DESCRIPTIONS OF MEDICAL FUNGI

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174 Descriptions of Medical Fungi Saccharomyces cerevisiae Meyen ex Hansen Synonomy: Candida robusta Diddens & Lodder Saccharomyces cerevisiae, commonly known as Baker’s yeast, may be found as a harmless and transient digestive commensal and coloniser of mucosal surfaces of normal individuals. The anamorphic state of S. cerevisiae is sometimes referred to as Candida robusta. This species is phylogenetically closely related to Candida glabrata and shares many clinical and microbiological characteristics to this species (Arendrup et al. 2014). S. cerevisiae may be involved in mucosal infections like vaginitis, and in bloodstream infections, particularly in fluconazole-exposed patients. Note: Saccharomyces boulardii, a genetically similar subtype that is used as a probiotic for prevention and treatment of various sorts of diarrhoea and recurrent Clostridium difficile-associated diarrhoea should be avoided in immunocompromised hosts (Enache-Angoulvant and Hennequin 2005, Arendrup et al. 2014). RG-1 organism. Morphological Description: Colonies are white to cream, smooth, glabrous and yeast-like. Large globose to ellipsoidal budding yeast-like cells or blastoconidia, 3.0- 10.0 x 4.5-21.0 µm. No capsules present on India Ink preparation. Physiological Tests: + Positive, - Negative, v Variable, w Weak, s Slow, nd No data Germ Tube - L-Sorbose - L-Arabinose - D-Glucitol - Fermentation Sucrose + D-Arabinose - M-D-glucoside Glucose + Maltose + D-Ribose - D-Gluconate - Galactose v Cellobiose - L-Rhamnose - DL-Lactate v Sucrose + Trehalose + D-Glucosamine - myo-Inositol - Maltose v Lactose - N-A-D-glucosamine - 2-K-D-gluconate nd Lactose - Melibiose v Glycerol - D-Glucuronate nd Trehalose - Raffinose + Erythritol - Nitrate - Assimilation Melezitose v Ribitol - Urease - Glucose + Soluble Starch - Galactitol - 0.1% Cycloheximide - Galactose v D-Xylose - D-Mannitol - Growth at 37 O C v Molecular Identification: ITS and/or D1/D2 sequencing is recommended (McCullough et al. 1988). References: McGinnis (1980), Barnett et al. (1983), Kreger-Van Rij (1984), Rippon (1988), Kurtzman and Fell (1988), de Hoog et al. (2000, 2015). Antifungal Susceptibility: S. cerevisiae (Australian National data); MIC µg/mL. No. 64 AmB 41 1 1 8 14 11 6 FLU 42 3 2 4 6 5 12 10 VORI 38 5 8 7 8 8 2 POSA 35 1 2 4 10 11 5 2 ITRA 42 2 6 9 10 10 1 1 3 ANID 32 3 3 17 6 3 MICA 32 1 21 9 1 CAS 36 2 3 11 14 5 1 5FC 42 7 32 1 1 1
Descriptions of Medical Fungi 175 Saksenaea vasiformis Complex The genus Saksenaea is characterised by the formation of flask-shaped sporangia with columellae and simple, darkly pigmented rhizoids. It is an emerging human pathogen (Holland, 1997) that is most often associated with cutaneous or subcutaneous lesions after trauma. Until recently, Saksenaea vasiformis was the only known species with a worldwide distribution in association with soil. However S. vasiformis has recently been split into three species; S. vasiformis, S erythrospora and S. oblongispora (Alvarez et al. 2010b). All three species have been isolated from clinical samples, but as yet no proven case reports have been published on the new species (de Hoog et al. 2015). Saksenaea vasiformis Saksena Morphological Description: Colonies are fast growing, downy, white with no reverse pigment, and made up of broad, non-septate hyphae typical of a mucormycetous fungus. Sporangia are typically flask-shaped with a distinct spherical venter and longneck, arising singly or in pairs from dichotomously branched, darkly pigmented rhizoids. Collumellae are prominent and dome-shaped. Sporangiospores are small, oblong, 1-2 x 3-4 µm, and are discharged through the neck following the dissolution of an apical mucilaginous plug. RG-2 organism. Key Features: Mucorales, unique flask-shaped sporangia, failure to sporulate on primary isolation media. Molecular Identification: ITS sequencing is required for differentiation of species within the complex, and may be necessary to achieve identification in a timely manner (Alvarez et al. 2010b, Walther et al. 2012, Halliday et al. 2015). Comment: Laboratory identification of this fungus may be difficult or delayed because of the mould’s failure to sporulate on primary isolation media or on subsequent subculture onto potato dextrose agar. Sporulation may be stimulated by using the agar block method described by Ellis and Ajello (1982), Ellis and Kaminski (1985) and Padhye and Ajello (1988), although this may still take a period of days to weeks. Failure to sporulate prohibits antifungal susceptibility testing. The agar block method to induce sporulation of Saksenaea spp. and Apophysomyces spp. A small block of agar is cut from a well established culture grown on PDA and is placed in the centre of petri dish containing 1% agar in distilled water. After 21 days at 26 O C sporangia might be formed at the periphery of the petri dish. Antifungal Susceptibility: S. vasiformis very limited data, due to poor sporulation (Sun et al. 2002 and Australian national data); MIC µg/mL. Antifungal Range MIC 90 Antifungal Range MIC 90 AmB 0.125-2 2 POSA 0.016-0.25 0.25 ITRA 0.016-0.03 0.03 VORI 0.5-4 4
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DESCRIPTIONS OF MEDICAL FUNGI

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