A peritoneal-dialysis peritonitis case involved Blastobotrys adeninivorans, initially called Candida ciferrii by VITEK-2 and MALDI-TOF. Persistent inflammation and culture positivity prompted multilocus sequencing. High MICs were observed across antifungal classes, but validated breakpoints do not exist. Resolution followed catheter removal and transition to haemodialysis.
Key findings
- Automated platforms reported Candida ciferrii, whereas sequencing confirmed B. adeninivorans. MICs were markedly elevated for amphotericin B, azoles and echinocandins. Inflammation resolved after PD catheter removal and haemodialysis transition, but MIC interpretation is uncertain without species-specific breakpoints.
Why this matters globally
Rare yeasts increasingly emerge in device-associated infections worldwide. The case highlights database limits in routine identification and the value of reference molecular networks.
Thai researcher contribution
Songkhla Rajabhat University, Chulalongkorn University, Thai Red Cross and King Chulalongkorn Memorial Hospital teams linked molecular mycology with dialysis care.
Limitations to consider
One case cannot estimate incidence or best management. Without validated breakpoints, resistance labels remain tentative. Multiple simultaneous changes prevent separating drug from catheter-removal effects, and the report is not individual treatment advice.