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Candida

Recently, several taxonomic rearrangements have been made and many well-known Candida species have been renamed and moved to other genera, notably Pichia kudriavzevii (formerly Candida krusei), Meyerozyma guilliermondii (formerly Candida guilliermondii), Clavispora lusitaniae (formerly Candida lusitaniae), Kluyveromyces marxianus (formerly Candida kefyr) and Wickerhamomyces anomalus (formerly Candida pelliculosa). C. glabrata and C. parapsilosis are now recognised as species complexes (Tavanti 2005; Correia 2006; Alcoba-Florez 2005).

The genus Candida is characterised by globose to elongate yeast-like cells or blastoconidia that reproduce by narrow-based multilateral budding. Pseudohyphae and occasionally true hyphae may also be present. Colony pigmentation is usually absent. Ballistoconidia are not formed. Arthroconidia may be formed, but not extensively. Sexual reproduction is absent. Glucose may be fermented. Nitrate may be assimilated. Starch-like compounds are not produced. The diazonium blue B reaction is negative. The genus is highly polyphyletic, as it comprises mitosporic species that are devoid of special distinguishing features (Lachance et al. 2011).

Several species may be aetiological agents, most commonly Candida albicans, followed by C. parapsilosis, C. glabrata, C. tropicalis and Pichia kudriavzevii. Altogether, these five species account for >95% of human infections. However a number of other species may also be isolated. All are ubiquitous and occur naturally on humans.

Species Descriptions

  • Candida albicans

    Candida albicans is a commensal of mucous membranes and the gastrointestinal tract. Environmental isolations have been made from sources contaminated by human or animal excreta, such as polluted water, soil, air and plants.

    RG-2 organism.

    Culture: 
    Colonies (SDA) white to cream-coloured smooth, glabrous, yeast-like.

    Microscopy: 
    Spherical to subspherical budding blastoconidia, 2-7 x 3-8 µm in size.

    India Ink Preparation: 
    Negative - no capsules present.

    Dalmau Plate Culture:
    Branched pseudohyphae with dense verticils of blastoconidia. Spherical chlamydospores, mostly terminal, often on a slightly swollen subtending cell, are formed near the edge of the cover slip.

    Physiological Tests: + Positive, - Negative, v Variable, w Weak, s Slow, nd No Data
    Germ Tube + L-Sorbose v L-Arabinose v D-Glucitol v
    Fermentation Sucrose v D-Arabinose v 𝝰-M-D-glucoside v
    Glucose + Maltose + D-Ribose v D-Gluconate v
    Galactose v Cellobiose - L-Rhamnose - DL-Lactate +
    Sucrose v Trehalose v D-Glucosamine v myo-Inositol -
    Maltose + Lactose - N-A-D-glucosamine v 2-K-D-Gluconate +
    Lactose - Melibiose - Glycerol v D-Glucuronate -
    Trehalose v Raffinose - Erythritol - Nitrate -
    Assimilation Melezitose v Ribitol v Urease -
    Glucose + Soluble Starch + Galactitol - 0.1% Cyclohgeximide +
    Galactose + D-Xylose + D-Mannitol + Growth at 40C +

    Key Features: 
    Germ tube positive, production of chlamydospores on Dalmau plate culture, fermentation of glucose, sugar assimilation profile and a distinctive green colour on CHROMagar. Note: Germ tube negative variants (previously known as C. claussenii), and sucrose-negative variants (previously described as C. stellatoidea) may occur.

    Antifungal Susceptibility: Candida albicans (Australian National data); MIC µg/mL.
    No <0.016 0.03 0.06 0.12 0.25 0.5 1 2 4 8 16 >32
    AmB 1725 2 16 162 644 548 305 48
    FLU 1728 2 2 2 83 468 706 314 62 12 11 18 48
    VORI 1445 1143 156 75 18 17 18 5 5 1 1 6
    POSA 1095 504 367 137 50 18 10 6 1 1
    ITRA 1728 144 443 661 378 43 30 10 3 1 17
    ANID 821 285 320 146 64 5 1
    MICA 819 731 261 73 11 4
    CAS 1171 16 207 409 327 112 17 2
    5FC 1728 912 362 164 171 62 16 7 5 3 3 19
  • Candida catenulata

    Synonymy: 
    Candida brumptii 

    Although most isolates of Candida catenulata originate from human sources, cases of candidaemia are uncommon.

