Vaginal yeast flora of pregnant women in the Gusco region of Peru

A study of the vaginal yeast flora in pregnant women living in Cusco and in its region (Peru), located approximately 3000 m above sea level, is reported. We observed 300 pregnant, healthy and non-diabetic women who attended a gynaecological clinic in the Lorena, Regional or IPSS (Instituto Peruano de Seguridad Social) hospitals in Cusco. A comprehensive clinical history was obtained from each patient. It included age, work, parity, time of pregnancy, use of contraceptives or antibiotics, type of vaginal symptoms, type and amount of vaginal secretion. The yeasts were isolated from 44.3% of the cases. The positive cases were more frequently found in the following categories: 20-30 year-old patients (69.2%), ninth month of pregnancy (49.6%), first pregnancy (41.4%), no delivery (58.7%) and no abortion (66.9%). Most women complained of leukorrhea (75.9%) with mucus, scarce without odour (18.8%) or lumpy, regular, without odour (15.8%) secretion. The yeasts isolated were Candida albicans (66.2%), other Candida species (12.8%), Torulopsis glabrata (8.3%) or other Torulopsis species (2.2%), Saccharomyces cerevisiae (7.5%), Rhodotorula sp. (1.5%) and Trichosporon cutaneum (1.5%).     

In vitro susceptibility of yeasts for fluconazole and itraconazole. Evaluation of a microdilution test

In vitro susceptibilities were determined for a total of 159 clinical isolates and 12 reference strains of yeasts belonging to different Candida species including 94 Candida albicans strains, and further genera such as Cryptococcus, Trichosporon, Geotrichum and Saccharomyces. Minimum inhibitory concentration (MIC) values for fluconazole and itraconazole were assessed using a microdilution technique with the semisynthetic high resolution (HR) medium supplemented with glucose and asparagine but without sodium hydrogen carbonate (pH 7.0), according to a proposal of the working group 'Clinical Mycology' of the German Speaking Mycological Society. Fluconazole MIC values for C. albicans were between 0.125 and > or = 128 micrograms ml-1. Thus, the median of 1 microgram ml-1 showed that the overall fluconazole susceptibility was good. As expected, Candida krusei (seven strains) exhibited diminished in vitro susceptibility with MIC values for fluconazole of 8 to 128 micrograms ml-1 with a median of 64 micrograms ml-1. Some Candida kefyr strains seemed to be less susceptible against fluconazole which was indicated by a MIC90 of 64 micrograms ml-1. Surprisingly, no Candida glabrata isolate exhibited a MIC value greater than 16 micrograms ml-1. Other Candida species, Trichosporon cutaneum, Geotrichum candidum and Saccharomyces cerevisiae showed low MICs to fluconazole. In vitro susceptibility testing of itraconazole revealed that all Candida species except C. albicans, but also Trichosporon cutaneum, Geotrichum candidum, and Saccharomyces cerevisiae exhibited acceptable low MIC values against itraconazole (0.03-2 micrograms ml-1). Their MIC90 values for itraconazole were in the close range between 0.125 and 2 micrograms ml-1. MIC values between 0.125 and 2 micrograms ml-1 were obtained, even for C. krusei strains. On the other hand, the range of C. albicans MICs was between 0.0125 and > or = 16 micrograms ml-1 with MIC50 and MIC90 values of 0.125 and > or = 16 micrograms ml-1, respectively, indicating that a considerable number of yeast strains have high MICs. The comparative evaluation of different experimental conditions revealed that there exists a marked influence both of inoculum size and incubation time on the results of susceptibility testing. Therefore, for routine usage 10(2) CFU ml-1 and 18-24 h incubation time for this microdilution method with HR medium are recommended.     

