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Rapid and accurate yeasts species identification in clinical laboratories is important for appropriate and timely antifungal treatment. We evaluate the performance of the new medium CHROMagar™ Candida Plus for presumptive identification of yeasts species and MALDI‐TOF identification. We identify 303 strains belonging to 60 clinically relevant yeasts species by using the new medium. Presumptive identification was correct at the Candida albicans complex, Candida tropicalis and Pichia kudriavzevii (Candida krusei) species. However, although this medium was able to identify all Candida auris and Candida glabrata strains, other species were misidentified as C. auris or C. glabrata. A total of 215 strains were identified by using MALDI‐TOF and evaluated two incubation temperatures (30°C and 37°C) and two incubation times (24 h and 72 h). Most strains (94%; 202/215) were correctly identified at the species (n:190) or complex level (n:12) at both temperatures and incubation times. However, we observed that the time of incubation (24 h vs. 72 h) affects the score values when yeasts are incubated at 37°C, but does not affect score values when yeasts are incubated at 30°C. In conclusion, the new medium has a good performance in the presumptive identification of the C. albicans complex, C. tropicalis and P. kudriavzevii (C. krusei). In addition, this medium is useful for the screening of C. auris and C. glabrata isolates, but identification should be confirmed by other more specific techniques, like MALDI‐TOF. [ABSTRACT FROM AUTHOR]

Background/aim: Candida infections are gaining more attention for the last few decades so diagnostic tools are very important for early diagnosis. Conventional identification of yeasts is time-consuming, molecular methods are more complicated and relatively expensive gold-standard methods. Matrix-assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF MS) was put into the market due to its speed and high accuracy. The aim of this study was to evaluate the performance of corn meal tween-80 agar (CMTA), CHROMagar Candida medium, and MALDI-TOF MS and to compare the obtained results with DNA sequencing. Materials and methods: The CHROMagar Candida medium, CMTA, and MALDI-TOF MS Biotyper System were used to test 416 isolates. The isolates with discrepant results by at least one of the three methods were subjected to sequence analysis. Results: The identification results of the 351 (%84.4) were compatible with all three methods. When compared to the sequencing results, the most accurate results were obtained by the MALDI-TOF MS, especially for rare Candida species. Conclusion: MALDI-TOF MS is found to be the most accurate identification tool for clinically important Candida strains. CMTA alone should not be used for the final identification of Candida species and the chromogenic medium should always be considered presumptive. [ABSTRACT FROM AUTHOR]

Objective: In this study, we have found the prevalence Candidal Sp. in skin infections of the patients attending at the department of medicine and Skin and VD. We have also evaluated the drug sensitivity patterns of identified Candida sp. Method: This prospective, cross-sectional study was conducted at the IMS and SUM hospital from January 2016 to February 2017, and comprised the causative organisms foe skin infections. Species differentiation was confirmed by specific culture medium method. Antifungal susceptibility of isolated Candida species were evaluated with disc diffusion method. Results: of the 219 Candida isolates, majority of them were isolated from the department of skin and VD 78(35.6%) and Medicine department 59(26.9%). Moreover, 144(65.8%) samples were of females and 75(34.2%) were of males. Candida albicans 128(58.45%) was the most predominant species followed by Candida glabrata 30(13.69%), Candida tropicalis 26(11.87%), Candida krusei 17(7.76%), Candida parapsilosis 12(5.47%), Candida dubliniensis 3(1.37%) and Candida lusitaniae 3(1.37). All isolates were least susceptible to amphotericin B with a susceptibility rate of 213(97.26%). The highest resistance was found for voriconazole 40(18.26%) compared to fluconazole 32(14.61%). Conclusion: Candida species were resistant to many antifungals and in this study it is revealed that Amphotericin B is the most sensitive antifungal for skin infections. [ABSTRACT FROM AUTHOR]

Background and Purpose: Diabetic patients are more susceptible to oral candidiasis infection than non-diabetics due to the factors promoting oral carriage of Candida. Several factors can increase colonization of Candida species in the oral cavity such as xerostomia, which reduces the salivary flow and is a salivary pH disorder. In the current study, we aimed to identify and compare the colonization level of Candida spp. in the oral cavity of diabetic and non-diabetic groups. Materials and Methods: Swabs were taken from the mouth of 106 participants and were cultured on Sabouraud dextrose agar (SDA) medium. Likewise, the saliva samples were collected for salivary glucose and pH measurements. The study was performed during June 2014-September 2015 on two groups of diabetic patients (n=58) and non-diabetics (n=48) as the control group. The Candida spp. were identified with PCR-restriction fragment length polymorphism (RFLP) using the restriction enzymes HinfI and MspI and were differentiated by culture on CHROMagar Candida medium. Results:The frequency of Candida spp. was higher in diabetic patients compared to non-diabetics. The most frequent Candida spp. in the diabetic patients were Candida albicans (36.2%), C. krusei (10.4%), C. glabrata (5.1%), and C. tropcalis (3.4%). Likewise, C. albicans was the most frequent species (27%) in the non-diabetic individuals. In this study, the results of both methods for identification of the isolates were consistent with each other. Conclusion: Xerostomia and disturbance of physiological factors including pH and glucose can promote overgrowth of Candida flora in the oral cavity. These factors are considered important predisposing factors for oral candidiasis in diabetic patients. In the present study, it was observed that application of CHROMagar Candida and PCR-RFLP methods at the same time contributes to more accurate identification of isolates.

Matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) is a rapid and accurate method to identify microorganisms in clinical laboratories. This study isolates yeast-like microorganisms in the oral washes that are collected from non-bedridden nursing home residents, using CHROMagar Candida plates, and identifies them using Bruker MALDI-TOF MS. The ribosomal DNA sequences of the isolates are then examined. Three hundred and twenty yeast isolates are isolated from the oral washes. Candida species form the majority (78.1%), followed by Trichosporon/Cutaneotrichosporon species (8.8%). Bruker MALDI-TOF MS gives a high-level confidence, with a log(score) value of ≥1.8, and identifies 96.9% of the isolates. There are six inconclusive results (1.9%), and those sequences are verified as rare clinical species, including Candida ethanolica, Cutaneotrichosporon jirovecii, Exophiala dermatitidis, and Fereydounia khargensis. Almost all of the isolates have a regular color on the CHROMagar Candida plates. If the colonies are grouped by color on the plates, a specific dominant yeast species is present in each color group, except for purple or orange isolates. In conclusion, MALDI-TOF MS is verified as a fast, accurate and practical method to analyze oral yeasts in elderly subjects.

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.

Introduction & Objective: Candida species can cause opportunistic infections in human. Although Candida albicans is major pathogenic species, non-albicans species of Candida such as C. glabrata , C. tropicalis and C. krusei have been increasingly reported. Identification of Candida species is essential for effective antifungal therapy and for infection control purposes. In the present study the commercial medium CHROMagar Candida was used as a differential method for identification of the yeasts isolated from patients. Materials & Methods: Sixteen standard strains of Candida and non?Candida yeasts were used as the reference cultures. 280 yeasts isolated from the patients referred to two Medical Mycology Laboratories in Tehran were cultured on the chromogenic medium CHROMagar Candida. The cultures incubated for 48 h at 35ºC and were differentiated based on the color of colonies in comparison with the standard strains. For colonies with unspecific color, a PCR-RFLP method was performed. Results: The most frequent species were Candida albicans(66.5%) followed by C. parapsilosis (8.6%), C. tropicalis (8.2%), C. glabrata (6.1%), C. krusei (4.6%), C. kefyr (2.5%), C. guilliermondii (0.7%), C. lusitania (0.35%) and Cryptococcus neoformans (0.35%). Conclusion: CHROMagar Candida can be a simple and straight-forward method for specific differentiation of medically important Candida species includingC. albicans, C. krusei, C. tropicalis and C. glabrata, but not for all Candidaisolates. More phenotypic or genotypic methods are necessary for exact identification of other Candida species.

The normal vaginal microbiota is a dynamic system that continually fluctuates under the environmental changes and different physiological conditions. Yeast infections of the vagina are caused by one of the species of fungus called Candida (C.). The study aimed to evaluate the types ofmycobiota in women with vulvovaginal candidiasis (VVC) who were performing vaginal douching (VD) or not. Furthermore, it studied the antifungal sensitivity toward different fungi isolated from the vagina. In a cross-sectional study conducted in Assiut University Hospital, Egypt, women with VVC were interviewed regarding relevant history including the habit of VD. Vaginal swabs were obtained and processed by direct microscope and by culture on CHROMagar Candida and other differential media. The types of Candida in women with the habit of VD were compared with those not having this habit. We found that VD habit was practiced by 67.4% of women with VVC, and Candida albicans was the commonest (78.3%) type observed. There was no significant difference in the percentage of non-albicans types between women performing VD (23.6%) and those not reporting this habit (18.9%). Harboring non-albicans types were significantly increased in regular performers of VD compared with those who had this procedure only after sexual intercourse or after the end of menstruation (36.8%,12.5%, and 16.7%, respectively) (P = .048). Thus, vaginal douching does not influence the type of Candida infection involved in VVC. Frequent performance of VD increases the likelihood of having non-albicans types and the resistance to the common antifungal agents. [ABSTRACT FROM AUTHOR]

