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Anh DN, Hung DN, Tien TV, Dinh VN, Son VT, Luong NV, Van NT, Quynh NTN, Van Tuan N, Tuan LQ, Bac ND, Luc NK, Anh LT, Trung DM. Prevalence, species distribution and antifungal susceptibility of Candida albicans causing vaginal discharge among symptomatic non-pregnant women of reproductive age at a tertiary care hospital, Vietnam. BMC Infect Dis 2021; 21:523. [PMID: 34082699 PMCID: PMC8176683 DOI: 10.1186/s12879-021-06192-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 05/13/2021] [Indexed: 12/13/2022] Open
Abstract
Background Vaginal candidiasis is frequent in women of reproductive age. Accurate identification Candida provides helpful information for successful therapy and epidemiology study; however, there are very limited data from the Vietnam have been reported. This study was performed to determine the prevalence, species distribution of yeast causing vaginal discharge and antifungal susceptibility patterns of Candida albicans among symptomatic non-pregnant women of reproductive age. Methods Vaginal discharge samples were collected from 462 women of reproductive age in Hanoi, Vietnam between Sep 2019 and Oct 2020. Vaginal swabs from these patients were examined by direct microscopic examination (10% KOH). CHROMagar™ Candida medium and Sabouraud dextrose agar supplemented with chloramphenicol (0.5 g/l) were used to isolate yeast, and species identification was performed using morphological tests and molecular tools (PCR and sequencing). Antifungal susceptibility testing was determined according to the Clinical and Laboratory Standards Institute guidelines (M27-A3 and M27-S4). Results The prevalence of vaginal yeast colonization in non-pregnant women was 51.3% of 462 participants. Nine different yeast species were identified. Among these isolates, C. albicans (51.37%) was the most frequent, followed by C. parapsilosis (25.88%), C. glabrata (11.37%), C. tropicalis (4.31%), C. krusei (3.92%), C. africana (1.57%), Saccharomyces cerevisiae (0.78%), C. nivariensis (1 isolates, 0.39%), and C. lusitaniae (1 isolates, 0.39%), respectively. Among C. albicans, all 46 isolates were 100% susceptible to micafungin, caspofungin, and miconazole. The susceptibility rates to amphotericine B, 5-flucytosine, fluconazole, itraconazole and voriconazole were 95.65, 91.30, 91.30, 82.61 and 86.95%, respectively. Conclusions The prevalence of VVC among symptomatic non-pregnant women of reproductive age in Vietnam was higher than many parts of the world. The high frequency of non-albicans Candida species, which were often more resistant to antifungal agents, was a notable feature. Resistance rates of vaginal C. albicans isolates to antifungal agents was low. Our findings suggest that continued surveillance of changes in species distribution and susceptibility to antifungals should be routinely screened and treated. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06192-7.
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Affiliation(s)
- Do Ngoc Anh
- Department of Medical Parasitology, Vietnam Military Medical University, Hanoi, Vietnam. .,Laboratory of Parasitology and Medical Mycology, 103 Military Hospital, Hanoi, Vietnam.
| | - Dao Nguyen Hung
- 103 Military Hospital, Vietnam Military Medical University, Hanoi, Vietnam
| | - Tran Viet Tien
- 103 Military Hospital, Vietnam Military Medical University, Hanoi, Vietnam
| | - Vu Nhat Dinh
- 103 Military Hospital, Vietnam Military Medical University, Hanoi, Vietnam
| | - Vu Tung Son
- Department of Epidemiology, Vietnam Military Medical University, Hanoi, Vietnam
| | | | - Nguyen Thi Van
- Laboratory of Parasitology and Medical Mycology, 103 Military Hospital, Hanoi, Vietnam
| | - Nguyen Thi Nhu Quynh
- Department of Medical Parasitology, Vietnam Military Medical University, Hanoi, Vietnam
| | - Nguyen Van Tuan
- Department of Medical Parasitology, Vietnam Military Medical University, Hanoi, Vietnam
| | - Le Quoc Tuan
- Department of Medical Parasitology, Vietnam Military Medical University, Hanoi, Vietnam.,Laboratory of Parasitology and Medical Mycology, 103 Military Hospital, Hanoi, Vietnam
| | - Nguyen Duy Bac
- Institute of Biomedicine and Pharmacy, Vietnam Military Medical University, Hanoi, Vietnam
| | - Nguyen Khac Luc
- Department of Medical Parasitology, Vietnam Military Medical University, Hanoi, Vietnam.,Laboratory of Parasitology and Medical Mycology, 103 Military Hospital, Hanoi, Vietnam
| | - Le Tran Anh
- Department of Medical Parasitology, Vietnam Military Medical University, Hanoi, Vietnam.,Laboratory of Parasitology and Medical Mycology, 103 Military Hospital, Hanoi, Vietnam
| | - Do Minh Trung
- Institute of Biomedicine and Pharmacy, Vietnam Military Medical University, Hanoi, Vietnam.
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Isolation of Different Species of Candida in Patients with Vulvovaginal Candidiasis from Damavand, Iran. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2018. [DOI: 10.5812/archcid.59291] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Safavieh M, Coarsey C, Esiobu N, Memic A, Vyas JM, Shafiee H, Asghar W. Advances in Candida detection platforms for clinical and point-of-care applications. Crit Rev Biotechnol 2017; 37:441-458. [PMID: 27093473 PMCID: PMC5083221 DOI: 10.3109/07388551.2016.1167667] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Invasive candidiasis remains one of the most serious community and healthcare-acquired infections worldwide. Conventional Candida detection methods based on blood and plate culture are time-consuming and require at least 2-4 days to identify various Candida species. Despite considerable advances for candidiasis detection, the development of simple, compact and portable point-of-care diagnostics for rapid and precise testing that automatically performs cell lysis, nucleic acid extraction, purification and detection still remains a challenge. Here, we systematically review most prominent conventional and nonconventional techniques for the detection of various Candida species, including Candida staining, blood culture, serological testing and nucleic acid-based analysis. We also discuss the most advanced lab on a chip devices for candida detection.
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Affiliation(s)
- Mohammadali Safavieh
- Division of Biomedical Engineering, Division of Renal medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Cambridge, MA, USA
| | - Chad Coarsey
- Department of Computer Engineering and Electrical Engineering and Computer Science, Florida Atlantic University, Boca Raton, FL, USA
- College of Engineering and Computer Science, Asghar-Lab, Micro and Nanotechnologies for Medicine, Boca Raton, FL, USA
| | - Nwadiuto Esiobu
- Biological Sciences Department, Florida Atlantic University, Davie, FL, USA
| | - Adnan Memic
- Center of Nanotechnology, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Jatin Mahesh Vyas
- Department of Medicine, Division of Infectious Disease, Massachusetts General Hospital, Boston, MA, USA
| | - Hadi Shafiee
- Division of Biomedical Engineering, Division of Renal medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Cambridge, MA, USA
| | - Waseem Asghar
- Department of Computer Engineering and Electrical Engineering and Computer Science, Florida Atlantic University, Boca Raton, FL, USA
- College of Engineering and Computer Science, Asghar-Lab, Micro and Nanotechnologies for Medicine, Boca Raton, FL, USA
- Biological Sciences Department, Florida Atlantic University, Davie, FL, USA
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Radic M, Goic-Barisic I, Novak A, Rubic Z, Tonkic M. Evaluation of PNA FISH® Yeast Traffic Light in identification of Candida species from blood and non-blood culture specimens. Med Mycol 2016; 54:654-8. [PMID: 27067303 DOI: 10.1093/mmy/myw012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 02/24/2016] [Indexed: 01/25/2023] Open
Abstract
PNA FISH(®) (peptide nucleic acid fluorescent in situ hybridization) Yeast Traffic Light (PNA FISH(®) YTL) assay is a commercially avaliable method for rapid identification of Candida spp. directly from positive blood cultures. This report provides a one-year experience in identification of yeasts from 25 specimens (15 positive blood cultures and 10 other clinically significant specimens) using PNA FISH(®) YTL and comparing it to VITEK 2 System. Overall, assay identification compatibility with VITEK 2 System was found among 21/25 (84%) isolates tested. Only 3/25 (12%) of the isolates were not identified, and one isolate was misidentified by the PNA FISH(®) YTL assay. Our results show that the assay is a reliable method in identification of Candida spp. not only from blood cultures, but even from other clinically significant specimens (urine cultures, catheter tip cultures, peritoneal fluid cultures) when compared to automated method like VITEK 2 System. This novel application of the PNA FISH(®) YTL assay could therefore contribute to cost savings and significant benefit to patients, as rapid information about isolated yeast species is provided.