Mycological examinations on the fungal flora of the chicken comb

A total of 500 combs of adult chickens from two different locations in Germany (Hessen and Schleswig-Holstein) were clinically and mycologically examined. The chickens came from three battery cages (n = 79), one voliere system (n=32), six flocks maintained on deep litter (n = 69) and 12 flocks kept on free outdoor range (n=320). Twenty-two of the 500 chicken combs (4.4%) were found to have clinical signs: only non-specific lesions neither typical of mycosis nor of avian pox such as desquamation with crust formation, yellow to brown or black dyschromic changes, alopecia in the surrounding area and moist inflammation. Only seven of the 22 clinically altered combs showed a positive mycological result; the non-pathogenic and geophilic Trichophyton terrestre in one case and non-pathogenic yeast in six cases. The following fungi were seen in the different housing systems: 13 dermatophytes (2.6% of 500 samples): 12 x T. terrestre, 1 x Trichophyton mentagrophytes, 11 isolates of Chrysosporium georgiae (2.2% of 500 samples) and 149 isolates of yeasts (29.8%): Malassezia sympodialis: n = 52, Kloeckera apiculata: n = 33, Trichosporon capitatum (syn. Geotrichum capitatum): n = 23, Trichosporon cutaneum/Trichosporon mucoides: n = 12, Trichosporon inkin (syn. Sarcinosporon inkin): n = 8 and Candida spp.: n = 21, including pathogenic or possibly pathogenic species: Candida albicans: n = 3, Candida famata: n = 4, Candida guilliermondii: n = 3, Candida lipolytica: n = 3, Candida dattila: n = 2 and one isolate each of Candida glabrata, Candida parapsilosis, Candida aaseri, Candida catenulata sive brumpti, Candida fructus and Candida kefyr sive pseudotropicalis. There is no stringent correlation between the clinical symptoms diagnosed on the chicken combs and the species of yeasts isolated. The causative agent of favus in chickens, Trichophyton gallinae, and the saprophytic yeast in pigeons, Cr. neoformans were not isolated. The most frequently isolated yeasts M. sympodialis and Kloeckera apiculata are suggested to be classified as members of the resident flora of the chicken comb.     

On the Incidence of Yeast Species from Human Sources in Finland

Summary: A survey from Finland of 2003 positive yeast isolates, obtained from vaginal discharge during a 17-year-period 1960—1976 is presented. The total number of different species is 36, 25 of which are only occasionally seen. Candida albicans is by far the commonest species, 1274 isolates out of 2003 (63.6 %). Among other yeasts there are Torulopsis glabrata in 187, Saccharomyces cerevisiae in 105, C. krusei in 87, C. guilliermondii in 67, C. parapsilosis in 51, T. Candida in 32, C. tropicalis in 15, and Trichosporon cutaneum in 6 isolates. Pityrosporum orbiculare and P. ovale were frequently present but often overlooked. Some 35 yeast strains remained unidentified. The vaginal flora is on the whole rather poor in species, and more than two or three different species are seldom seen simultaneously on the scene. Zusammenfassung: Innerhalb eines Zeitraumes von 17 Jahren (1960—1976) wurden im Mykologischen Labor der Universitäts-Hautklinik in Turku, Finnland, 2003 positive Hefeproben aus vaginalem Fluor analysiert. Insgesamt wurden 36 verschiedene Arten gefunden, die Mehrzahl (25) derselben zwar nur ganz sporadisch als Einzelbefunde. In 1274 Proben (63,6%) konnte Candida albicans kulturell nachgewiesen werden. Von anderen Arten sind zu nennen Torulopsis glabrata in 187 Proben (9 %), Saccharomyces cerevisiae in 105 (5 %), C. krusei in 87 (4 %), C. guilliermondii in 67, C. parapsilosis in 51, T. Candida in 32 und C. tropicalis in 15 Proben. Pityrosporum orbiculare und P. ovale wurden während mehrerer Jahre ganz übersehen. Sie kommen in der Vulva und Vagina recht häufig vor. Die Mykoflora der Vagina scheint nicht sehr artreich zu sein. Das gleichzeitige Zusammentreffen von mehr als zwei oder drei verschiedenen Hefearten sieht man wohl nur selten.     