    RG-1 organism. 

    Culture: 
    Colonies (SDA) white to cream-coloured smooth, soft and wrinkled, yeast-like.

    Microscopy: 
    Ovoid to cylindrical budding blastoconidia, 1.5-4.5 x 4-12 µm.

    India Ink Preparation: 
    Negative - no capsules present.

    Dalmau Plate Culture:
    Pseudohyphae consisting of chains of ovoid or cylindroid cells, and sometimes small verticils of ovoid blastoconidia.

    Physiological Tests: + Positive, - Negative, v Variable, w Weak, s Slow, nd No Data
    Germ Tube - L-Sorbose - L-Arabinose - D-Glucitol v
    Fermentation Sucrose - D-Arabinose - 𝝰-M-D-glucoside -
    Glucose v Maltose v D-Ribose v D-Gluconate v
    Galactose -,s Cellobiose - L-Rhamnose - DL-Lactate -
    Sucrose - Trehalose v D-Glucosamine v myo-Inositol -
    Maltose -,s Lactose - NAD-glucosamine + 2KD-Gluconate v
    Lactose - Melibiose - Glycerol + D-Glucuronate -
    Trehalose - Raffinose - Erythritol - Nitrate -
    Assimilation Melezitose - Ribitol v Urease -
    Glucose + Soluble Starch v Galactitol - 0.1% Cyclohgeximide +,s
    Galactose + D-Xylose v D-Mannitol + Growth at 40C v

    Key Features: 
    Separation from most physiologically similar species can be accomplished based on positive growth responses on D-mannitol, D-glucitol and resistance to 0.1% cycloheximide, combined with negative responses for sorbose and erythritol utilisation or growth in vitamin-free medium.

    Antifungal Susceptibility: Candida catenulata (Australian National data); MIC µg/mL.
    No <0.016 0.03 0.06 0.125 0.25 0.5 1 2 4 8 16 >32
    AmB 3 2 1
    FLU 3 1 1 1
    VORI 3 2 1
    POSA 3 2 1
    ITRA 3 1 1 1
    ANID 3 1 2
    MICA 3 1 2
    CAS 3 1 2
    5FC 3 3
  • Candida dubliniensis

    Candida dubliniensis is an occasional cause of candidaemia and mucosal infection, especially in HIV patients.

    RG-2 organism.

    Culture:
    Colonies (SDA) white to cream-coloured smooth, glabrous, yeast-like.

    Microscopy:
    Spherical to subspherical budding blastoconidia, 3-8 x 2-7 µm in size.

    India Ink Preparation:
    Negative - no capsules present.

    Dalmau Plate Culture:
    Branched pseudohyphae with dense verticils of blastoconidia and spherical, mostly terminal chlamydospores.

    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 - 𝝰-M-D-glucoside +,s
    Glucose + Maltose + D-Ribose - D-Gluconate -
    Galactose +,s Cellobiose - L-Rhamnose - DL-Lactate +
    Sucrose - Trehalose s,+ D-Glucosamine v myo-Inositol -
    Maltose + Lactose - NAD-glucosamine + 2KD-Gluconate +
    Lactose - Melibiose - Glycerol w,s,+ D-Glucuronate -
    Trehalose v Raffinose - Erythritol - Nitrate -
    Assimilation Melezitose w,+ Ribitol + Urease -
    Glucose + Soluble Starch w,+ Galactitol - 0.1% Cyclohgeximide +
    Galactose + D-Xylose s,+ D-Mannitol + Growth at 40C +

    Key Features:
    Germ tube positive, similar to C. albicans, except for absence of growth at 42C; glycerol (mostly +), methyl-a-D-glucoside (-), trehalose (-), and D-xylose (-). Initial colonies dark green on CHROMagar and producing rough colonies on bird seed agar. ITS sequencing and MALDI-TOF can reliably distinguish C. dubliniensis from C. albicans.