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Affiliation(s)
- Marina Radic
- Department of Clinical Microbiology, University Hospital Centre Split, Split, Croatia University of Split School of Medicine, Split, Croatia
| | - Ivana Goic-Barisic
- Department of Clinical Microbiology, University Hospital Centre Split, Split, Croatia University of Split School of Medicine, Split, Croatia
| | - Anita Novak
- Department of Clinical Microbiology, University Hospital Centre Split, Split, Croatia University of Split School of Medicine, Split, Croatia
| | - Zana Rubic
- Department of Clinical Microbiology, University Hospital Centre Split, Split, Croatia University of Split School of Medicine, Split, Croatia
| | - Marija Tonkic
- Department of Clinical Microbiology, University Hospital Centre Split, Split, Croatia University of Split School of Medicine, Split, Croatia
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Zhao L, de Hoog GS, Cornelissen A, Lyu Q, Mou L, Liu T, Cao Y, Vatanshenassan M, Kang Y. Prospective evaluation of the chromogenic medium CandiSelect 4 for differentiation and presumptive identification of non-Candida albicans Candida species. Fungal Biol 2015; 120:173-8. [PMID: 26781374 DOI: 10.1016/j.funbio.2015.09.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Revised: 09/10/2015] [Accepted: 09/21/2015] [Indexed: 11/15/2022]
Abstract
Rapid identification of pathogenic yeasts is a crucial step in timely and appropriate antifungal therapy. For diagnostics in the clinical laboratory, simplified alternatives to barcoding are needed. CandiSelect 4 (CS4) medium, a chromogenic medium for isolation of clinical yeasts, allows routine recognition of Candida albicans and presumptive identification of Candida tropicalis, Candida glabrata, and Candida krusei. We evaluated an extension of this method with 46 non-Candida albicans Candida (NCAC) and 7 Malassezia species. The medium supported growth of all species tested and a wide diversity of cultural types were observed. Colony colours were in violet, turquoise (including green and blue), or white tinges. Eight NCAC species produced violet pigmentation similar to that of C. albicans. Most NCAC species, including C. glabrata and C. tropicalis were distributed in the turquoise group. Malassezia species were invariably blue.
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Affiliation(s)
- Liang Zhao
- Department of Microbiology, Guizhou Medical University, 550004 Guiyang, China
| | - G Sybren de Hoog
- CBS-KNAW Fungal Biodiversity Centre, 3584 CT Utrecht, The Netherlands
| | - Akke Cornelissen
- CBS-KNAW Fungal Biodiversity Centre, 3584 CT Utrecht, The Netherlands
| | - Qian Lyu
- Department of Microbiology, Guizhou Medical University, 550004 Guiyang, China
| | - Lili Mou
- Department of Microbiology, Guizhou Medical University, 550004 Guiyang, China
| | - Taohua Liu
- Department of Microbiology, Guizhou Medical University, 550004 Guiyang, China
| | - Yu Cao
- Department of Microbiology, Guizhou Medical University, 550004 Guiyang, China
| | | | - Yingqian Kang
- Department of Microbiology, Guizhou Medical University, 550004 Guiyang, China; CBS-KNAW Fungal Biodiversity Centre, 3584 CT Utrecht, The Netherlands.
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Nerurkar V, Khan S, Kattungal S, Bhatia S. Identifying Candida and other yeast-like fungi: utility of an identification algorithm in resource limited setting. J Clin Diagn Res 2015; 8:DC01-4. [PMID: 25653943 DOI: 10.7860/jcdr/2014/9753.5259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Accepted: 09/10/2014] [Indexed: 11/24/2022]
Abstract
AIM The increasing recovery rates of unusual yeasts with innate drug resistance make accurate identification crucial for successful therapy and infection control measures. The current study was undertaken to study the utility of CHROMagar Candida (CC) and evaluate an identification algorithm, using germ tube test (GT), CC and a commercial identification kit, API ID 32C. SETTINGS AND DESIGN The prospective study was carried out at a private laboratory in Mumbai, India. MATERIALS AND METHODS Identification of 533 yeast and yeast like isolates was carried out using an identification algorithm, comprising of the GT, CC and API tests. RESULTS CC was useful to detect mixed cultures. We were able to identify 393/533, i.e. 73.7 % of isolates using GT and CC Tests only. This was because C. albicans and C. tropicalis, which can be reliably identified using CC, constituted 75.2 % of the isolates. We were unable to identify 140 isolates, i.e. 26.3 %, using GT and CC tests only and performed additional testing using API ID 32C. CC was not found to be reliable in identifying C. krusei. CONCLUSION The diverse identification profile obtained in our study substantiates the need for all diagnostic microbiology laboratories to be better prepared for identifying unusual yeasts. Though GT or CC testing cannot alone suffice for identification of all clinically encountered Candida and yeast-like fungi, use of GT, CC and automated identification systems in a step-wise algorithm can enable the same in a more cost effective manner.
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Affiliation(s)
- Vidya Nerurkar
- Section Head-Microbiology, EIA & Serology, SRL Ltd. , Mumbai, India
| | - Suveb Khan
- Senior Scientific Officer, SRL Ltd , Mumbai, India
| | | | - Simi Bhatia
- Laboratory Director, SRL Ltd . Mumbai, India
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Gopinathan S, Janagond AB, Agatha D, P.R. T. Detection of FUR1 Gene in 5-Flucytosine Resistant Candida Isolates in Vaginal Candidiasis Patients. J Clin Diagn Res 2013; 7:2452-5. [PMID: 24392370 PMCID: PMC3879835 DOI: 10.7860/jcdr/2013/6160.3574] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Accepted: 08/04/2013] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND AIMS This study was done to detect the prevalence, risk factors for vaginal candidiasis in Chennai and to evaluate different methods for speciation of Candida isolates from vaginal candidiasis patients. This study was also aimed at detecting resistance patterns of Candida spp to common antifungals and at detecting mutant FUR1 genes in 5-Flucytosine (5 FC) resistant isolates. MATERIAL AND METHODS Two hundred clinically suspected vaginal candidiasis patients were screened for candidiasis and isolated Candida were speciated by standard morphological and biochemical tests (sugar fermentation and assimilation) and by using CHROM agar-Candida medium. Antifungal susceptibility was performed by disk diffusion method (CLSI M44-A) using fluconazole, itraconazole and 5FC disks. Five FC resistant isolates were subjected to PCR for detection of mutant FUR1 genes. RESULTS A total of 72 (36%) Candida spp. were obtained. Vaginal candidiasis was more prevalent in 31-40 years age group and among those with poor genital hygiene and who wore tight fitting synthetic/nylon underclothes . C.albicans (35), C.tropicalis (8), C.glabrata (21), C.krusei (4) were identified by both carbohydrate assimilation test and by using CHROM agar-Candida medium. C.kefyr (2) and C.parapsilosis (2) could not be identified using CHROM agar-Candida. Resistance to fluconazole, itraconazole and 5-flucytosine was seen in 19.44%, 23.61% and 41.66% of the isolates respectively. Mutant FUR1 gene was detected in all the Candida spp that were resistant to 5FC. CONCLUSION C.albicans was the commonest species which caused vaginal candidiasis in Chennai. Though CHROM agar-candida medium is a useful differential isolation medium capable of early presumptive identification of Candida species, it could not identify C.kefyr and C.parapsilosis. Azole resistance was low in C. albicans but it was high in non-albicans Candida spp. Prevalence of primary resistance to 5-flucytosine was high in the strains studied and in all of them, it was mediated by mutant FUR1 gene.