Incidence of Yeasts in Pregnant and Non-Pregnant Women in Nigeria: Hefen bei Schwangeren und Nichtschwangeren in Nigeria

The yeast flora of vagina and associated sites (cervix, urethra, perineum and rectum) in 224 pregnant and 106 non-pregnant Nigerian women was investigated. A variety of yeasts represented by 12 species were isolated. Candida albicans was the most frequently isolated species in both groups, accounting for 63.6% of the isolates from pregnant women and 44.8% of the isolates from non-pregnant women. Other species of yeasts infrequently or occasionally encountered were Torulopsis glabrata, C. tropicalis, C. pseudotropicalis, C. parapsilosis, C. krusei, C. guilliermondii, C. stellatoidea, T. candida, T. etchellsii, Saccharomyces cerevisiae, Rhodotorula rubra and Cryptococcus uniguttulatus. C. albicans was also the principal species recovered from symptomatic cases in both groups, followed by T. glabrata in pregnant women and C. parapsilosis in non-pregnant women.     

On the Incidence of Yeast Species from Human Sources in Finland

Summary: Yeasts were, during a 17-year period, 1960–1976, cultivated from 11,700 samples of human skin. In the present paper only the yeasts from 5,160 samples, from different regions of the body, except the feet and nails, are considered, with the purpose of giving a review of the different species and their frequency in Finland, as well as their power or tendency to simultaneous occurrence. (The feet and nails, comprising some 6,300 yeast isolates will be presented later.) Most samples originated from skin lesions which were thought to be caused by dermatophytes or yeasts, or from eczematous conditions where a secondary invasion of Candida was considered likely. This explains the high frequency of certain yeasts, especially C. albicans. It is to regret that no samples from healthy skin served as controls. The number of different species is 76, but only the following occurred more frequently in human skin lesions (number of strains in brackets): Candida albicans (1,975), C. guilliermondii (193), C. krusei (48), C. parapsilosis (800), C. tropicalis (28), C. zeylanoides (19), Cryptococcus albidus (93), Cr. neoformans et uniguttulatus (35), Han-senula anomala (28), Pityrosporum orbiculare (370), P. ovale (883), Rhodotorula rubra (115), Saccharomyces cerevisiae (91), Torulosis Candida (216), T. glabrata (93), and Trichosporon cutaneum (81). The major part, 56 yeast species, were seen only occasionally. Many of these species had, however, never before been found in Finland. Some 150 different combinations of simultaneously occurring yeast species were encountered. Zusammenfassung: Während einer 17jährigen Periode von 1960 bis 1976 wurden Hefen aus 11 700 Proben von menschlicher Haut gezüchtet. In der vorliegenden Arbeit werden nur Hefen berücksichtigt, die von 5160 Proben aus verschiedenen Körperregionen, mit Ausnahme der Füße und Nägel, gewonnen wurden. Dies geschieht mit der Absicht, einen Überblick über die verschiedenen Arten und die Häufigkeit ihres Auftretens in Finnland zu geben sowie ihr Vermögen bzw. ihre Tendenz zum simultanen Auftreten aufzuzeigen. (Proben von den Füßen und Nägeln, die etwa 6300 Hefeisolate beinhalten, werden später publiziert.) Die meisten Proben stammten von Hautveränderungen, bei denen eine Dermatophytose oder eine Hefemykose vermutet wurde, oder von ekzematösen Veränderungen, bei denen eine sekundäre Hefebesiedlung für wahrscheinlich gehalten wurde. Dieses erklärt das häufige Vorkommen bestimmter Hefen, insbesondere von Candida albicans. Bedauerlicherweise liegen keine Proben von gesunder Haut als Kontrolle vor. Die Anzahl der versdiiedenen isolierten Arten ist 76, aber nur die folgenden kamen häufiger in menschlichen Hautveränderungen vor (Anzahl der isolierten Stämme): Candida albicans (1975), Candida guilliermondii (193), Candida krusei (48), Candida parapsilosis (800), Candida tropicalis (28), Candida zeylanoides (19), Cryptococcus albidus (93), Cryptococcus neoformans et uniguttulatus (35), Hansenula anomala (28), Pityrosporum orbiculare (370), P. ovale (883), Rhodotorula rubra (115), Saccharomyces cerevisiae (91), Torulopsis Candida (216), T. glabrata (93) und Trichosporon cutaneum (81). Der größere Teil, 56 Hefearten, wurde nur gelegentlich beobachtet. Viele dieser Arten waren jedoch vorher noch niemals in Finnland gefunden worden. Etwa 150 verschiedene Kombinationen von gleichzeitig vorkommenden Hefearten wurden angetroffen.     

