2016 ; Vol.26-12: 2206~2213
|Author||Tae-Hyoung Kim, Oh Joo Kweon, Hye Ryoun Kim, Mi-Kyung Lee|
|Place of duty||Department of Urology, Chung-Ang University College of Medicine, Seoul 06973, Republic of Korea|
|Title||Identification of Uncommon Candida Species Using Commercial Identification Systems|
J. Microbiol. Biotechnol.2016 ;
|Abstract||Recently, several studies have revealed that commercial microbial identification systems do
not accurately identify the uncommon causative species of candidiasis, including Candida
famata, Meyerozyma guilliermondii, and C. auris. We investigated the accuracy of species-level
identification in a collection of clinical isolates previously identified as C. famata (N = 38),
C. lusitaniae (N = 1 2), and M. guilliermondii (N = 5) by the Vitek 2 system. All 55 isolates were
re-analyzed by the Phoenix system (Becton Dickinson Diagnostics), two matrix-assisted laser
desorption ionization-time of flight mass spectrometry analyzers (a Vitek MS and a Bruker
Biotyper), and by sequencing of internal transcribed spacer (ITS) regions or 26S rRNA gene
D1/D2 domains. Among 38 isolates previously identified as C. famata by the Vitek 2 system,
the majority (27/38 isolates, 71.1%) were identified as C. tropicalis (20 isolates) or C. albicans (7
isolates) by ITS sequencing, and none was identified as C. famata. Among 20 isolates that were
identified as C. tropicalis, 17 (85%) were isolated from urine. The two isolates that were
identified as C. auris by ITS sequencing originated from ear discharge. The Phoenix system did
not accurately identify C. lusitaniae, C. krusei, or C. auris. The correct identification rate for 55
isolates was 92.7% (51/55 isolates) for the Vitek MS and 94.6% (52/55 isolates) for the Bruker
Biotyper, as compared with results from ITS sequencing. These results suggest that C. famata is
very rare in Korea, and that the possibility of misidentification should be noted when an
uncommon Candida species is identified.|
|Key_word||Candida, Identification, MALDI-TOF MS, Sequencing|
Castanheira M, Woosley LN, Diekema DJ, Jones RN, Pfaller MA. 2013. Candida guilliermondii and other species of Candida misidentified as Candida famata: assessment by Vitek 2, DNA sequencing analysis, and matrix-assisted laser desorption ionization-time of flight mass spectrometry in two global antifungal surveillance programs. J. Clin. Microbiol. 51: 117-124.
Chao QT, Lee TF, Teng SH, Peng LY, Chen PH, Teng LJ, Hsueh PR. 2014. Comparison of the accuracy of two conventional phenotypic methods and two MALDI-TOF MS systems with that of DNA sequencing analysis for correctly identifying clinically encountered yeasts. PLoS One 9:e109376.
Desnos-Ollivier M, Ragon M, Robert V, Raoux D, Gantier JC, Dromer F. 2008. Debaryomyces hansenii (Candida famata), a rare human fungal pathogen often misidentified as Pichia guilliermondii (Candida guilliermondii). J. Clin. Microbiol. 46:3237-3242.
Diekema D, Arbefeville S, Boyken L, Kroeger J, Pfaller M. 2012. The changing epidemiology of healthcare-associated candidemia over three decades. Diagn. Microbiol. Infect. Dis. 73: 45-48.
Clinical and Laboratory Standards Institute. 2008. Interpretive criteria for identification of bacteria and fungi by DNA target sequencing; approved guideline. CLSI document MM18-A. Clinical and Laboratory Standards Institute, Wayne, PA.
Jamal WY, Ahmad S, Khan ZU, Rotimi VO. 2014. Comparative evaluation of two matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) systems for the identification of clinically significant yeasts. Int. J. Infect. Dis. 26: 167-170.
Kathuria S, Singh PK, Sharma C, Prakash A, Masih A, Kumar A, et al. 2015. Multidrug-resistant Candida auris misidentified as Candida haemulonii: characterization by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS), and DNA sequencing and its antifungal susceptibility profile variability by VITEK 2, CLSI broth microdilution, and E-test method. J. Clin. Microbiol. 53: 1823-1830.
Kim HY, Huh HJ, Choi R, Ki CS, Lee NY. 2015. Three cases of candidiasis misidentified as Candida famata by the Vitek 2 system. Ann. Lab. Med. 35: 175-177.
Kim SH, Shin JH, Mok JH, Kim SY, Song SA, Kim HR, et al. 2014. Misidentification of Candida guilliermondii as C. famata among strains isolated from blood cultures by the VITEK 2 system. Biomed. Res. Int. 2014: 250408.
Kim T-H, Chung D-S, Lee M-K. 2007. Risk factors for hospital-acquired urinary tract infection due to Candida species. Kor. J. Med. Mycol. 12: 156-162.
Lacroix C, Gicquel A, Sendid B, Meyer J, Accoceberry I, Francois N, et al. 2014. Evaluation of two matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) systems for the identification of Candida species. Clin. Microbiol. Infect. 20: 153-158.
Leaw SN, Chang HC, Sun HF, Barton R, Bouchara JP, Chang TC. 2006. Identification of medically important yeast species by sequence analysis of the internal transcribed spacer regions. J. Clin. Microbiol. 44: 693-699.
Lee MK, Yong D, Kim M, Kim MN, Lee K. 2010. [Species distribution and antifungal susceptibilities of yeast clinical isolates from three hospitals in Korea, 2001 to 2007]. Kor. J. Lab. Med. 30: 364-372.
Lee WG, Shin JH, Uh Y, Kang MG, Kim SH, Park KH, Jang HC. 2011. First three reported cases of nosocomial fungemia caused by Candida auris. J. Clin. Microbiol. 49: 3139-3142.
Marcos JY, Pincus DH. 2013. Fungal diagnostics: review of commercially available methods. Methods Mol. Biol. 968: 25-54.
Miceli MH, Diaz JA, Lee SA. 2011. Emerging opportunistic yeast infections. Lancet Infect. Dis. 11: 142-151.
Pfaller MA, Diekema DJ, Gibbs DL, Newell VA, Ellis D, Tullio V, et al. 2010. Results from the artemis disk global antifungal surveillance study, 1997 to 2007: a 10.5-year analysis of susceptibilities of Candida species to fluconazole and voriconazole as determined by CLSI standardized disk diffusion. J. Clin. Microbiol. 48: 1366-1377.
Posteraro B, Ruggeri A, De Carolis E, Torelli R, Vella A, De Maio F, et al. 2013. Comparative evaluation of BD Phoenix and Vitek 2 systems for species identification of common and uncommon pathogenic yeasts. J. Clin. Microbiol. 51:3841-3845.
Putignani L, Del Chierico F, Onori M, Mancinelli L, Argentieri M, Bernaschi P, et al. 2011. MALDI-TOF mass spectrometry proteomic phenotyping of clinically relevant fungi. Mol. Biosyst. 7: 620-629.
Satoh K, Makimura K, Hasumi Y, Nishiyama Y, Uchida K, Yamaguchi H. 2009. Candida auris sp. nov., a novel ascomycetous yeast isolated from the external ear canal of an inpatient in a Japanese hospital. Microbiol. Immunol. 53: 41-44.
Won EJ, Shin JH, Lee W-K, Koo SH, Kim SY, Park Y-J, et al. 2013. Distribution of yeast and mold species isolated from clinical specimens at 12 hospitals in Korea during 2011. Ann. Clin. Microbiol. 16: 92-100.