    Antifungal Susceptibility: Candida dubliniensis (Australian National data); MIC µg/mL.
    No <0.016 0.03 0.06 0.125 0.25 0.5 1 2 4 8 16 >32
    AmB 74 1 1 3 28 30 10 1
    FLU 74 24 24 21 5
    VORI 71 71
    POSA 63 34 18 8 3
    ITRA 74 28 14 22 6 4
    ANID 49 8 12 9 12 2 6
    MICA 49 15 18 8 2 6
    CAS 66 8 23 17 9 1 1 7
    5FC 74 12 49 7 4 1 1
  • Candida glabrata complex

    Recently Candida glabrata has been recognised as a species complex consisting of C. glabrata, C. bracarensis (Correia et al. 2006) and C. nivariensis (Alcoba-Flórez et al. 2005). These three species are phenotypically indistinguishable and are best identified by molecular methods. C. bracarensis was described based on PCR-fingerprints and sequence divergence in the D1/D2 domains (Correia et al. 2006). C. nivariensis was differentiated from other yeasts on the basis of ITS sequences (Borman et al. 2008).

    RG-2 organism.

    Culture: 
    Colonies (SDA) white to cream-coloured smooth, glabrous, yeast-like.

    Microscopy:
    Ovoid to ellipsoidal budding blastoconidia, 3.4 x 2.0 µm in size. No pseudohyphae or chlamydospores produced.

    India Ink Preparation: 
    Negative - no capsules present.

    Dalmau Plate Culture: 
    Ovoid budding yeast cells only. No pseudohyphae produced.

    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 - 𝝰-M-D-glucoside -
    Glucose + Maltose - D-Ribose - D-Gluconate +
    Galactose - Cellobiose - L-Rhamnose - DL-Lactate v
    Sucrose - Trehalose v D-Glucosamine - myo-Inositol -
    Maltose - Lactose - N-A-D-glucosamine - 2-K-D-Gluconate v
    Lactose - Melibiose - Glycerol v D-Glucuronate -
    Trehalose v Raffinose - Erythritol - Nitrate -
    Assimilation Melezitose - Ribitol - Urease -
    Glucose + Soluble Starch - Galactitol - 0.1% Cyclohgeximide -
    Galactose - D-Xylose - D-Mannitol - Growth at 40C +

    Key Features:
    Germ tube negative yeast and sugar assimilation pattern. C. glabrata is a common yeast species found on the body surface. Approximately 10% of clinical isolates show azole cross-resistance.

    Antifungal Susceptibility: Candida glabrata (Australian National data); MIC µg/mL.
    No <0.03 0.06 0.12 0.25 0.5 1 2 4 8 16 32 >64
    AmB 999 10 25 274 339 283 63 5
    FLU 1000 1 1 1 8 21 60 77 316 302 213
    VORI 892 25 45 90 195 278 119 45 68 26 1
    POSA 770 3 8 15 40 115 228 231 5 125
    ITRA 1000 2 7 30 88 210 316 110 32 6 199
    ANID 629 265 208 134 5 2 3 10 1 1
    MICA 629 600 7 4 3 2 3 3 2 5
    CAS 779 35 187 292 185 58 9 3 1 9
    5FC 998 309 631 27 7 6 5 4 1 1 7

    RG-2 organism.

    Culture: 
    Colonies (SDA) white to cream-coloured smooth, glabrous, yeast-like.

    Microscopy: 
    Ellipsoidal budding blastoconidia, 3.9-6 x 2-4 µm in size. No pseudohyphae or chlamydospores produced.

    India Ink Preparation: 
    Negative - no capsules present.

    Dalmau Plate Culture: 
    No pseudohyphae produced.

    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 - 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 v D-Glucuronate -
    Trehalose s Raffinose - Erythritol - Nitrate -
    Assimilation Melezitose - Ribitol - Urease -
    Glucose + Soluble Starch - Galactitol - 0.1% Cyclohgeximide -
    Galactose - D-Xylose - D-Mannitol - Growth at 40C +

    Key Features: 
    C. bracarensis has variable API 20C patterns that overlap with C. nivariensis and some C. glabrata isolates, and has variable results with a rapid trehalose assay. Note: C. glabrata produces mauve-coloured colonies on CHROMagar, whereas isolates of C. bracarensis, C. nivariensis, C. norvegensis and C. inconspicua produce white colonies on CHROMagar (Alcoba-Flórez et al. 2005, Bishop et al. 2008).

    Antifungal Susceptibility: Candida bracarensis (Australian National data); MIC µg/mL.
    No <0.03 0.06 0.125 0.25 0.5 1 2 4 8 16 32 >64
    AmB 3 1 1 1
    FLU 3 2 1
    VORI 3 2 1
    POSA 3 2 1
    ITRA 3 2 1
    ANID 3 1 2
    MICA 3 3
    CAS 3 2 1
    5FC 3 1 1 1

    RG-2 organism.