Ein vereinfachtes Verfahren zum Nachweis fermentativer Leistungen der Hefen

Ein einfaches Verfahren zur schnellen Prüfung des Gärvermögens von Hefen wird beschrieben. Die Prüfung erfolgt auf einer mit verschiedenen Bohrungen versehenen Teflonplatte. Ein Teil dieser Bohrungen wird mit Hefesuspension und Zuckerlösung gefüllt und mit Glasscheibchen bedeckt. Die bei der Gärung gebildeten Gasblasen sammeln sich unter den Glasscheibchen.
Die Hefesuspension wird durch Abschwemmen einer Oberflächenkultur auf Sabouraud-Dextrose-oder-Maltose-Agar von einer normalen Petrischale erhalten.
Zentrifugieren, Auswaschen oder Aushungern der Hefen vor dem Test erübrigt sich.
Zur Verarbeitung von zehn Hefen wird eine Arbeitszeit von etwa einer Stunde benötigt. Die fermentativen Leistungen werden nach 6—8stündiger Bebrütung bei 35° C beurteilt.
In 24 Typstämmen der Gattungen Candida, Torulopsis, Trichosporon und Saccharo-myces wurde die Brauchbarkeit der Methode für diagnostische Zwecke demonstriert.

Summary

A simple method for the screening of sugar fermentation of yeasts is described, which makes centrifugation and starvation of yeast cells prior to the fermentation test unnecessary. Yeast cells suspended in sugar solution are placed in the holes of a teflonplate. The filled holes are closed with circular coverglasses. Gasbubbles developed by the fermentation process collect below the coverglasses. Results are recorded finally after 6-8 hours of incubation at 35°C.
The yeast cell suspension is obtained by rinsing off surface colonies grown on Sabouraud-dextrose respectivly-maltose agar in usual Petri dishes.
The applicability of the method for the determination of yeasts has been demonstrated on 24 type strains of the genera Candida, Torulopsis, Trichosporon, and Saccharomyces.     

Methoden zur Bestimmung von Hefen

Nach einleitenden Bemerkungen über die Bestimmung von Hefen werden zwei Methoden beschrieben, die sich seit Jahren bewährt haben und daher zu empfehlen sind. Be-sonders in schwierigen Fällen führt das Röhrchenauxanogramm zu besseren Ergebnissen als die sonst üblichen Methoden. Die Bestimmung von hefeähnlichen Pilzen wird an Beispielen aus den Gattungen Dipodascus, Geotrichum und Trichosporon gezeigt. Geo-trichum candidum scheint als vegetative Form zu Dipodascus aggregatus zu gehören. Die zweite Methode betrifft das Gärröhrchen nach G uerra , das die Gäreigenschaften von Hefen und anderen Pilzen zuverlässig erkennen läßt.

Summary

After some remarks on the determination of yeasts two methods are described which have been proven useful in the determination of yeasts for many years and which are therefore recommended. The tube auxanogram shows the differences in growth better than other methods. The determination of yeastlike and other fungi is examplified with species of the genera Dipodascus, Geotrichum and Trichosporon. As a result of these characterizations Geotrichum candidum appears to be the vegetative form of Dipodascus aggregatus. The second method is the use of the fermentation tube of GUERRA which allows a reliable qualitative and semi-quantitative detection of the fermenting properties of yeasts.     

Comparative evaluation of Candi Select test and conventional methods for identification of Candida albicans in routine clinical isolates

The Candi Select test (Sanofi Diagnostics, Pasteur, Marnes-La-Coquette, France) is a new yeast-selective medium for the identification of Candida albicans in the clinical laboratory. The performance of this test was compared with the conventional methods of chlamydospore formation, germ tube formation and carbohydrate fermentation. Four hundred and twenty clinical yeast isolates from 412 fresh clinical specimens, including 283 C. albicans, 59 C. tropicalis, 39 Trichosporon spp., 19 C. glabrata, 11 Cryptococcus neoformans and 9 other yeasts, were evaluated. Colonies of C. albicans produced a blue-green colour on the Candi Select media which could be distinguished from the other yeasts with the naked eye within 24-48 h. The sensitivity and specificity of the Candi Select test for the identification of C. albicans were 99.65% and 97.08%, respectively. The blue-green colonies of C. albicans were easy to identify and recognize in mixed cultures and did not need detailed microscopic examination.     