En el medio CHROMagar Candida, Candida guilliermondii desarrolló una colonia de color rosado-púrpura. En láminas de agar leche-tween 80 al 1%, presentó a las 48 h de cultivo a 28 °C levaduras pequeñas, ovoides y brotantes, de 3 a 5 µm, que no formaron seudomicelio y que posteriormente desarrollaron un conglomerado característico de seudohifas con disposición radiada. Estas se encontraron bien desarrolladas a las 96 h de incubación. Los ensayos de asimilación resultaron negativos para la trehalosa y positivos para la sacarosa . Estos hallazgos fueron validados en el 100% de los aislamientos con los métodos automatizados ID 32C y Vitek YBC, los que señalaron a Candida famata como segunda opción, con un porcentaje de confianza del 10%. El estudio de la micromorfología de las levaduras aumenta la probabilidad de una identificación correcta, particularmente si se debe discriminar entre especies que presentan perfiles bioquímicos similares.Candida guilliermondii developed a pink-purplish colony on CHROMagar Candida. In the micromorphology in milk-tween 80 1% agar at 28 °C after 48 h of incubation C. guilliermondii showed small (3-5 µm), spherical yeasts without pseudohyphaes. This Candida species presented a characteristic cluster of blastospores with pseudohyphaes radiating from the centre at 96 h. The trehalose-sucrose assimilation assay was applied to the C. guilliermondii isolates which proved negative for trehalose and positive for sucrose. These results allowed for the presumptive identification of C. guilliermondii. The results were concordant in 100% of the isolates with the identification of the C. guilliermondii species by the ID 32C and Vitek YBC methods. Such automated methods offered Candida famata as a second option, with a reliability percentage of 10%. Micromorphological studies increase yeast identification reliability, especially among species presenting similar biochemical profiles.

Copyright of Revista Iberoamericana de Micologia is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Vulvovaginal candidiasis (VVC), particularly the recurrent form, remains an intractable problem for clinicians, microbiologists, and patients. It is essential to confirm the clinical diagnosis by mycological methods and avoid empirical therapy. The recovery of yeast in fungal culture, such as on Sabouraud dextrose agar, remains the gold standard for diagnosis. In this investigation, we examined 474 participants, including 122 (25.7%) with acute VVC cases, 249 (52.5%) who had recurrent VVC (RVVC) cases, and 103 (21.7%) healthy controls. We also administered a questionnaire to obtain information on patient lifestyle and medical, gynecological, and sexual history. In addition, we compared the performance of chromID Candida agar (CAN2) to CHROMagar Candida (CAC) and Sabouraud dextrose agar with gentamicin and chloramphenicol (SGC2). The yeasts were identified by conventional methods including the germ tube test, microscopic morphology on cornmeal-Tween 80 agar, and the commercial API 20C AUX system. We detected yeasts in 60 of 122 (49.2%) patients with acute VVC cases, 110 of 249 (44.2%) with RVVC cases, and in 35 of 103 (34%) healthy controls ( P = 0.07). A total of 205 samples were found to be positive for fungi (43.2%), of which 176 (85.9%) were monofungal, and 29 (14.1%) were polyfungal. In addition, 198 of these samples (96.6%) were positive on CAN2, 195 (95.1%) on CAC, 189 (92.2%) on SGC2, and 183 (89.3%) samples on all three ( P = 0.17). The 234 yeast isolates recovered were C. albicans ( n = 118), C. glabrata ( n = 82), C. kefyr ( n = 11), C. krusei ( n = 9), C. lipolytica ( n = 3), C. colliculosa ( n = 2), C. parapsilosis ( n = 2), C. pelliculosa ( n = 2), C. tropicalis ( n = 2), and other species of Candida ( n = 3). Of the 29 polyfungal populations, 28 (96.6%) were detected in CAN2, 25 in (86.2%) CAC, and 25 (86.2%) on both ( P = 0.35). Notably, we detected the high predominance of C. albicans+ C. glabrata (86.2%) in polyfungal populations. Briefly, the detection of C. albicans after 24 h of incubation was easier on CAN2 (64.4%) than on CAC (25.4%). This study showed that CAN2 is a rapid and reliable medium for immediate identification of C. albicans and for detecting polyfungal populations in vaginal specimens. We observed that the use of antibiotics, intrauterine devices, as well as, perineal laceration, short anovaginal distance (< 3 cm), and genital epilation in common areas are predisposing factors for RVVC ( P < 0.001). In addition, we detected that the use of menstrual pad, using an (IUD), and having a history of childbirth increased the risk of both acute and recurrent VVC ( P < 0.01), whereas the use of a daily pad and walking daily significantly decreased the risk of both acute and recurrent VVC ( P < 0.01). [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]

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 ≥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. [ABSTRACT FROM AUTHOR]