    Culture: 
    Colonies (SDA) white to cream-coloured smooth, glabrous, yeast-like.

    Microscopy:
    Ellipsoidal budding blastoconidia, 3-5 x 1.8-3 µm in size. No pseudohyphae or chlamydospores produced.

    India Ink Preparation: 
    Negative - no capsules present.

    Dalmau Plate Culture:
    No pseudohyphae produced.

    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 - 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 v Galactitol - 0.1% Cyclohgeximide -
    Galactose - D-Xylose - D-Mannitol - Growth at 40C +

    Key Features:
    C. nivariensis is closely related to C. glabrata and C. bracarensis. These three species were found to differ by DNA-DNA reassociation experiments, RAPD-typing, AFLP-typing and D1/D2 and ITS sequence divergence (Alcoba-Flórez et al. 2005, Correia et al. 2006, Wahyuningsih et al. 2008).

    Antifungal Susceptibility: Candida nivariensis (Australian National data); MIC µg/mL.
    No <0.03 0.06 0.125 0.25 0.5 1 2 4 8 16 32 >64
    AmB 4 1 1 2
    FLU 4 1 1 2
    VORI 4 2 1 1
    POSA 4 1 1 2
    ITRA 4 4
    ANID 4 1 1 2
    MICA 4 4
    CAS 4 2 2
    5FC 4 2 2 1
  • Candida haemulonii complex

    Candida haemulonii has recently been reclassified as a complex of three phenotypically identical but genotypically distinct entities: C. haemulonii, C. duobushaemulonii and C. haemulonii var. vulnera, based on ITS and D1/D2 sequencing (Cendejas-Bueno et al. 2012, Ramos et al. 2015).

    Candida haemulonii

    RG-1 organism.

    Culture: 
    Colonies (SDA) white to cream-coloured smooth, glabrous, yeast-like.

    Microscopy: 
    Ovoid to globose, budding yeast-like cells or blastoconidia, 2-7 x 2-7 µm. No pseudohyphae produced.

    India Ink Preparation: 
    Negative - no capsules present.

    Dalmau Plate Culture: 
    No pseudohyphae produced.

    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 - 𝝰-M-D-glucoside -
    Glucose + Maltose + D-Ribose - D-Gluconate +
    Galactose - Cellobiose - L-Rhamnose +,w DL-Lactate -
    Sucrose - Trehalose + D-Glucosamine +,s myo-Inositol -
    Maltose - Lactose - NAD-glucosamine + 2KD-Gluconate +
    Lactose - Melibiose - Glycerol +,s D-Glucuronate -
    Trehalose +,s Raffinose +,s Erythritol - Nitrate -
    Assimilation Melezitose +,w Ribitol +,s Urease -
    Glucose + Soluble Starch - Galactitol - 0.1% Cyclohgeximide -
    Galactose +,w D-Xylose - D-Mannitol + Growth at 37C -

    Key Features: Germ tube negative yeast and sugar assimilation pattern. Molecular identification may be required. C. haemulonii has been reported from a few cases of fungaemia but clinical isolations remain rare.

    Antifungal Susceptibility: Candida haemulonii (data from Cendejas-Bueno et al. 2012, Ramos et al. 2015 and Australian National data); MIC µg/mL.
    No <0.03 0.06 0.125 0.25 0.5 1 2 4 8 16 32 >64
    AmB 30 3 10 7 7 1 2
    FLU 30 1 3 1 25
    VORI 28 1 1 1 1 20 4
    POSA 23 3 1 1 3 16
    ITRA 30 2 1 2 1 24
    ANID 21 13 1 3 1 1 2
    MICA 21 2 10 3 2 4
    CAS 28 1 2 4 6 1 14
    5FC 25 2 4 7 6 2 3 1
  • Candida inconspicua

    Candida inconspicua is a rare cause of candidaemia.

    RG-2 organism.

    Culture: 
    Colonies (SDA) white to cream-coloured smooth, glabrous, yeast-like.

    Microscopy:
    Ellipsoidal budding blastoconidia, 3-5 x 1.8-3 µm in size. No pseudohyphae or chlamydospores produced.

    India Ink Preparation: 
    Negative - no capsules present.