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Affiliation(s)
- Sasikala Gopinathan
- Assistant Professor, Department of Microbiology, Vinayaka Missions Kirupananda Variyar Medical College, Seeragapadi, Salem- 636308, Tamilnadu, India
| | - Anand B. Janagond
- Assistant Professor, Department of Microbiology, Sri Muthukumaran Medical College and Research Institute, Chennai, Tamilnadu, India
| | - David Agatha
- Assistant Professor, Department of Microbiology, Madras Medical College, Chennai, Tamilnadu, India
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Ouanes A, Kouais A, Marouen S, Sahnoun M, Jemli B, Gargouri S. [Contribution of the chromogenic medium CHROMagar(®)Candida in mycological diagnosis of yeasts]. J Mycol Med 2013; 23:237-41. [PMID: 24161925 DOI: 10.1016/j.mycmed.2013.07.058] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Revised: 07/15/2013] [Accepted: 07/19/2013] [Indexed: 10/26/2022]
Abstract
The incidence of invasive candidiasis has increased dramatically over the last decades due to a larger number of patients at risk. The diagnosis remains difficult as the clinical presentation is not specific and the biological diagnosis usually takes several days to become positive. We propose in this work through a prospective study to evaluate the contribution of a chromogenic medium CHROMagar(®) (Becton-Dickinson) in the mycological diagnosis of Candida. We selected 680 samples from patients hospitalized in the intensive care unit for epidemiological surveillance over a period of 11 weeks. We treated samples by culture on Sabouraud and on CHROMagar(®). The species identification was performed by chlamydosporulation test and carbohydrate assimilation tests. We found that the CHROMagar(®)Candida evaluated in our work was a valuable tool in the primary culture in differentiating the most frequently isolated yeast species and in better detection of mixed cultures.
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Affiliation(s)
- A Ouanes
- Service de parasitologie-mycologie, hôpital militaire principal d'instruction de Tunis, 1008 Montfleury, Tunis, Tunisie.
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Iyampillai T, Michael JS, Mathai E, Mathews MS. Use of CHROMagar medium in the differentiation ofCandidaspecies: is it cost-effective in developing countries? ANNALS OF TROPICAL MEDICINE AND PARASITOLOGY 2013; 98:279-82. [PMID: 15119973 DOI: 10.1179/000349804225003244] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The opportunistic infection of humans with Candida is becoming more common. As several species of Candida are relatively insusceptible to the commonly used antifungal drugs, rapid identification of the species involved can facilitate effective treatment. CHROMagar Candida medium (CCM) is a commercial product designed to allow the rapid identification of Candida to species level. To explore the potential usefulness of CCM in a developing country, attempts were made to identify the Candida species in 107 Indian isolates (obtained, consecutively, from 90 clinical specimens, over a year-long period, in a tertiary-level teaching hospital), using CCM and more conventional methods in parallel. The most common species appeared to be C. tropicalis (representing 40% of the isolates), followed by C. albicans (28%) and C. glabrata (23%). Although use of CCM allowed the isolates from 84 (93.3%) of the clinical specimens to identified to species level within 48 h, it took at least 7 days to identify the yeasts in 90% of the specimens using the more conventional procedures. With the results of the conventional methods set as the 'gold standard', the use of CCM appeared to allow all of the C. albicans, C. tropicalis and C. krusei isolates and most (92%) of the C. glabrata to be correctly identified. The costs/isolate identified with the CCM were no more than those of the conventional methods. As many (67%) of the isolates examined were of potentially drug-resistant yeasts (C. tropicalis, C. glabrata or C. krusei), there is clearly a need to identify local isolates quickly, to prevent treatment with ineffective drugs. In terms of both performance and cost, CCM appears to be a good method to use.
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Affiliation(s)
- T Iyampillai
- Department of Microbiology, Christian Medical College and Hospital, Vellore 632004, India
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Jamali H, Chai LC, Thong KL. Detection and isolation of Listeria spp. and Listeria monocytogenes in ready-to-eat foods with various selective culture media. Food Control 2013. [DOI: 10.1016/j.foodcont.2012.11.033] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Mahmoudi Rad M, Zafarghandi S, Abbasabadi B, Tavallaee M. The epidemiology of Candida species associated with vulvovaginal candidiasis in an Iranian patient population. Eur J Obstet Gynecol Reprod Biol 2011; 155:199-203. [DOI: 10.1016/j.ejogrb.2010.11.022] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2010] [Revised: 09/21/2010] [Accepted: 11/30/2010] [Indexed: 01/31/2023]
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Guzel AB, Ilkit M, Akar T, Burgut R, Demir SC. Evaluation of risk factors in patients with vulvovaginal candidiasis and the value of chromID Candida agar versus CHROMagar Candida for recovery and presumptive identification of vaginal yeast species. Med Mycol 2011; 49:16-25. [DOI: 10.3109/13693786.2010.497972] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ozcan K, Ilkit M, Ates A, Turac-Bicer A, Demirhindi H. Performance of Chromogenic Candida agar and CHROMagar Candida in recovery and presumptive identification of monofungal and polyfungal vaginal isolates. Med Mycol 2010; 48:29-34. [PMID: 19191167 DOI: 10.3109/13693780802713224] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Chromogenic Candida agar (OCCA) is a novel medium facilitating isolation and identification of Candida albicans, C. tropicalis, and C. krusei, as well as indicating polyfungal population in clinical samples. We compare the performance of OCCA, to CHROMagar Candida (CAC) and Sabouraud chloramphenicol agar (SCA). Vaginal swab samples from 392 women were simultaneously inoculated onto three study media. A total of 161 (41.1%) were found to be positive for fungi of which 140 (87%) were monofungal, and 21 (13%) polyfungal. One-hundred and fifty-seven samples (97.5%) were positive on CAC, 156 (96.9%) on OCCA, 148 (91.9%) on SCA and 144 (89.4%) samples were positive on all three media. The yeasts were identified by conventional methods including germ tube test, microscopic morphology on cornmeal-Tween 80 agar, and the commercial API 20C AUX. The 182 isolates were C. albicans (n = 104), C. glabrata (n = 51), C. krusei (n = 7), C. tropicalis (n = 5), C. famata (n = 3), C. kefyr (n = 3), C. zeylanoides (n = 3), C. colliculosa (n = 2), and other species of Candida (n = 4). Among the 21 polyfungal populations, 20 (95.2%) were detected in OCCA, 14 (66.7%) in CAC, and 13 (61.9%) in CAC and OCCA (P <0.05). Most polyfungal populations (47.6%) yielded C. albicans + C. glabrata. The efficiency of both chromogenic media for C. albicans was >or=92.9% at 72 h. OCCA is more efficient and reliable for rapidly identifying C. albicans and polyfungal populations than CAC. However, CAC is more efficient for identifying C. krusei and C. tropicalis. A chromogenic agar with a higher isolation rate of yeasts and better detection of polyfungal populations than SCA, is suggested as a medium of first choice when available.