Persistent fungemia--risk factors and outcome in 40 episodes

The aim of this multicenter survey was to assess risk factors and mortality in patients with persistent fungemia (PF). Cases of persistent fungemia, defined as positive blood culture for at least 3 causative days of antifungal therapy were selected. Forty cases of persistent fungemia (lasting more than 3 days) were compared with 270 non-persistent fungemias appearing within the same period, and analyzed by univariate and multivariate analysis for risk factors and outcome. The median number of days of positive culture was 4.4 (3 - 20): 22 episodes were due to Candida albicans, 1 due to non-albicans Candida spp., 6 episodes due to non-Candida spp. Yeasts: 15 were catheter related, 16 patients had yeast-infected surgical wounds, 12 were neutropenic, 4 cases were caused by species resistant in vitro, 2 to amphotericin B (Trichosporon spp.) and 2 to fluconazole (C. laurentii, C. glabrata). Fifteen patients (37.5%) died, 7 of whom due to fungemia. Nineteen cases had one known risk factor (10 had infected wound, 4 infected vascular catheter, 3 were neutropenic and 2 had inappropriate therapy). Fourteen cases had two known risk factors (4 had wound and infected catheter, 4 neutropenia and infected catheter, 2 neutropenia and resistant organism, 4 other combinations. Two cases had 3 known risk factors and one had 4 risk factors for persistent fungemia. Artificial ventilation, C. glabrata etiology, non-Candida spp. yeasts such as Trichosporon spp. and Cryptococcus spp. and prior surgery were significantly associated with persistent fungemia in univariate, whereas only C. glabrata etiology in multivariate analysis. Breakthrough fungemia during empiric therapy with fluconazole was also observed more frequently in patients with persistent fungemia. However, there was no difference in both attributable and overall mortality between both groups.     

Evaluation of the "Yeast-IDENT System" for the Identification of Medically Important Yeasts./Bewertung des "Yeast-IDENT-Systems" zur Identifizierung medizinisch wichtiger Hefen

Summary: Ninety-one coded cultures belonging to nine genera of medically important yeasts were used to evaluate the newly marketed “Yeast-IDENT” (Y-I) system for identification. The results were compared with conventional procedures which included microscopic morphology, carbohydrate assimilation and fermentation tests, other nutritional tests, and/or API 20C. The Y-I system identified isolates of Candida albicans, C. guilliermondii, C. lusitaniae, C. pseudotropicalis, Cryptococcus albidus, Cr. neoformans, Rhodotorula rubra, Saccharomyces cerevisiae, Sporobolomyces salmonicolor, Torulopsis candida and T. glabrata with 100% accuracy. With the Y-I system, other species identified with variable degree of accuracy (50–89%) included C. krusei, C. parapsilosis, C. rugosa, C. tropicalis, Cr. laurentii, Hansenula anomala and Trichosporon beigelii. One isolate each of Cr. luteolus, Cr. terreus and Prototheca wickerhamii (an achlorophyllous alga) were not identified with the Y-I system. Overall accuracy of the Y-I system was 87.2% when compared with the conventional and/or API 20C. The Y-I system is rapid and requires only 4h of incubation at 35–37°C compared with 72h to 14 d necessary for the other two procedures. Zusammenfassung: Einundneunzig verschlüsselte Kulturen von neun Genera medizinisch wichtiger Hefen wurden zur Bewertung eines neuen »Yeast-IDENT«-(Y-I)-Systems für die Hefeidentifizierung verwendet. Die Resultate wurden mit konventionellen Methoden unter Einschluß der mikroskopischen Morphologie, der Kohlenhydratassimilation und -fermentation sowie anderer Verwertungsteste und/oder mit dem API 20 C-System verglichen. Das Y-I-System identifizierte Isolate von Candida albicans, C. guilliermondii, C. lusitaniae, C. pseudotropicalis, Cryptococcus albidus, Cr. neoformans, Rhodotorula rubra, Saccharomyces cerevisiae, Sporobolomyces salmonicolor, Torulopsis candida und T. glabrata mit 100%iger Genauigkeit. Andere Hefearten wurden mit dem Y-I-System in unterschiedlichem Ausmaß (50–80%) erkannt, darunter C. krusei, C. parapsilosis, C. rugosa, C. tropicalis, Cr. laurentii, Hansenula anomala und Trichosporon beigelii. Je ein Isolat von Cr. luteolus, Cr. terreus und Prototheca wickerhamii (einer chlorophyllfreien Alge) wurden mit dem Y-I-System nicht identifiziert. Die Gesamtgenauigkeit des Y-I-Systems lag bei 87,2%, verglichen mit den konventionellen Methoden und/oder API 20 C. Das Y-I-System ist schnell und erfordert nur 4 h Bebrütungsdauer bei 35–37°C im Vergleich zu 72 h bis 14 d, die bei den beiden anderen Methodiken benötigt werden.     