    Dalmau Plate Culture: 
    No pseudohyphae produced.

    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 - 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% Cyclohgeximide -
    Galactose - D-Xylose - D-Mannitol - Growth at 40C +

    Key Features:
    Germ tube negative yeast and sugar assimilation pattern and colonies are white on Candida CHROMagar.

    Antifungal Susceptibility: Candida inconspicua limited data available (Guitard et al. 2013 Australian National data); MIC µg/mL.
    No <0.03 0.06 0.125 0.25 0.5 1 2 4 8 16 32 >64
    AmB 16 5 1 1 3 6 1
    FLU 16 2 4 10
    VORI 13 2 4 3 2 1 1
    POSA 13 2 3 5 2 1
    ITRA 15 2 6 6 1
    ANID 2 2
    MICA 2 2
    CAS 13 1 5 5 1
    5FC 14 1 1 2 4 3 1 1 1
  • Candida parapsilosis complex

    Recently Candida parapsilosis has been recognised as a complex of four species: C. parapsilosis, C. orthopsilosis, C. metapsilosis and Lodderomyces elongisporus (Tavanti et al. 2005). These four species are phenotypically indistinguishable and are best identified by ITS sequencing or MALDI-TOF MS analysis.

    RG-2 organism.

    Culture: 
    Colonies (SDA) white to cream-coloured smooth, glabrous, yeast-like.

    Microscopy:
    Predominantly small, globose to ovoid budding blastoconidia, 3-4 x 5-8 µm, with some larger elongated forms present.

    India Ink Preparation: 
    Negative - no capsules present.

    Dalmau Plate Culture: 
    Abundant, much-branched pseudohyphae in a delicate tree-like pattern with 2-3 blastoconidia in small clusters at intervals along the pseudohyphae.

    Physiological Tests: + Positive, - Negative, v Variable, w Weak, s Slow, nd No Data
    Germ Tube - L-Sorbose +,s L-Arabinose + D-Glucitol +
    Fermentation Sucrose + D-Arabinose - 𝝰-M-D-glucoside +
    Glucose + Maltose + D-Ribose v D-Gluconate v
    Galactose + Cellobiose - L-Rhamnose - DL-Lactate -
    Sucrose + Trehalose + D-Glucosamine v myo-Inositol -
    Maltose -,s Lactose - NAD-glucosamine + 2KD-Gluconate +
    Lactose - Melibiose - Glycerol + D-Glucuronate -
    Trehalose -,s Raffinose - Erythritol - Nitrate -
    Assimilation Melezitose + Ribitol v Urease -
    Glucose + Soluble Starch - Galactitol - 0.1% Cyclohgeximide -
    Galactose + D-Xylose + D-Mannitol + Growth at 37C +

    Key Features:
    Abundant, much-branched pseudohyphae in a delicate tree-like pattern with 2-3 blastoconidia in small clusters at intervals along the pseudohyphae.

    Antifungal Susceptibility: Candida parapsilosis (Australian National data); MIC µg/mL.
    No <0.03 0.06 0.12 0.25 0.5 1 2 4 8 16 32 >64
    AmB 607 10 28 131 142 201 80 2
    FLU 608 12 66 122 169 136 67 27 4 4 1
    VORI 529 365 100 48 14 3 1
    POSA 437 171 182 69 13 2
    ITRA 608 96 134 279 84 12 3
    ANID 342 3 6 7 45 149 107 18 7
    MICA 342 1 3 2 51 164 90 26 5
    CAS 459 1 1 5 38 183 177 46 4 1 3
    5FC 608 34 193 176 158 38 5 2 2

    RG-2 organism.

    Culture: 
    Colonies (SDA) white to cream-coloured smooth, glabrous, yeast-like.

    Microscopy:
    Ellipsoid, subglobose to fusiform budding blastoconidia, 4 x 3-6 µm, with some larger subglobose forms present.

    India Ink Preparation: 
    Negative - no capsules present.

    Dalmau Plate Culture: 
    Abundant, much branched pseudohyphae produced.