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Fast detection of Candida albicans and/or bacteria in blood plasma by “sample-self-focusing” using capillary electrophoresis-laser-induced fluorescence. J Pharm Biomed Anal 2010; 53:75-80. [DOI: 10.1016/j.jpba.2010.03.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2009] [Revised: 03/08/2010] [Accepted: 03/09/2010] [Indexed: 11/22/2022]
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Willinger B. Speziesdiagnostik: Von der Agarplatte zur Molekularbiologie. Mycoses 2010; 53 Suppl 1:19-25. [DOI: 10.1111/j.1439-0507.2009.01836.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Martins M, Henriques M, Ribeiro AP, Fernandes R, Gonçalves V, Seabra A, Azeredo J, Oliveira R. Oral Candida carriage of patients attending a dental clinic in Braga, Portugal. Rev Iberoam Micol 2010; 27:119-24. [PMID: 20403455 DOI: 10.1016/j.riam.2010.03.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2009] [Revised: 03/04/2010] [Accepted: 03/31/2010] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The ability of the Candida species to colonize surfaces can be considered as a risk factor for oral infection. AIMS To establish oral Candida carriage in patients attending a dental clinic in Braga, Portugal. METHODS A total of 97 patients were analysed. Swab samples were collected and directly cultured onto CHROMagar Candida. Representative yeasts were identified by polymerase chain reaction. RESULTS From the samples analysed 54.6% (n=53) were Candida positive, and Candida albicans was the most frequently isolated species, accounting for 79% of all the species identified. Non-C. albicans Candida (NCAC) species recovered included Candida parapsilosis, Candida glabrata, Candida tropicalis, and Candida guilliermondii. There was a lack of association between the presence of C. albicans or NCAC species, and age, gender, or prostheses wearing in this population. In 17% of the cases (n=9), polymicrobial cultures, with two different Candida species, were identified. CONCLUSIONS This study shows a high Candida carriage rate among this population, thus pointing to the relevance of an accurate diagnostic approach in Candida species identification.
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Affiliation(s)
- Margarida Martins
- Institute for Biotechnology and Bioengineering, Centre of Biological Engineering, Universidade do Minho, Braga, Portugal
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Nadeem SG, Hakim ST, Kazmi SU. Use of CHROMagar Candida for the presumptive identification of Candida species directly from clinical specimens in resource-limited settings. Libyan J Med 2010; 5. [PMID: 21483597 PMCID: PMC3071170 DOI: 10.3402/ljm.v5i0.2144] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2009] [Accepted: 01/01/2010] [Indexed: 11/28/2022] Open
Abstract
Introduction Identification of yeast isolated from clinical specimens to the species level has become increasingly important. Ever-increasing numbers of immuno-suppressed patients, a widening range of recognized pathogens, and the discovery of resistance to antifungal drugs are contributing factors to this necessity. Material and methods A total of 487 yeast strains were studied for the primary isolation and presumptive identification, directly from clinical specimen. Efficacy of CHROMagar Candida has been evaluated with conventional methods including morphology on Corn meal–tween 80 agar and biochemical methods by using API 20 C AUX. Results The result of this study shows that CHROMagar Candida can easily identify three species of Candida on the basis of colonial color and morphology, and accurately differentiate between them i.e. Candida albicans, Candida tropicalis, and Candida krusei. The specificity and sensitivity of CHROMagar Candida for C. albicans calculated as 99%, for C. tropicalis calculated as 98%, and C. krusei it is 100%. Conclusion The data presented supports the use of CHROMagar Candida for the rapid identification of Candida species directly from clinical specimens in resource-limited settings, which could be very helpful in developing appropriate therapeutic strategy and management of patients.
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Affiliation(s)
- Sayyada Ghufrana Nadeem
- Department of Microbiology, Mycology Research and Reference Institute, Jinnah University for Women, Karachi, Pakistan
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18
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KITASATO Y, TAO Y, HOSHINO T, TACHIBANA K, INOSHIMA N, YOSHIDA M, TAKATA S, OKABAYASHI K, KAWASAKI M, IWANAGA T, AIZAWA H. Comparison ofAspergillusgalactomannan antigen testing with a new cut-off index andAspergillusprecipitating antibody testing for the diagnosis of chronic pulmonary aspergillosis. Respirology 2009; 14:701-8. [DOI: 10.1111/j.1440-1843.2009.01548.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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19
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Leung KCM, McMillan AS, Cheung BPK, Leung WK. Sjögren's syndrome sufferers have increased oral yeast levels despite regular dental care. Oral Dis 2008; 14:163-73. [PMID: 18302677 DOI: 10.1111/j.1601-0825.2007.01368.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM To investigate the prevalence and quantity of oral yeasts and their association with oral candidiasis in Sjögren's syndrome (SS) patients receiving regular dental care. MATERIALS AND METHODS Yeasts in oral rinse and full-mouth supra-gingival plaque samples from 25 primary SS, 27 secondary SS and 29 control subjects were selectively cultured. All yeasts except single-species isolates were genotyped using pulsed field gel electrophoresis (PFGE). RESULTS Ten (19%) SS sufferers had symptomless candidiasis. SS subjects had a higher prevalence (73%vs 7%) and quantity of yeasts than controls in both oral rinse and plaque samples (P < 0.05). The prevalence of yeasts in plaque was associated with candidiasis regardless of denture wearing (P < or = 0.04). Candida albicans was the predominant yeast isolated. PFGE showed 20 (66% of total) C. albicans isolate pairs, i.e. C. albicans species isolated from plaque and oral rinse samples of the same individual, were of closely related genetic clonal types (P < 0.01). CONCLUSIONS Despite effective oral hygiene, more SS subjects than controls had detectable levels of oral yeasts and their presence in supra-gingival plaque was associated with candidiasis. Candida albicans colonized supra-gingival biofilm even in well-maintained SS individuals, posing a challenge to the control of oral candidiasis.
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Affiliation(s)
- K C M Leung
- Oral Rehabilitation, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
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20
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Baixench MT, Viguié C, Paugam A. Isolation of Candida dubliniensis in a French hospital mycology laboratory. J Med Microbiol 2008; 57:258-259. [DOI: 10.1099/jmm.0.47577-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- M. T. Baixench
- Laboratoire de Parasitologie-Mycologie, Hôpital Cochin, 75014 Paris, France
| | - C. Viguié
- Laboratoire de Parasitologie-Mycologie, Hôpital Cochin, 75014 Paris, France
| | - A. Paugam
- Laboratoire de Parasitologie-Mycologie, Hôpital Cochin, 75014 Paris, France
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21
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Willinger B. Trends und neue Entwicklungen in der Diagnostik von Pilzinfektionen. Wien Med Wochenschr 2007; 157:476-81. [DOI: 10.1007/s10354-007-0462-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2007] [Accepted: 07/03/2007] [Indexed: 10/22/2022]
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22
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Abstract
The focus of this review is the evolution of biochemical phenotypic yeast identification methods with emphasis on conventional approaches, rapid screening tests, chromogenic agars, comprehensive commercial methods, and the eventual migration to genotypic methods. As systemic yeast infections can be devastating and resistance is common in certain species, accurate identification to the species level is paramount for successful therapy and appropriate patient care.
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Affiliation(s)
- D H Pincus
- bioMérieux, Inc., Hazelwood, Missouri 63042, USA.