Disseminated infection with Trichosporon asahii

Summary. Trichosporon fungaemia and disseminated, purpuric, papular skin lesions developed on the head, trunk and extremities of a 5-year-old female with acute lymphocytic leukaemia. Histopathologically, the skin lesions demonstrated dermal budding yeasts. She died despite treatment with antifungal drugs. The isolate from the blood was further identified morphologically and physiologically as Trichosporon asahii , based on the revision of the genus Trichosporon by Guého et al. (1992). According to the new revision. T. asahii is the only taxon regularly involved in systemic mycoses, so that most of the isolates previously reported as T. beigelii (formerly, T. cutaneum ) in human deep mycoses are now thought to belong to T. asahii.
Zusammenfassung. Bei einem fünfjährigen Mädchen mit akuter lymphatischer Leukämie entwickelte sich eine Trichosporon -Fungämie mit disse-minierten, papulösen Hautläsionen und Purpura an Kopf, Stamm und Extremitäten. Histopathologisch wurden in den Hautläsionen sprossende Hefezellen nachgewiesen. Die Patientin verstarb trotz antimykotischer Chemotherapie. Der aus dem Blut isolierte Erreger wurde als Trichosporon asahii identifiziert. Im von Guého et al. revidierten Genus Trichosporon ist T. asahii die einzige Art, die regelmäßig an der Entstehung systemischer Mykosen beteiligt ist. Die meisten der bisher aus tiefen Mykosen des Menschen isolierten Trichosporon -Stämme, die früher als T. beigelii bzw. T. cutaneum bezeichnet wurden, werden nunmehr als zu T. asahii gehörend angesehen.     

Molecular characterisation and antifungal susceptibility of clinical Trichosporon isolates in India

In Asian countries, Trichosporon infection is a well‐known disease in Japan. In India, the infection is increasingly recognised. The study was conducted to characterise the clinical Trichosporon isolates from India by phenotypic and molecular techniques. A total of 31 Trichosporon clinical isolates, recovered from patients of 14 hospitals across India were sequenced (ITS and IGS1 regions of rDNA). In vitro drug susceptibility testing of the isolates was performed against amphotericin‐B, fluconazole, itraconazole, voriconazole and posaconazole. IGS1, rather than ITS sequences, correctly identified the isolates: Trichosporon asahii, 20; Trichosporon ovoides, 3; Trichosporon inkin, 2; Trichosporon asteroides, 1; Trichosporon mucoides, 1; Trichosporon loubieri, 1; Trichosporon debeurmannianum, 1; and Trichosporon dermatis, 1. Trichosporon asahii genotype III was the most common type, followed by genotype I and VII. Both these targets did not help to identify one Trichosporon to the species level. Trichosporon debeurmannianum, T. dermatis and T. asteroides were isolated for the first time from a human disease in India. The minimum inhibitory concentrations for voriconazole and posaconazole were within effective range. The study highlights the presence of wide range of Trichosporon species causing infection in India. Voriconazole or posaconazole may be the better drugs to treat such patients.     

