A new method of antibiotyping yeasts for subspecies discrimination and distribution in human clinical specimens

A study of the antibiotypes of 764 isolates of the genera Candida and Torulopsis from different clinical specimens is reported. The typing method was based on the susceptibility results obtained by the standardized and partially automated kit ATB-Fungus (API-bioMérieux), giving to each strain a code of six figures, according to these criteria: susceptibility to 5-fluorocytosine, amphotericin B, nystatin, miconazole, econazole, and ketoconazole. Candida albicans serotypes were determined by the Candida Check test (Iatron, Japan). Twenty-six antibiotypes were found in C. albicans (482 isolates), 21 types in serotype A, and 15 in serotype B strains. Candida parapsilosis (115 isolates) was divided into 11 antibiotypes, Torulopsis glabrata (53 isolates) into five, Candida guilliermondii (36 isolates) into 10 and Candida tropicalis (31 isolates) into eight. Depending on the sample origin, 000000 (susceptibility to all the antifungals tested) was the predominant C. albicans antibiotype (92.9% of blood isolates, 41.2% of vaginal isolates, 33.3% of respiratory isolates, isolates, 31.01% or oral and digestive tract isolates, and 25.0% of nail and skin isolates). No predominant antibiotypes were found in strains from respiratory tract, skin ad nails. A reproducibility close to 99% was found with the test. Simplicity and standardization could make this method useful for typing Candida and Torulopsis isolates.

[Assessment of the sensitivity to antifungal agents of clinical isolates of Candida albicans serotype A and B by the ATB Fungus method]

BACKGROUND

Candida albicans is the most frequently species isolated in patients with candidiasis. This species may be antigenically divided in serotypes A and B, which have a different pathogenic behavior and antifungal susceptibility pattern.

METHODS

The antifungal susceptibility of 443 clinical isolates from both serotypes of C. albicans to 5-fluorocytosine (5FC), amphotericin B, nystatin, econazole, miconazole and ketoconazole has been tested by means of the ATB Fungus method.

RESULTS

Both serotypes showed a similar in vitro susceptibility to amphotericin B, nystatin, econazole, miconazole and ketoconazole. All the isolates were susceptible to amphotericin B and nystatin. A small number of in vitro resistant isolates were observed to azole compounds. However, serotype B was significantly more resistant than serotype A (p = 0.0001) to 5FC.

CONCLUSIONS

C. albicans serotype B shows a lower susceptibility than serotype A to 5FC, an antifungal product not marketed in Spain. Serotyping of C. albicans does not offer additional information on antifungal susceptibility of clinical isolates from this species.

Colony morphotype on Sabouraud-triphenyltetrazolium agar: a simple and inexpensive method for Candida subspecies discrimination

A new method of Candida subspecies discrimination on Sabouraud-triphenyltetrazolium agar is reported. Five hundred sixty-two strains of Candida and Torulopsis glabrata, previously identified by conventional mycological methods, were studied. Each strain received a three-letter code and a number based on its colonial morphology. Sixteen morphotypes were found for Candida albicans, 6 were found for Candida parapsilosis, 4 were found for both Candida guilliermondii and Candida krusei, and 12 were found for Candida tropicalis. None of the 56 T. glabrata strains studied grew on this agar. A reproducibility of 95% was found for C. albicans. The simplicity and low cost could make this method useful for typing Candida spp.