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23
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Xiang H, Xiong L, Liu X, Tu Z. Rapid simultaneous detection and identification of six species Candida using polymerase chain reaction and reverse line hybridization assay. J Microbiol Methods 2007; 69:282-7. [PMID: 17337309 DOI: 10.1016/j.mimet.2007.01.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2006] [Revised: 01/18/2007] [Accepted: 01/24/2007] [Indexed: 10/23/2022]
Abstract
The aim of this study was to develop and evaluate PCR based reverse line blot (RLB) hybridization assay for rapid detection of the most common Candida isolates from clinical specimens. A pair of universal primers targeting the ITS2 region of the gene from 28S rRNA to 5.8S rRNA was designed for PCR amplification of DNA from 6 Candida species (C. albicans, C. tropicalis, C. krusei, C. glabrata, C. parapsilosis, C. dubliniensis), the reverse primer was biotin labeled. PCR products, which were 302-441 bp length, were hybridized with 6 specific oligonucleotides probes immobilized on a nylon membrane. These 6 probes proved specific (they hybridized with only their target molecules). The assay was shown to be sensitive in detecting yeast to a concentration of 10 CFU/ml. This method was used to test 100 isolates and 200 vaginal swabs. The results agreed with those of culture for all but 3 of 100 isolates. Sequencing was performed on these 3 samples and confirmed that the culture results were inaccurate. Our results show the PCR-RLB positive rate (49%) is higher than culture (39%) and smear microscopic screening (27%) (P<0.05). In conclusion, the PCR/RLB developed in this study is specific and offers increased sensitivity compared to culture for the detection of Candida species in swab specimens. Moreover, the improved detection of cases of polycandidal candidiasis is advantageous.
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Affiliation(s)
- Huaguo Xiang
- Institute of Molecular Biology, Center for Preventive and Control of Sexually Transmitted Disease, Shenzhen Chronic Disease Hospital, 2021 Buxin Road, Shenzhen City, Guangdong Province, 518020 People's Republic of China
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24
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Eraso E, Moragues MD, Villar-Vidal M, Sahand IH, González-Gómez N, Pontón J, Quindós G. Evaluation of the new chromogenic medium Candida ID 2 for isolation and identification of Candida albicans and other medically important Candida species. J Clin Microbiol 2006; 44:3340-5. [PMID: 16954270 PMCID: PMC1594741 DOI: 10.1128/jcm.00213-06] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The usefulness of Candida ID 2 (CAID2) reformulated medium (bioMérieux, France) has been compared with that of the former Candida ID (CAID; bioMérieux), Albicans ID 2 (ALB2; bioMérieux), and CHROMagar Candida (CAC; Chromagar, France) chromogenic media for the isolation and presumptive identification of clinically relevant yeasts. Three hundred forty-five stock strains from culture collections, and 103 fresh isolates from different clinical specimens were evaluated. CAID2 permitted differentiation based on colony color between Candida albicans (cobalt blue; sensitivity, 91.7%; specificity, 97.2%) and Candida dubliniensis (turquoise blue; sensitivity, 97.9%; specificity, 96.6%). Candida tropicalis gave distinguishable pink-bluish colonies in 97.4% of the strains in CAID2 (sensitivity, 97.4%; specificity, 100%); the same proportion was reached in CAC, where colonies were blue-gray (sensitivity, 97.4%; specificity, 98.7%). CAC and CAID2 showed 100% sensitivity values for the identification of Candida krusei. However, with CAID2, experience is required to differentiate the downy aspect of the white colonies of C. krusei from other white-colony-forming species. The new CAID2 medium is a good candidate to replace CAID and ALB2, and it compares well to CAC for culture and presumptive identification of clinically relevant Candida species. CAID2 showed better results than CAC in some aspects, such as quicker growth and color development of colonies from clinical specimens, detection of mixed cultures, and presumptive differentiation between C. albicans and C. dubliniensis.
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Affiliation(s)
- Elena Eraso
- Laboratorio de Micología Médica, Departamento de Inmunología, Microbiología, y Parasitología, Facultad de Medicina y Odontología, Universidad del País Vasco-Euskal Herriko Unibertsitatea, Apartado 699, E-48080 Bilbao, Spain
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25
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Abstract
The yeasts, being favorite eukaryotic microorganisms used in food industry and biotechnologies for production of biomass and various substances, are also used as model organisms in genetic manipulation, molecular and biological research. In this respect, Saccharomyces cerevisiae is the best-known species but current situation in medicine and industry requires the use of other species. Here we summarize the basic taxonomic, morphological, physiological, genetic, etc. information about the pathogenic yeast Candida glabrata that is evolutionarily very closely related to baker's yeast.
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Affiliation(s)
- A Bialková
- Department of Microbiology and Virology, Faculty of Science, Comenius University, Bratislava, Slovakia
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26
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Campanha NH, Neppelenbroek KH, Spolidorio DMP, Spolidorio LC, Pavarina AC. Phenotypic methods and commercial systems for the discrimination between C. albicans and C. dubliniensis. Oral Dis 2006; 11:392-8. [PMID: 16269032 DOI: 10.1111/j.1601-0825.2005.01135.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Candida dubliniensis is a recently described Candida species associated with oral candidosis that exhibits a high degree of phenotypic similarity to Candida albicans. However, these species show differences in levels of resistance to antimycotic agents and ability to cause infections. Therefore, accurate clinical identification of C. dubliniensis and C. albicans species is important in order to treat oral candidal infections. Phenotypic identification methods are easy-to-use procedures for routine discrimination of oral isolates in the clinical microbiology laboratory. However, C. dubliniensis may be so far underreported in clinical samples because most currently used identification methods fail to recognize this yeast. Phenotypic methods depend on growth temperature, carbon source assimilation, chlamydospore and hyphal growth production, positive or negative growth on special media and intracellular enzyme production, among others. In this review, some phenotypic methods are presented with a special emphasis on the discrimination of C. dubliniensis and C. albicans.
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Affiliation(s)
- N H Campanha
- Department of Dental Materials and Prosthodontics, Araraquara Dental School, São Paulo State University, São Paulo, Brazil
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27
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Saunte DM, Klingspor L, Jalal S, Arnau J, Arendrup MC. Four cases of Candida albicans infections with isolates developing pink colonies on CHROMagar Candida plates. Mycoses 2005; 48:378-81. [PMID: 16262872 DOI: 10.1111/j.1439-0507.2005.01146.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Candida albicans, the most commonly isolated yeast species, is typically identified by its green colony-colour on CHROMagar Candida plates. We here report four cases of Candida albicans infections, in which the initial identification was non-albicans isolates due to a clear pink colour of the colonies on CHROMagar Candida plates. However, classical phenotypic criteria, biochemical assimilation pattern and molecular characterisation identified all four isolates as C. albicans isolates.
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Affiliation(s)
- D M Saunte
- Unit of Mycology and Parasitology, Department for Bacteriology, Mycology and Parasitology, Statens Serum Institute, Copenhagen, Denmark.
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28
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Murray CK, Beckius ML, Green JA, Hospenthal DR. Use of chromogenic medium in the isolation of yeasts from clinical specimens. J Med Microbiol 2005; 54:981-985. [PMID: 16157554 DOI: 10.1099/jmm.0.45942-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Over a 1 year period 3296 specimens submitted for fungal culture were plated onto routine mycological media (RM) and CHROMagar Candida (CaC) to evaluate the capability of CaC to improve on RM. With RM, cultures producing single yeast isolates were identified from 802 specimens. CaC produced similar results, with 76 % agreement. Of 761 specimens that yielded a single Candida species by RM, 615 (81 %) produced one or more yeast isolates using CaC. Of concern, 132 negative CaC cultures corresponded to specimens that yielded C. albicans alone on RM. When yeasts were recovered, CaC correctly identified 98 % of C. albicans, 93 % of Candida tropicalis, 96 % of Candida glabrata and 100 % of Candida krusei based on typical colours. CaC did potentially improve on RM by detecting yeasts in 91 specimens that yielded none by routine methods. CaC was noted to recover more yeast isolates than RM when mixed cultures were detected. Overall, the role of CaC in improving RM appears limited.