The yeast species causing fungemia at a university hospital in Riyadh,Saudi Arabia,during a 10-year period

This study is a retrospective investigation to determine the species of yeasts causing fungemia in a university hospital in Saudi Arabia during the years 1991-2000. A total of 189 episodes of fungemia were encountered, of which 121 (64%) occurred during 1991-1995, whereas only 68 cases (36%) were found between 1996 and 2000. Overall, 50.3% episodes were due to Candida albicans including five episodes of C. dubliniensis, followed by C. tropicalis (27%), C. parapsilosis (7.9%), C. glabrata (7.4%), C. krusei (3.2%), C. famata (1.0%); 3.2% were due to other species, namely Blastoschizomyces capitatus, Hansenula anomala, Rhodotorula rubra, and Trichosporon beigelii. The percentage of episodes of fungemia caused by C. albicans ranged from 36.4% in 1991 to 71.4% in 2000, revealing an increase in recent years. The incidence of non-C. albicans fungemia decreased from 63 (33.3%) during the first 5 years (1991-1995) to 31 (16.4%) episodes during the second 5 years. Moreover, no fungemia due to C. glabrata and C. krusei were observed during the last 3 years. Overall, during the years of the study, a decreasing incidence of yeast fungemia was observed. Fungemia occurred more frequently in patients with leukemia (24%), prematurity (16%), postsurgery (10.6%), and lymphoma (9.5%). Patients with respiratory infections and preterm infants more often had C. albicans fungemia, whereas C. tropicalis predominated in patients with hepatic disorders and leukemia. The study reports for the first time the involvement of C. dubliniensis in yeast fungemia occurring in Saudi Arabia.     

Moniliella suaveolens var. nigra. Moniliella suaveolens var. nigra

Summary:  Moniliella suaveolens (Lindner ex Lindner) von Arx var. nigra (Burn et Staub) de Hoog was isolated for the first time from a hyperkeratose lesion on the hand palms of a patient hospitalized in Gottwaldov, Czechoslovakia. This black yeast-like organism occurred in company with pathogenic yeasts, Candida albicans, C. krusei and Trichosporon cutaneum. In this paper, M. suaveolens var. nigra is described morphologically and physiologically.
Zusammenfassung:  Moniliella suaveolens (Lindner ex Lindner) von Arx var. nigra (Burri et Staub) de Hoog wurde erstmals in der Tschechoslowakei an einer Hyperkeratose beider Handoberflächen eines hospitalisierten Patienten in Gottwaldov gefunden. Dieser schwarze Mikrooorganismus wurde aus einer Mischkultur mit Candida albicans, C. krusei und Trichosporon cutaneum isoliert und morphologisch und physiologisch beschrieben.     

Identification of yeast isolated from dermatological patients by MALDI-TOF mass spectrometry

Species identification of yeasts is based on biochemical (e.g. API ID 32 C^®, bioMérieux) and molecular biological approaches. As an alternative to DNA‐dependent methods, mass spectral analysis based identification of micro‐organisms has become increasingly recognized. In a number of studies, matrix‐assisted laser desorption/ionization time‐of‐flight mass spectrometry (MALDI‐TOF MS) has been applied for the rapid classification and identification of micro‐organisms. In this study, the applicability of MALDI‐TOF MS for identifying yeasts isolated from dermatological patients was analysed and compared with the results from the API ID 32 C^® system. Furthermore, sequencing the internal transcribed spacer (ITS) regions of the ribosomal DNA was employed as reference method. Candida (C.) albicans was isolated in 41.9% of all cases, C. parapsilosis in 20.3%, C. glabrata in 10.8%, and C. krusei in 6, 8.1%. Rarely isolated yeasts were Candida colliculosa, famata, guilliermondii, lusitaniae, and tropicalis as well as Geotrichum candidum, Rhodotorula mucilaginosa and Trichosporon mucoides. The MALDI TOF results were equal to the results gained by ITS sequence analysis in 94%, whereas API ID 32 C^® provided the correct diagnosis in 84.3% (of all cases). This lower identification rate is mostly referable to frequent misidentifications of C. krusei as C. inconspicua/norvegensis,Candida tropicalis, or Geotrichum capitatum. In contrast, all C. krusei strains were correctly identified by MALDI TOF MS. In conclusion, species identification by MALDI‐TOF MS was proven to be consistent with ITS sequence analysis; the technique has a resolving power comparatively as high as ITS sequence analysis.     

