric microdilution using Sensititre Yeast One Panel (TREK Diagnostic Systems, USA). 

Results: The most common isolated sites were blood culture (n=7) and urine culture (n=7). 11 patients had a history of underlying malignancy, while six patients did not have any immunosuppression. Eight patients were neutropenic at diagnosis. The median neutrophil count was 57/mm3 (0-550) and the median duration of neutropenia was 25.5 days (14-43). Voriconazole or amphotericin B were the first choices in the treatment. 13 patients died during the follow-up. In six of them (35.3%) the main cause of death was attributed to S.capitata.

Conclusion: There has been an increase in the number of S.capitata infections in recent years. It has been reported mainly from Mediterranean countries, including Turkey. Recommendations as to appropriate treatment regimens and breakpoints for antifungal agents are unclear. Voriconazole or amphotericin B alone or in combination seems to be effective. Further studies are warranted in order to contribute to the management of the infection.