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Affiliation(s)
- C K Murray
- Department of Medicine, Infectious Disease Service1 and Department of Pathology and Area Laboratory Support2, Brooke Army Medical Center, Fort Sam Houston, TX, USA
| | - M L Beckius
- Department of Medicine, Infectious Disease Service1 and Department of Pathology and Area Laboratory Support2, Brooke Army Medical Center, Fort Sam Houston, TX, USA
| | - J A Green
- Department of Medicine, Infectious Disease Service1 and Department of Pathology and Area Laboratory Support2, Brooke Army Medical Center, Fort Sam Houston, TX, USA
| | - D R Hospenthal
- Department of Medicine, Infectious Disease Service1 and Department of Pathology and Area Laboratory Support2, Brooke Army Medical Center, Fort Sam Houston, TX, USA
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29
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Wilson DA, Joyce MJ, Hall LS, Reller LB, Roberts GD, Hall GS, Alexander BD, Procop GW. Multicenter evaluation of a Candida albicans peptide nucleic acid fluorescent in situ hybridization probe for characterization of yeast isolates from blood cultures. J Clin Microbiol 2005; 43:2909-12. [PMID: 15956416 PMCID: PMC1151928 DOI: 10.1128/jcm.43.6.2909-2912.2005] [Citation(s) in RCA: 108] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We evaluated aliquots from 244 clinical blood culture bottles that demonstrated yeasts on Gram stain using a Candida albicans peptide nucleic acid (PNA) fluorescent in situ hybridization (FISH) probe. The sensitivity, specificity, positive predictive value, and negative predictive value of the C. albicans PNA FISH test in this study were 99%, 100%, 100%, and 99.3%, respectively.
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Affiliation(s)
- D A Wilson
- Section of Clinical Microbiology, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA
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30
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Yucesoy M, Ozbek OA, Oztek AO, Marol S. Comparison of three differential media for the presumptive identification of yeasts. Clin Microbiol Infect 2005; 11:245-7. [PMID: 15715727 DOI: 10.1111/j.1469-0691.2004.01058.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This study evaluated three differential media, CHROMagar Candida, BiGGY agar and Albicans ID2 agar, for the presumptive identification of yeast species. In total, 215 yeast isolates were included in the study. The sensitivity and specificity of CHROMagar Candida, BiGGY agar and Albicans ID2 agar for the detection of Candida albicans were 100% and 100%, 91% and 92.7%, and 99.2% and 92.7%, respectively. CHROMagar Candida was a reliable tool for the presumptive identification of C. albicans, Candida tropicalis, Candida krusei and Candida glabrata. Albicans ID2 agar was useful for the detection of C. albicans.
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Affiliation(s)
- M Yucesoy
- Department of Microbiology and Clinical Microbiology, Dokuz Eylul University, Faculty of Medicine, Izmir, Turkey.
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31
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Silva JO, Franceschini SA, Lavrador MAS, Candido RC. Performance of selective and differential media in the primary isolation of yeasts from different biological samples. Mycopathologia 2004; 157:29-36. [PMID: 15008342 DOI: 10.1023/b:myco.0000012223.38967.7d] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
In view of the increase in yeast infections, especially polymicrobial ones, differential culture media have acquired increasing importance. The present study evaluated the Sabouraud chloramphenicol, Biggy agar, Pagano Levin agar and CHROMagar Candida media in terms of isolation, number of yeast colony forming units per plate, and inhibition of bacteria and filamentous fungi. To this end, we used 223 biological samples, including feces, and oral, vaginal and anal mucosae from 86 patients presenting or not symptoms of fungal infections. The four media did not differ significantly in terms of detection of yeast-positive cultures. The number of colony forming units per plate ranged from zero to 2.380, with a predominance of counts of 1 to 9 colonies per plate. No significant differences were observed among the four culture media in terms of number of colonies counted, for each kind of biological material. Fifteen species belonging to the genera Candida, Saccharomyces, Cryptococcus, Trichosporon and Rhodotorula were isolated, with C. albicans being the predominant species, followed by C. parapsilosis and R. rubra. CHROMagar Candida and Biggy agar were complementary in the isolation of the different species and favored a greater recovery of polymicrobial cultures. Pagano Levin agar isolated the smallest variety of species. Sabouraud chloramphenicol agar was the least effective in terms of bacterial inhibition and favored a greater development of filamentous fungi. The results suggest that more than one culture medium should be used for an adequate primary isolation.
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32
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Yücesoy M, Marol S. Performance of CHROMAGAR candida and BIGGY agar for identification of yeast species. Ann Clin Microbiol Antimicrob 2003; 2:8. [PMID: 14613587 PMCID: PMC280667 DOI: 10.1186/1476-0711-2-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2003] [Accepted: 10/29/2003] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The importance of identifying the pathogenic fungi rapidly has encouraged the development of differential media for the presumptive identification of yeasts. In this study two differential media, CHROMagar Candida and bismuth sulphite glucose glycine yeast agar, were evaluated for the presumptive identification of yeast species. METHODS A total number of 270 yeast strains including 169 Candida albicans, 33 C. tropicalis, 24 C. glabrata, 18 C. parapsilosis, 12 C. krusei, 5 Trichosporon spp., 4 C. kefyr, 2 C. lusitaniae, 1 Saccharomyces cerevisiae and 1 Geotrichum candidum were included. The strains were first identified by germ tube test, morphological characteristics on cornmeal tween 80 agar and Vitek 32 and API 20 C AUX systems. In parallel, they were also streaked onto CHROMagar Candida and bismuth sulphite glucose glycine yeast agar plates. The results were read according to the color, morphology of the colonies and the existance of halo around them after 48 hours of incubation at 37 degrees C. RESULTS The sensitivity and specificity values for C. albicans strains were found to be 99.4, 100% for CHROMagar Candida and 87.0, 75.2% for BiGGY agar, respectively. The sensitivity of CHROMagar Candida to identify C. tropicalis, C. glabrata and C. krusei ranged between 90.9 and 100% while the specificity was 100%. The sensitivity rates for BiGGY agar were 66.6 and 100% while the specificity values were found to be 95.4 and 100% for C. tropicalis and C. krusei, respectively. CONCLUSIONS It can be concluded that the use of CHROMagar Candida is an easy and reliable method for the presumptive identification of most commonly isolated Candida species especially C. albicans, C. tropicalis and C. krusei. The lower sensitivity and specificity of BiGGY agar to identify commonly isolated Candida species potentially limits the clinical usefulness of this agar.