Wandel des dermatomykologischen Erregerspektrums

Zusammenfassung. In der vorliegenden Arbeit wurde das Erregerspektrum bei 3607 Patienten mit Verdacht auf Dermatomykose im Einzugsgebiet der Berliner Charité untersucht. Die Identifizierung von Dermatophyten und Schimmelpilzen erfolgte konventionell, die der Hefen unter Einbeziehung biochemischer und genetischer Verfahren. Charakteristisch für den gegenwärtigen Erregerwandel sind Veränderungen innerhalb der Dermatophytenflora und die wachsende Bedeutung von opportunistischen Hefen. Ausgehend von einem stabilen 5-Arten-Grundbestand aus Trichophyton rubrum, T. mentagrophytes, Candida albicans, C. parapsilosis und Trichosporon cutaneum wird über die zunehmende Verbreitung von Microsporum canis, T. mentagrophytes var. granulosum und T. tonsurans berichtet.
Summary. The spectrum of aetiologic agents isolated from 3607 patients suspicious for dermatomycosis being in the care of the Berlin Charité Clinics was analysed. Identification of dermatophytes and moulds were performed conventionally. For the identification of yeasts biochemical and genetic methods were used. Among the dermatophytes in comparison of present with previous incidence rates changes can be observed. Opportunistic yeasts are recognized in increasing importance. Five fungal species are forming a stable base of aetiologic agents of dermatomycoses, i.e. Trichophyton rubrum, T. mentagrophytes, Candida albicans, C. parapsilosis and Trichosporon cutaneum , completed by increasing incidence of Microsporum canis, T. mentagrophytes var. granulosum and T. tonsurans .     

Zum Wachstum von Sproßpilzen auf actidionhaltigen Nährböden

Es wurden 74 verschiedene Sproßpilzarten auf ihr Vermögen hin untersucht, in Nährböden mit 400 bis 500 μg Actidion/ml zu wachsen. Von mehreren im klinischen Untersuchungsmaterial häufig vorkommenden Arten konnte jeweils eine größere Anzahl von Stämmen überprüft werden. Dabei zeigte sich, daß sich alle Stämme von Candida albicans, Candida guilliermondii, Candida lipolytica, Candida tropicalis, Candida pseudotropicalis, Trichosporen capitatum und Trichosporen cutaneum gut, hingegen Candida krusei, Candida parapsilosis und Cryptococcus neoformans nicht entwickeln konnten. Torulopsis candida, Torulopsis famata, Torulopsis glabrata und Torulopsis inconspicua sowie auch Candida mycoderma und Pichia membranaefaciens haben sowohl actidionempfindliche als auch -unenipfindliche Stämme.

Summary

Several strains (numbers varying from 1 to 60) of 74 different (individual) species of yeasts were cultivated on media (Mycoselagar, maltextract-agar) containing 400–500 μ/ml Actidione, to study infraspecific variation of Actidione-sensitivity. Among the yeasts of clinical importance in all the strains of Candida albicans (30), C. guilliermondii (30), C. lipolytica (20), C. tropicalis (25), C. pseudotropicalis (4), Trichosporon capitatum (5), and T. cutaneum (15), growth was not reduced, while all the strains of Candida krusei (25), C. parapsilosis (60), and Cryptococcus neoformans (6) more or less absolutely failed to grow under these conditions. Within the species Torulopsis candida, T. inconspicua, Candida mycoderma and Pichia membranaefaciens sensitive and insensitive strains were seen.     

Differentiation of yeasts in mastitis milk]

Differentiating 174 yeasts from clinical samples to get a survey of those species found in mastitis milk and milking machines we identified five genera with 29 species. Species of the genus Candida dominated with 77% of all samples. More than 25% of yeasts from milk were identified as C. rugosa and more than 20% as C. catenulata. The six species found most often represented 74% of all yeasts in this group. Yeasts from milking machines were more heterogeneous.