DESCRIPTIONS OF MEDICAL FUNGI

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156 Descriptions of Medical Fungi Pichia kudriavzevii Boidin et al. Synonymy: Candida krusei (Castellani) Berkhout. Issatchenkia orientalis Kudryavtesev. Pichia kudriavzevii is regularly associated with some forms of infant diarrhoea and occasionally with systemic disease. It has also been reported to colonise the gastrointestinal, respiratory and urinary tracts of patients with granulocytopenia. Environmental isolations have been made from beer, milk products, skin, faeces of animals and birds. RG-2 organism. Culture: Colonies (SDA) white to cream-coloured smooth, glabrous, yeast-like. Microscopy: Predominantly small, elongated to ovoid blastoconidia, 2-5 x 4-5 µm. India Ink Preparation: Negative - no capsules present. Dalmau Plate Culture: Abundant long, wavy, branched pseudohyphae with elongated to ovoid blastoconidia, budding off in verticillate branches. Molecular Identification: ITS sequencing recommended. MALDI-T<strong>OF</strong> MS: Able to accurately identify this species. Physiological Tests: + Positive, - Negative, v Variable, w Weak, s Slow Germ Tube - L-Sorbose - L-Arabinose - D-Glucitol - Fermentation Sucrose - D-Arabinose - α-M-D-glucoside - Glucose + Maltose - D-Ribose - D-Gluconate - Galactose - Cellobiose - L-Rhamnose - DL-Lactate + Sucrose - Trehalose - D-Glucosamine + myo-Inositol - Maltose - Lactose - N-A-D-glucosamine + 2-K-D-gluconate - Lactose - Melibiose - Glycerol + D-Glucuronate - Trehalose - Raffinose - Erythritol - Nitrate - Assimilation Melezitose - Ribitol - Urease - Glucose + Soluble Starch - Galactitol - 0.1% Cycloheximide v Galactose - D-Xylose - D-Mannitol - Growth at 40 O C + Key Features: Germ tube negative yeast and sugar assimilation pattern. Colonies pale pink on Candida CHROMagar. Antifungal Susceptibility: P. kudriavzevii (Australian National data); MIC µg/mL. CLSI clinical breakpoints are marked where available (Pfaller and Diekema 2012). Note: P. kudriavzevii is intrinsically resistant to fluconazole (No CLSI breakpoints). No. 64 AmB 152 1 2 25 41 61 18 4 FLU 152 1 9 45 77 VORI 135 5 16 62 40 7 3 2 POSA 115 1 8 18 49 30 6 1 2 ITRA 152 1 3 16 73 47 10 2 ANID 86 5 35 26 19 1 MICA 86 1 0 32 34 19 CAS 115 1 15 55 29 13 1 1 5FC 152 3 2 5 15 92 33 2
Descriptions of Medical Fungi 157 Synonymy: Candida norvegensis Dietrichson ex van Uden & Buckley. Pichia norvegensis is a very rare clinical isolate that has been reported as a causative agent of peritonitis and disseminated candidiasis in a patient on CAPD. RG-1 organism. Pichia norvegensis Leask & Yarrow Culture: Colonies (SDA) white to cream-coloured smooth, glabrous, yeast-like. Microscopy: Ovoid to ellipsoid, budding blastoconidia, 2.0-4 x 3-10 µm. India Ink Preparation: Negative - no capsules present. Dalmau Plate Culture: Spherical to ovoid budding yeast cells only. Abundant pseudohyphae produced. Molecular Identification: ITS sequencing recommended. MALDI-T<strong>OF</strong> MS: Able to accurately identify this species. Physiological Tests: + Positive, - Negative, v Variable, w Weak, s Slow Germ Tube - L-Sorbose - L-Arabinose - D-Glucitol - Fermentation Sucrose - D-Arabinose - α-M-D-glucoside - Glucose s Maltose - D-Ribose - D-Gluconate - Galactose - Cellobiose + L-Rhamnose - DL-Lactate w Sucrose - Trehalose - D-Glucosamine + myo-Inositol - Maltose - Lactose - N-A-D-glucosamine - 2-K-D-gluconate - Lactose - Melibiose - Glycerol + D-Glucuronate - Trehalose - Raffinose - Erythritol - Nitrate - Assimilation Melezitose - Ribitol - Urease - Glucose + Soluble Starch - Galactitol - 0.1% Cycloheximide - Galactose - D-Xylose - D-Mannitol - Growth at 37 O C + Key Features: Germ tube negative yeast and sugar assimilation pattern. Antifungal Susceptibility: P. norvegensis very limited data (Guitard et al. 2013, Australian National data); MIC µg/mL. No. 64 AmB 8 1 6 1 FLU 8 1 2 1 4 VORI 5 2 1 2 POSA 5 2 3 ITRA 7 1 4 1 1 ANID 1 1 MICA 1 1 CAS 4 2 2 5FC 5 1 1 1 1 1
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DESCRIPTIONS OF MEDICAL FUNGI

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