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Affiliation(s)
- Mine Yücesoy
- Dokuz Eylül University, Faculty of Medicine, Department of Microbiology and Clinical Microbiology, Izmir, Turkey
| | - Serhat Marol
- Dokuz Eylül University, Faculty of Medicine, Department of Microbiology and Clinical Microbiology, Izmir, Turkey
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Radfar L, Shea Y, Fischer SH, Sankar V, Leakan RA, Baum BJ, Pillemer SR. Fungal load and candidiasis in Sjögren's syndrome. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2003; 96:283-7. [PMID: 12973284 DOI: 10.1016/s1079-2104(03)00224-5] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE We sought to investigate the prevalence of Candida carriage and the relationships between salivary flow rates and oral Candida load in patients with Sjögren's syndrome (SS). METHODS The oral Candida load of patients with SS was evaluated by culturing oral rinse (swish and spit) samples. Culture, Gram stain, and wet-mount test results were reported. RESULTS One hundred three patients (96 women) met European criteria for SS (91 with primary SS and 12 with secondary SS). The mean age (95% confidence interval) was 55 years (range, 51-57 years). Oral rinse cultures were positive in 77% of subjects. The total stimulated salivary flow rate was inversely correlated with oral Candida load (r = -0.47; P </=.0001). The oral rinse samples yielded gram-positive results in 38% of patients with SS, and the Fungi-Fluor assay (wet mount) results were positive in 49%. CONCLUSIONS The prevalence of Candida carriage varies according to the methods used to determine the presence of the organism and is similar to that reported in the literature. A low stimulated salivary flow rate-not a low unstimulated flow rate-was associated with Candida carriage.
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Affiliation(s)
- Lida Radfar
- State Univeristy of New York, Buffalo, NY 14214, USA
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Tambosis E, Atkins BL, Capizzi T, Gottlieb T. Rapid and cost-effective identification of Candida species using multipoint inoculation of CHROMagar Candida media, cycloheximide sensitivity and carbohydrate assimilation tests. Pathology 2003; 35:151-6. [PMID: 12745454 DOI: 10.1080/0031302031000082250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Evanthia Tambosis
- Department of Microbiology and Infectious Diseases, Concord Hospital, Hospital Road, Concord, New South Wales 2139, Australia
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35
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Fotedar R, al-Hedaithy SS. Identification of chlamydospore-negative Candida albicans using CHROMagar Candida medium. Mycoses 2003; 46:96-103. [PMID: 12870197 DOI: 10.1046/j.1439-0507.2003.00867.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This study was undertaken to evaluate the utility of CHROMagar Candida medium for the identification of chlamydospore-negative Candida albicans. A total of 60 isolates including 45 chlamydospore-negative C. albicans, 10 chlamydospore-positive C. albicans (positive controls) and five non-C. albicans (negative controls) were investigated. On the basis of germ tube test, assimilation of trehalose (Tre), glucosamine (GlcN), N-acetyl glucosamine (GlcNAc), secretory aspartyl production and serotyping, the 45 chlamydospore-negative C. albicans isolates were assigned to the reported three groups. Eighteen isolates showing positive germ tube test, negative for the assimilation of Tre, GlcN/GlcNAc, strong producers of proteinase (2+) and assigned to serotype B belonged to group I. Whereas, the isolates in group II and group III showed common characteristics including assimilation of Tre, GlcN/GlcNAc, moderate production of proteinase (1+) and were serotype A, except for the fact that group II isolates were germ tube positive and group III isolates were negative. Using CHROMagar Candida medium, all the 45 chlamydospore-negative and 10 positive control isolates were accurately identified on the basis of characteristic green color at 37 degrees C for 48 h of incubation. On the other hand at an optimum incubation temperature of 37 degrees C none of the non-C. albicans (negative controls) showed characteristic green color thus yielding a 100% sensitivity and specificity. Isolates in group-I showed a slow growth rate and no visible growth was observed at 24 h, whereas, groups II, III and the control isolates showed visible growth at 24 h. Besides differences in growth rates, these isolates also varied in their characteristic colony color which gradually changed over a period of time. The results of this study clearly suggest that CHROMagar Candida medium is not only a simple, reliable and cost effective method for the identification of chlamydospore-negative atypical C. albicans, but can also be used to differentiate various groups of chlamydospore-negative C. albicans.
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Affiliation(s)
- R Fotedar
- Department of Pathology, Medical Mycology Unit, College of Medicine, King Khalid University Hospital, Riyadh, Saudi Arabia.
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36
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María José L, Guadalupe C, Francisco S, Manuel C. CHROMAgar Candida más fluconazol: comparación con técnicas de microdilución. Enferm Infecc Microbiol Clin 2003. [DOI: 10.1016/s0213-005x(03)72994-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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37
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Hospenthal DR, Murray CK, Beckius ML, Green JA, Dooley DP. Persistence of pigment production by yeast isolates grown on CHROMagar Candida medium. J Clin Microbiol 2002; 40:4768-70. [PMID: 12454192 PMCID: PMC154593 DOI: 10.1128/jcm.40.12.4768-4770.2002] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We evaluated the persistence of pigmentation in yeast isolates grown on the chromogenic medium CHROMagar Candida over 7 days. Candida, Cryptococcus, and Trichosporon isolates were inoculated alone or mixed onto duplicate sets of plates and incubated at 30 and 35 degrees C. Candida albicans and Candida krusei were readily identified throughout the reading period, but Candida glabrata was difficult to differentiate from other species until the 3- or 4-day time point. Candida tropicalis produced colonies similar to those of rare Cryptococcus and Trichosporon species, and mixed cultures were often difficult to identify as such.
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Affiliation(s)
- Duane R Hospenthal
- Department of Medicine, Brooke Army Medical Center, Fort Sam Houston, Texas, USA.
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38
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Cooke VM, Miles RJ, Price RG, Midgley G, Khamri W, Richardson AC. New chromogenic agar medium for the identification of Candida spp. Appl Environ Microbiol 2002; 68:3622-7. [PMID: 12089051 PMCID: PMC126815 DOI: 10.1128/aem.68.7.3622-3627.2002] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
A new chromogenic agar medium (Candida diagnostic agar [CDA]) for differentiation of Candida spp. is described. This medium is based on Sabouraud dextrose agar (Oxoid CM41) and contains (per liter) 40.0 g of glucose, 10.0 g of mycological peptone, and 15.0 g of agar along with a novel chromogenic glucosaminidase substrate, ammonium 4-(2-[4-(2-acetamido-2-deoxy-beta-D-glucopyranosyloxy)-3-methoxyphenyl]-vinyl)-1-(propan-3-yl-oate)-quinolium bromide (0.32 g liter(-1)). The glucosaminidase substrate in CDA was hydrolyzed by Candida albicans and Candida dubliniensis, yielding white colonies with deep-red spots on a yellow transparent background after 24 to 48 h of incubation at 37 degrees C. Colonies of Candida tropicalis and Candida kefyr were uniformly pink, and colonies of other Candida spp., including Candida glabrata and Candida parapsilosis, were white. CDA was evaluated by using 115 test strains of Candida spp. and other clinically important yeasts and was compared with two commercially available chromogenic agars (Candida ID agar [bioMerieux] and CHROMagar Candida [CHROMagar Company Ltd.]). On all three agars, colonies of C. albicans were not distinguished from colonies of C. dubliniensis. However, for the group containing C. albicans plus C. dubliniensis, both the sensitivity and the specificity of detection when CDA was used were 100%, compared with values of 97.6 and 100%, respectively, with CHROMagar Candida and 100 and 96.8%, respectively, with Candida ID agar. In addition, for the group containing C. tropicalis plus C. kefyr, the sensitivity and specificity of detection when CDA was used were also 100%, compared with 72.7 and 98.1%, respectively, with CHROMagar Candida. Candida ID agar did not differentiate C. tropicalis and C. kefyr strains but did differentiate members of a broader group (C. tropicalis, C. kefyr, Candida lusitaniae plus Candida guilliermondii); the sensitivity and specificity of detection for members of this group were 94.7 and 93.8%, respectively. In addition to the increased sensitivity and/or specificity of Candida detection when CDA was used, differentiation of colony types on CDA (red spotted, pink, or no color) was unambiguous and did not require precise assessment of colony color.
