Candida glabrataEsophagitis: Are We Seeing the Emergence of a New Azole-Resistant Pathogen?

Abstract

Background.Candida glabrata(C. glabrata) has become a recognized pathogen in fungal esophagitis. A proportion of these isolates are azole-resistant which may have treatment implications. Variability in the prevalence of this organism exists in the limited data available.Objective. To determine the incidence ofC. glabrataesophagitis in a North American hospital setting and to highlight factors that may predispose patients to this condition.Methods. Patient charts were collected from January 1, 2009 to July 30, 2011. Any charts of patients identified as having esophagitis with a positive fungal culture were reviewed for the species ofCandidaand the presence of factors that would predispose them to esophageal candidiasis.Results. The prevalence ofCandidaesophagitis based on culture was 2.2% (37 subjects).C. glabratawas the 2nd most prevalent pathogen identified (24.3% or 9 subjects). Of theC. glabratacohort, all patients had at least one factor predisposing them to candidiasis.Conclusion.C. glabrataesophagitis makes up a large portion of the candidal esophagitis seen in hospital.C. glabratainfections were associated with at least one risk factor for candidal infection. Given its resistance to azole-based therapy, this may have treatment implications for how candidal esophagitis is approached by the clinician.