Prospective evaluation of the new chromogenic medium CandiSelect 4 for differentiation and presumptive identification of the major pathogenic Candida species
The rapid identification of pathogenic yeasts is a crucial step in ensuring that effective antifungal treatment is started as early as possible. CandiSelect 4 (CS4; Bio-Rad) is a new chromogenic medium for the isolation of fungi, the direct identification of Candida albicans and the presumptive identification of the major pathogenic Candida species. The performance of CS4 was compared with that of another chromogenic medium, CHROMagar Candida (CA; Becton Dickinson). For primary cultures, 502 of the 1549 (32 %) samples were culture-positive. A total of 542 yeasts were isolated including 465 monomicrobial and 37 mixed cultures: 392 C. albicans, 60 Candida glabrata, 25 Candida tropicalis, 12 Candida krusei and 53 other Candida species. The percentage of C. albicans isolates that could be identified directly after 24, 48 and 72 h culture was 31.6, 82.9 and 92.1 %, respectively, for CS4, and 32.9, 82.9 and 91.1 % for CA. The presumptive identification of C. glabrata, C. tropicalis and C. krusei was evaluated after 48 h incubation. The percentage of strains with morphologically typical colonies was 80, 68 and 84.6 %, respectively, for CS4 compared with 75, 76 and 76.9 % for CA. For pure subcultures, from 24 h, all isolates of C. albicans (n=21) were directly identifiable on the two chromogenic media CA and CS4. At 48 h, the proportion of typical strains observed on the two chromogenic media was identical for C. glabrata (85 %) and C. krusei (100 %). A slight difference in favour of CS4 was observed for C. tropicalis (100 vs 95 %). CS4 also allowed the growth of several other fungi. CS4 can be recommended as a primary isolation medium for the identification of C. albicans, and for the rapid and effective differentiation of the major pathogenic Candida species.
BuchnerT.,
FegelerW.,
BernhardtH.,
BrockmeyerN.,
DuswaldK. H.,
HerrmannM.,
HeuserD.,
JehnU.,
Just-NublingG.other authors2002; Treatment of severe Candida infections in high-risk patients in Germany: consensus formed by a panel of interdisciplinary investigators. Eur J Clin Microbiol Infect Dis 21:337–352[CrossRef]
CardenesC. D.,
CarrilloA. J.,
AriasA.,
Rodriguez-AlvarezC.,
Torres-LanaA.,
SierraA.,
ArevaloM. P.2002; Comparison of Albicans ID2 agar plate with the germ tube for presumptive identification of Candida albicans
. Diagn Microbiol Infect Dis 42:181–185[CrossRef]
CookeV. M.,
MilesR. J.,
PriceR. G.,
MidgleyG.,
KhamriW.,
RichardsonA. C.2002; New chromogenic agar medium for the identification of Candida spp. Appl Environ Microbiol 68:3622–3627[CrossRef]
Fricker-HidalgoH.,
OrengaS.,
LebeauB.,
PellouxH.,
Brenier-PinchartM. P.,
Ambroise-ThomasP.,
GrillotR.2001; Evaluation of Candida ID, a new chromogenic medium for fungal isolation and preliminary identification of some yeast species. J Clin Microbiol 39:1647–1649[CrossRef]
Letscher-BruV.,
MeyerM. H.,
GaloisyA. C.,
WallerJ.,
CandolfiE.2002; Prospective evaluation of the new chromogenic medium Candida ID, in comparison with Candiselect, for isolation of molds and isolation and presumptive identification of yeast species. J Clin Microbiol 40:1508–1510[CrossRef]
OddsF. C.,
BernaertsR.1994; CHROMagar Candida, a new differential isolation medium for presumptive identification of clinically important Candida species. J Clin Microbiol 32:1923–1929
PasqualottoA. C.,
NedelW. L.,
MachadoT. S.,
SeveroL. C.2005; A comparative study of risk factors and outcome among outpatient-acquired and nosocomial candidaemia. J Hosp Infect 60:129–134[CrossRef]
RexJ. H.,
WalshT. J.,
SobelJ. D.,
FillerS. G.,
PappasP. G.,
DismukesW. E.,
EdwardsJ. E.2000; Practice guidelines for the treatment of candidiasis. Infectious Diseases Society of America. Clin Infect Dis 30:662–678[CrossRef]
RousselleP.,
FreydiereA. M.,
CouillerotP. J.,
de MontclosH.,
GilleY.1994; Rapid identification of Candida albicans by using Albicans ID and fluoroplate agar plates. J Clin Microbiol 32:3034–3036
SanglardD.,
OddsF. C.2002; Resistance of Candida species to antifungal agents: molecular mechanisms and clinical consequences. Lancet Infect Dis 2:73–85[CrossRef]
WisplinghoffH.,
BischoffT.,
TallentS. M.,
SeifertH.,
WenzelR. P.,
EdmondM. B.2004; Nosocomial bloodstream infections in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study. Clin Infect Dis 39:309–317[CrossRef]
Prospective evaluation of the new chromogenic medium CandiSelect 4 for differentiation and presumptive identification of the major pathogenic Candida species