    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 - 𝝰-M-D-glucoside +
    Glucose + Maltose + D-Ribose + D-Gluconate +
    Galactose - Cellobiose - L-Rhamnose - DL-Lactate -
    Sucrose - Trehalose + D-Glucosamine - myo-Inositol -
    Maltose - Lactose - NAD-glucosamine + 2KD-Gluconate +
    Lactose - Melibiose - Glycerol + D-Glucuronate -
    Trehalose - Raffinose - Erythritol - Nitrate -
    Assimilation Melezitose + Ribitol + Urease -
    Glucose + Soluble Starch v Galactitol - 0.1% Cyclohgeximide -
    Galactose + D-Xylose + D-Mannitol + Growth at 37C +

    Key Features:
    Candida metapsilosis cannot be distinguished morphologically from C. parapsilosis and C. orthopsilosis, but can be identified by ITS sequencing (Asadzadeh et al. 2009, Borman et al. 2009, Tavanti et al. 2005) and MALDI-TOF MS analysis.

    Antifungal Susceptibility: Candida metapsilosis (Diekema et al. 2009 Australian National data); MIC µg/mL.
    No <0.03 0.06 0.12 0.25 0.5 1 2 4 8 16 32 >64
    AmB 32 1 5 12 11 2 1
    FLU 32 1 19 10 2
    VORI 32 27 3 2
    POSA 32 8 16 6 1
    ITRA 2 1 1
    ANID 13 2 5 3 2 1
    MICA 13 9 3 1
    CAS 26 1 5 15 4 1
    5FC 2 2

    Note: Additional data for ITRA MIC range 0.06-0.5, MIC90 = 0.25; and 5FC MIC range 0.06-64, MIC90 = 0.5 (Gomez-Lopez et al. 2008, Miranda-Zapico et al. 2011).

    RG-2 organism.

    Culture: 
    Colonies (SDA) white to cream-coloured smooth, glabrous, yeast-like.

    Microscopy:
    Ellipsoid to subglobose budding blastoconidia, 2-5 x 3-7 µm, with some larger elongated forms present.

    India Ink Preparation: 
    Negative - no capsules present.

    Dalmau Plate Culture:
    Abundant, much-branched pseudohyphae produced.

    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 - 𝝰-M-D-glucoside +
    Glucose + Maltose + D-Ribose - D-Gluconate +
    Galactose - Cellobiose - L-Rhamnose - DL-Lactate -
    Sucrose - Trehalose + D-Glucosamine - myo-Inositol -
    Maltose - Lactose - NAD-glucosamine + 2KD-Gluconate +
    Lactose - Melibiose - Glycerol + D-Glucuronate -
    Trehalose - Raffinose - Erythritol - Nitrate -
    Assimilation Melezitose + Ribitol + Urease -
    Glucose + Soluble Starch v Galactitol - 0.1% Cyclohgeximide -
    Galactose + D-Xylose + D-Mannitol + Growth at 37C +

    Key Features:  
    Candida orthopsilosis cannot be distinguished morphologically from C. parapsilosis and C. metapsilosis, but can be identified by ITS sequencing (Asadzadeh et al. 2009, Borman et al. 2009, Tavanti et al. 2005) and MALDI-TOF MS analysis.

    Antifungal Susceptibility: Candida nivariensis (Diekema et al. 2009 and Australian National data); MIC µg/mL.
    No <0.03 0.06 0.12 0.25 0.5 1 2 4 8 16 32 >64
    AmB 224 3 3 30 45 60 48 23 9
    FLU 196 1 9 45 85 24 16 9 4 3
    VORI 176 124 35 6 13 2 2
    POSA 136 26 49 41 9 11
    ITRA 94 17 30 32 15
    ANID 86 1 2 9 20 44 10
    MICA 85 2 3 36 37 6 1
    CAS 146 6 18 45 36 27 10 4
    5FC 92 56 22 8 3 1 1 1
  • Candida rugosa complex

    Candida rugosa has recently been recognised as a species complex of C. rugosa, C. pseudorugosa and another as yet undescribed species (Li et al. 2006, Paredes et al. 2012). These species are best identified by ITS sequencing.

    Candida rugosa 

    RG-1 organism. 

    Culture: 
    Colonies (SDA) white to cream-coloured smooth, glabrous, yeast-like.

    Microscopy: 
    Ellipsoidal to elongate budding blastoconidia, 5-11 x 1.5-2.5 µm. Sometimes short pseudohyphae may be produced.

    India Ink Preparation: 
    Negative - no capsules present.

    Dalmau Plate Culture: 
    Densely branched pseudohyphae produced.

