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Introduction: Kodamaea ohmeri is a rare, recognized pathogen that has previously been isolated from environmental sources. The patients commonly affected by this yeast include immunocompromised as well as immunocompetent patients having several associated risk factors. Methodology: We report three cases in which K. ohmeri was isolated from blood using Bact T/ALERT. Identification was carried out by MALDI-TOF MS (Vitek-MS, BioMérieux, Marcy-l'Etoile, France) in addition to color characteristics on chromogenic media. The patients had diminished immune response on account of a multitude of comorbidities. Results: K. ohmeri can be misidentified as Candida tropicalis, Candida albicans, or Candida hemolounii by conventional methods; correct and timely identification can be achieved by MALDI-TOF MS. Antifungal susceptibility breakpoints for K. ohmeri are currently not defined. An Echinocandin was added to the treatment regimen of all three of the cases. Conclusions: Identification of K. ohmeri using conventional methods is difficult and unusual yeasts should be carefully observed, especially upon prolonged incubation. [ABSTRACT FROM AUTHOR]

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 stepwise algorithm can enable the same in a more cost effective manner. [ABSTRACT FROM AUTHOR]

Background: Vulvovaginal candidiasis (VVC) remains one of the most common infections of the female genital tract. This local study was conducted to identify the spectrum of Candida species associated with VVC and recurrent vulvovaginal candidiasis (RVVC) using different phenotypic and genotypic methods and assess their fluconazole susceptibility. Methods: High vaginal swabs were collected from 576 patients with VVC. Swabs were subjected to KOH 10% and cultured on Sabouraud dextrose agar. The species identification of Candida isolates was made using phenotypic methods, including the germ tube test, corn meal agar (CMA), CHROMagar Candida, and PCR-RFLP as the best genotypic methods for confirmation of Candida species in vulvovaginal candidiasis. Fluconazole susceptibility testing was performed using the disk diffusion method. Results: The data were analyzed using the chi-square test. The prevalence of candidiasis was 61%. The socio-demographic profile corresponded to a woman aged 29.14 ± 4.8 years on average, pregnant (77%), diabetic (19%), with hypertension (10%), recurrent (9%), a history of fluconazole use (4%), and under 30 years of age (73%). Vaginal swab cultures yielded Candida growth in 352 cases (61%). Candida albicans was the predominant isolated species (78%), while the most common non-albicans species were C. glabrata (14.7%), C. parapsilosis (4.2%), C. tropicalis (2.8%), and C. krusei (0.56%). Isolates of C. glabrata and C. krusei exhibited the highest rate of Double-Disk Synergy (DDS) resistance among all isolates tested. Conclusion: C. albicans was the most common species. Careful periodical surveillance is needed to identify any changes in the susceptibility patterns to fluconazole with the increased use of this antifungal agent in Sayad Shirazi tertiary care hospital, Iran. [ABSTRACT FROM AUTHOR]

Summary: A growing population of immunosuppressed patients has resulted in increasingly frequent diagnoses of invasive fungal infections, including those caused by unusual yeasts. The incidence of non-albicans species of Candida is increasing compared with that of Candida albicans, and several species, such as Candida glabrata and Candida krusei, may be resistant to azole antifungal therapy. Trichosporon species are the second most common cause of fungaemia in patients with haematological malignant disease and are characterised by resistance to amphotericin and echinocandins and poor prognosis. Rhodotorula species belong to the family Cryptococcaceae, and are a cause of catheter-related fungaemia, sepsis, and invasive disease in severely immunosuppressed patients. An increasing number of sporadic cases of invasive fungal infections by non-neoformans cryptococci have been reported in immunocompromised hosts, especially for patients with advanced HIV infection or cancer who are undergoing transplant. Other uncommon yeasts that can cause invasive disease in severely immunosuppressed patients include Geotrichum, Hansenula, Malassezia, and Saccharomyces. Host immune status is a crucial determinant of the type of invasive fungal infection a patient is at risk for. Diagnosis can be challenging and relies heavily on traditional cultures of blood and other sterile sites, although serum (1,3)-β-D-glucan testing might have an adjunctive role. Although rare yeasts are emerging as opportunistic human pathogens, diagnosis remains challenging and treatment suboptimal. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]