Ability for growth support and species differentiation by colony features were compared on two commercial chromogenic agars, CHROMagar Candida and newly developed Pourmedia Vi Candida. Eleven strains (ten species) of standard strains and twenty-four isolates (five species) of clinical strains were tested. All isolates were grown on both agar plates in 48 hours at 35 degrees C, however, several species had not matured in 22 hours. Color of the colonies for each strain were stable on both agars. The results show that Pourmedia Vi Candida is equivalent to CHROMagar Candida in its ability to differentiate species as a primary culture plate. [ABSTRACT FROM AUTHOR]

CHROMagar Candida and Candida ID2 are widely used for the isolation and presumptive identification of Candida spp. based on the color of the colonies on these two media. We have studied the usefulness of these chromogenic media for differentiating Candida dubliniensis from Candida albicans isolates. One hundred isolates of C. dubliniensis and 100 C. albicans isolates were tested on Candida ID2, CHROMagar Candida (CHROMagar), and CHROMagar Candida reformulated by BBL. CHROMagar Candida and CHROMagar Candida BBL did not allow a clear differentiation of the two species based upon the shade of the green color of C. dubliniensis colonies. However, on Candida ID2, all C. dubliniensis isolates produced turquoise blue colonies whereas 91% of C. albicans colonies were cobalt blue. The sensitivity and the specificity for differentiating between C. dubliniensis fromC. albicans on Candida ID2 were 100% and 91%, respectively; whereas on CHROMagar Candida these values were 63% and 89% and on CHROMagar Candida BBL they were 18% and 98%. Candida ID2 agar provides a simple and accurate laboratory approach for the identification and differentiation of C. dubliniensis on the basis of the colony color. [ABSTRACT FROM AUTHOR]

The aim of this study was to test the hypothesis that the oral biology of yeasts in children alters in response to presence of an upper removable appliance (URA). Thirty-four normal controls and 34 patients, undergoing removable orthodontic appliance treatment were studied. Saliva samples were obtained from all subjects along with a foam imprint from the fitting surface of the URA in the case of patients. Samples were cultured on CHROMagar Candida. Colonies that were green-blue in colour were confirmed as Candida albicans by the germ-tube test. Other yeasts were identified by means of commercial identification kits. Oral yeast species were isolated from 32.3% of healthy controls compared with 76.5% of children with a URA (p < 0.01). C. albicans was the most prevalent species isolated from saliva and appliance in the same individual (13) and from saliva alone in both patient (six) and control (ten) individuals. In eight of 34 patients, but in only one of 34 controls, more than one yeast species was present. The prevalence of oral colonization by Candida spp. is significantly higher amongst wearers of removable orthodontic appliances. Furthermore, the oral biology of yeasts is affected by URA wear so that colonization is more important, and by a wider variety of Candida species, and multispecies are seen. [ABSTRACT FROM AUTHOR]

CHROMagar Candida is a new differential culture medium that allows selective isolation of yeasts and simultaneously identifies colonies of Candida albicans, Candida glabrata, Candida tropicalis and Candida krusei. We evaluated this medium and compared it with a reference medium, Sabouraud glucose agar, for the presumptive identification of yeast species isolated directly on the medium from 1150 clinical specimens. A total of 731 specimens showed no growth, 299 isolates (70.2%) showed growth to the same extent on both media. Forty mixed cultures were detected on both media. More than one isolate was detected in 30 of the tested specimens on either CHROMagar (26 specimens) or Sabouraud glucose agar (four specimens). We found a sensitivity of 98.8% and a specificity of 100% for C. albicans, 66.7% and 99.8% for C. tropicalis, 100% and 100% for C. krusei, and 98% and 95.7% for C. glabrata. Regarding these results, CHROMagar Candida is recommended as a useful isolation medium capable of the presumptive identification of yeasts and better detection of mixed cultures in clinical specimens. [ABSTRACT FROM AUTHOR]

Matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) is a rapid and accurate method to identify microorganisms in clinical laboratories. This study isolates yeast-like microorganisms in the oral washes that are collected from non-bedridden nursing home residents, using CHROMagar Candida plates, and identifies them using Bruker MALDI-TOF MS. The ribosomal DNA sequences of the isolates are then examined. Three hundred and twenty yeast isolates are isolated from the oral washes. Candida species form the majority (78.1%), followed by Trichosporon/Cutaneotrichosporon species (8.8%). Bruker MALDI-TOF MS gives a high-level confidence, with a log(score) value of ≥1.8, and identifies 96.9% of the isolates. There are six inconclusive results (1.9%), and those sequences are verified as rare clinical species, including Candida ethanolica, Cutaneotrichosporon jirovecii, Exophiala dermatitidis, and Fereydounia khargensis. Almost all of the isolates have a regular color on the CHROMagar Candida plates. If the colonies are grouped by color on the plates, a specific dominant yeast species is present in each color group, except for purple or orange isolates. In conclusion, MALDI-TOF MS is verified as a fast, accurate and practical method to analyze oral yeasts in elderly subjects. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Medical Mycology / Journal de Mycologie Médicale is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)