    Physiological Tests: + Positive, - Negative, v Variable, w Weak, s Slow, nd No Data
    Germ Tube - L-Sorbose v L-Arabinose - D-Glucitol v
    Fermentation Sucrose - D-Arabinose - 𝝰-M-D-glucoside -
    Glucose - Maltose - D-Ribose - D-Gluconate v
    Galactose - Cellobiose - L-Rhamnose - DL-Lactate v
    Sucrose - Trehalose - D-Glucosamine - myo-Inositol -
    Maltose - Lactose - NAD-glucosamine + 2KD-Gluconate -
    Lactose - Melibiose - Glycerol + D-Glucuronate -
    Trehalose - Raffinose - Erythritol - Nitrate -
    Assimilation Melezitose - Ribitol - Urease -
    Glucose + Soluble Starch - Galactitol - 0.1% Cyclohgeximide -
    Galactose + D-Xylose + D-Mannitol v Growth at 37C +

    Key Features: 
    Germ tube negative yeast and sugar assimilation pattern (D-Xylose and Glycerol +ve; Ribitol -ve.). C. rugosa has been associated with catheter related fungaemia and has been isolated from human and bovine faeces, sea water and soil.

    Antifungal Susceptibility:  Candida rugosa limited data (Diekema et al. 2009, Espinal-Ingroff et al. 2014 and Australian National data); MIC µg/mL
    No <0.03 0.06 0.12 0.25 0.5 1 2 4 8 16 32 >64
    AmB 21 1 1 5 5 7 1 1
    FLU 97 1 3 15 24 29 8 8 6 1 2
    VORI 80 50 16 4 7 3
    POSA 66 17 27 9 8 5
    ITRA 5 1 1 1 1 1
    ANID 20 3 4 4 4 3 2
    MICA 20 2 3 5 6 2 2
    CAS 25 1 1 2 3 10 1 1 2
  • Candida tropicalis

    Candida tropicalis is a major cause of septicaemia and disseminated candidiasis. It is also found as part of the normal human mucocutaneous flora and environmental isolations have been made from faeces, shrimp, kefir and soil.

    RG-2 organism.

    Culture: 
    Colonies (SDA) white to cream-coloured smooth, glabrous, yeast-like.

    Microscopy: 
    Spherical to subspherical budding yeast-like cells or blastoconidia, 3.5-7 x 5.5-10 µm.

    India Ink Preparation: 
    Negative - no capsules present.

    Dalmau Plate Culture:
     Abundant, long, wavy, branched pseudohyphae with numerous ovoid blastoconidia, budding off. Terminal vesicles (chlamydospores) are not produced.

    Physiological Tests: + Positive, - Negative, v Variable, w Weak, s Slow, nd No Data
    Germ Tube - L-Sorbose v L-Arabinose - D-Glucitol +
    Fermentation Sucrose v D-Arabinose - 𝝰-M-D-glucoside v
    Glucose + Maltose + D-Ribose v,s D-Gluconate v
    Galactose + Cellobiose v L-Rhamnose - DL-Lactate v
    Sucrose v Trehalose + D-Glucosamine v myo-Inositol -
    Maltose + Lactose - NAD-glucosamine + 2KD-Gluconate +
    Lactose - Melibiose - Glycerol v D-Glucuronate -
    Trehalose +,s Raffinose - Erythritol - Nitrate -
    Assimilation Melezitose v Ribitol v Urease -
    Glucose + Soluble Starch + Galactitol - 0.1% Cyclohgeximide +
    Galactose + D-Xylose + D-Mannitol + Growth at 40C +

    Key Features:
    Germ tube negative yeast and sugar assimilation pattern. Colonies are dark blue on Candida CHROMagar.

    Antifungal Susceptibility:  Candida tropicalis (Australian National data); MIC µg/mL.
    No <0.03 0.06 0.12 0.25 0.5 1 2 4 8 16 32 >64
    AmB 284 1 8 45 94 97 38 1
    FLU 284 1 10 46 98 65 32 14 4 4 10
    VORI 251 64 64 58 34 14 6 5 1 4 1
    POSA 190 39 35 53 33 17 6 2 5
    ITRA 284 15 22 94 98 43 2 1 1 1 7
    ANID 126 17 29 67 11 1 1
    MICA 126 105 16 2 1 1 1
    CAS 207 16 68 67 40 9 3 1
    5FC 284 49 139 54 21 5 2 1 1 2 1 2 7

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