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39
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Rigby S, Procop GW, Haase G, Wilson D, Hall G, Kurtzman C, Oliveira K, Von Oy S, Hyldig-Nielsen JJ, Coull J, Stender H. Fluorescence in situ hybridization with peptide nucleic acid probes for rapid identification of Candida albicans directly from blood culture bottles. J Clin Microbiol 2002; 40:2182-6. [PMID: 12037084 PMCID: PMC130801 DOI: 10.1128/jcm.40.6.2182-2186.2002] [Citation(s) in RCA: 129] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A new fluorescence in situ hybridization (FISH) method that uses peptide nucleic acid (PNA) probes for identification of Candida albicans directly from positive-blood-culture bottles in which yeast was observed by Gram staining (herein referred to as yeast-positive blood culture bottles) is described. The test (the C. albicans PNA FISH method) is based on a fluorescein-labeled PNA probe that targets C. albicans 26S rRNA. The PNA probe is added to smears made directly from the contents of the blood culture bottle and hybridized for 90 min at 55 degrees C. Unhybridized PNA probe is removed by washing of the mixture (30 min), and the smears are examined by fluorescence microscopy. The specificity of the method was confirmed with 23 reference strains representing phylogenetically related yeast species and 148 clinical isolates covering the clinically most significant yeast species, including C. albicans (n = 72), C. dubliniensis (n = 58), C. glabrata (n = 5), C. krusei (n = 2), C. parapsilosis (n = 4), and C. tropicalis (n = 3). The performance of the C. albicans PNA FISH method as a diagnostic test was evaluated with 33 routine and 25 simulated yeast-positive blood culture bottles and showed 100% sensitivity and 100% specificity. It is concluded that this 2.5-h method for the definitive identification of C. albicans directly from yeast-positive blood culture bottles provides important information for optimal antifungal therapy and patient management.
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Affiliation(s)
- Susan Rigby
- Applied Biosystems, Bedford, Massachusetts 01730, USA
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40
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Bauters TG, Nelis HJ. Comparison of chromogenic and fluorogenic membrane filtration methods for detection of four Candida species. J Clin Microbiol 2002; 40:1838-9. [PMID: 11980972 PMCID: PMC130677 DOI: 10.1128/jcm.40.5.1838-1839.2002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
CHROMagar Candida medium was inoculated with a variety of clinical samples (n = 282) by using membrane filtration instead of swabbing or streaking. This modified CHROMagar procedure increased the ability to detect yeast by 16.7%. Compared to an enzymatic two-step membrane filtration method with fluorogenic substrates, it yielded similar recovery but was slower.
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Affiliation(s)
- T G Bauters
- Laboratory for Pharmaceutical Microbiology, Department of Pharmaceutical Analysis, Ghent University, Harlebekestraat 72, 9000 Ghent, Belgium
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41
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Willinger B, Hillowoth C, Selitsch B, Manafi M. Performance of candida ID, a new chromogenic medium for presumptive identification of Candida species, in comparison to CHROMagar Candida. J Clin Microbiol 2001; 39:3793-5. [PMID: 11574621 PMCID: PMC88437 DOI: 10.1128/jcm.39.10.3793-3795.2001] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Candida ID agar allows identification of Candida albicans and differentiation of other Candida species. In comparison with CHROMagar Candida, we evaluated the performance of this medium directly from 596 clinical specimens. In particular, detection of C. albicans after 24 h of incubation was easier on Candida ID (sensitivity, 96.8%) than on CHROMagar (sensitivity, 49.6%).
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Affiliation(s)
- B Willinger
- Department of Clinical Microbiology, Hygiene Institute of the University of Vienna, Vienna, Austria.
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42
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Navarro-García F, Sánchez M, Nombela C, Pla J. Virulence genes in the pathogenic yeast Candida albicans. FEMS Microbiol Rev 2001; 25:245-68. [PMID: 11250036 DOI: 10.1111/j.1574-6976.2001.tb00577.x] [Citation(s) in RCA: 110] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
In recent years, the incidence of fungal infections has been rising all over the world. Although the amount of research in the field of pathogenic fungi has also increased, there is still a need for the identification of reliable determinants of virulence. In this review, we focus on identified Candida albicans genes whose deletant strains have been tested in experimental virulence assays. We discuss the putative relationship of these genes to virulence and also outline the use of new different systems to examine the precise effect in virulence of different genes.
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Affiliation(s)
- F Navarro-García
- Departamento de Microbiología II, Facultad de Farmacia, Universidad Complutense de Madrid, Spain
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43
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Freydiere AM, Guinet R, Boiron P. Yeast identification in the clinical microbiology laboratory: phenotypical methods. Med Mycol 2001; 39:9-33. [PMID: 11270413 DOI: 10.1080/mmy.39.1.9.33] [Citation(s) in RCA: 107] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Emerging yeast pathogens are favoured by increasing numbers of immunocompromised patients and by certain current medical practices. These yeasts differ in their antifungal drug susceptibilities, and rapid species identification is imperative. A large variety of methods have been developed with the aim of facilitating rapid, accurate yeast identification. Significant recent commercial introductions have included species-specific direct enzymatic colour tests, differential chromogenic isolation plates, direct immunological tests, and enhanced manual and automated biochemical and enzymatic panels. Chromogenic isolation media demonstrate better detection rates of yeasts in mixed cultures than traditional media, and allow the direct identification of Candida albicans by means of colony colour. Comparative evaluation of rapid methods for C. albicans identification, including the germ tube test, shows that chromogenic media may be economically advantageous. Accurate tests for single species include the Bichrolatex Albicans and Krusei Color tests, both immunologically based, as well as the Remel Rapid Trehalose Assimilation Broth for C. glabrata. Among broad-spectrum tests, the RapID Yeast Plus system gives same-day identification of clinical yeasts, but performance depends on inoculum density and geographic isolate source. The API 20 C AUX system is considered a reference method, but newer systems such as Auxacolor and Fungichrom are as accurate and are more convenient. Among automated systems, the ID 32 C strip, the Vitek Yeast Biochemical Card and the Vitek 2 ID-YST system correctly identify >93% of common yeasts, but the ID-YST is the most accurate with uncommon yeasts, including C. dubliniensis. Spectroscopic methods such as Fourier transformed-infrared spectroscopy offer potential advantages for the future. Overall, the advantages of rapid yeast identification methods include relative simplicity and low cost. For all rapid methods, meticulous, standardized multicenter comparisons are needed before tests are fully accepted.
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Affiliation(s)
- A M Freydiere
- Laboratoire de Microbiologie, H pital de l'Antiquaille, Lyon, France.
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44
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Abstract
The color of colonies of 9 Candida species was examined on the chromogenic medium CHROMagar Candida incubated for 24-72 h at 25 degrees C, 30 degrees C or 37 degrees C. Colors and colony forms characteristic of C. albicans, C. dubliniensis, C. krusei and C. tropicalis were formed most rapidly and with the deepest hues at 37 degrees C. After 48 h incubation at 25 degrees C, 9 of 48 C. albicans isolates gave pink colonies instead of the green colonies characteristic for the species, and the blue-purple colony color characteristic of C. tropicalis isolates was not formed until 48 h at 25 degrees C. Incubation of the chromogenic medium at temperatures below 30 degrees C cannot be recommended for reliable presumptive identification of Candida spp., and pink colonies of C. glabrata would not be reliably distinguished from pink colonies formed by other species under any of the incubation conditions used.
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Affiliation(s)
- F C Odds
- Department of Molecular and Cell Biology, Institute of Medical Sciences, Foresterhill, University of Aberdeen, AB25 2ZD, Scotland,
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