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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5575_Библиотеки_им_академика_М_И_Перельмана
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Synonymy: Candida fabianii Kodama et al.
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Cyberlindnera fabianii is a rare opportunistic yeast species. Its ability to cause septicaemia, produce biofilm, and rapid acquisition of resistance to fluconazole and voriconazole, reinforced the need for its identification from its closely related species (Arastehfar et al., 2019; Park et al., 2019).
RG-1 organism
Culture: Colonies (SDA) white to cream coloured, smooth, glabrous, yeast-like.
Microscopy: Spheroidal to ellipsoidal budding blastoconidia, 3.0-6.5 x 2-5.5 μm in size. No pseudohyphae
are produced. Asci when present, are spherical, containing one to four spherical, finely roughened ascospores.
India ink preparation: Negative - no capsules present.
Dalmau plate culture: Spherical to ovoid budding yeast cells and occasional pseudohyphae produced.
Molecular identification: ITS sequencing recommended.
MALDI-ToF MS: Able to accurately identify this species.
Germ tube formation: Negative.
Physiological tests: (+ Positive, - Negative, v Variable, w Weak, s Slow, n not done).
Fermentation:
Glucose + Sucrose + Lactose –
Galactose – Maltose +,s Trehalose –
Growth reactions:
Glucose + L-Sorbose – myo-Inositol –
Sucrose + L-Rhamnose – DL-Lactate +
Raffinose + D-Xylose + D-Gluconate +
Melibiose – L-Arabinose – 2-Keto-D-gluconate –
Galactose – D-Arabinose – D-Glucosamine –
Lactose – D-Ribose – N-Acetyl-D-glucosamine –
Trehalose + Glycerol + D-Glucuronate n
Maltose + Erythritol – Nitrate +
Melezitose + Ribitol – Urease –
Methyl-α-D-glucoside + Galactitol – 0.1% Cycloheximide n
Soluble starch + D-Mannitol + Growth at 37oC +
Cellobiose + D-Glucitol +
Key features: Germ tube negative yeast and sugar assimilation pattern. Molecular identification may be
required.
© CAB International 2023. Descriptions of Medical Fungi (eds S. Kidd, C.Halliday and D. Ellis) 96
Antifungal susceptibility: (Table 29.1).
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Table 29.1. Cyberlindnera fabianii (Pfaller et al., 2015; and Australian national data); MIC μg/mL.
Antifungal No. ≤0.016 0.03 0.06 0.125 0.25 0.5 1 2 4 8 16 32 ≥64
AmB 1 1
FLU 1 1
VORI 5 4 1
POSA 5 3 2
ITRA 1 1
ANID 1 1
MICA 4 2 1 1
5FC 1 1
References: Kurtzman (2011a).
DOI: 10.1079/9781800622340.0029
Descriptions of Medical Fungi 97
30 Cylindrocarpon Wollenw.
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The genus contains 35 species, widespread, mostly from soil and as an occasional human and animal pathogen. Cylindrocarpon differs from Fusarium by lacking an asymmetrical foot-cell on the macroconidia
(Summerbell and Schroers, 2002).
RG-2 organism if isolated from humans
Morphological description: Colonies are fast growing, hyaline or bright coloured, suede-like or woolly
(Fig. 30.1). Sporodochia may occasionally be present. Conidiophores consist of simple or repeatedly verticil-
late phialides, arranged in brush-like structures. Phialides are cylindrical to subulate, with small collarettes
producing hyaline, smooth-walled conidia, which are arranged in slimy masses. Two types of conidia may be
produced; macroconidia which have one to several septate, hyaline, straight or curved, cylindrical to fusiform, with a rounded apex and flat base; and microconidia which are one-celled, and usually clearly distinct
from the macroconidia (Fig. 30.1). Chlamydospores may be present or absent, hyaline to brown, spherical,
formed singly, in chains or in clumps, intercalary or terminal (Fig. 30.1).
Molecular identification: ITS sequencing recommended.
References: Booth (1966); Domsch et al. (2007); de Hoog et al. (2015).
(a)
(c)
Fig. 30.1. Cylindrocarpon spp. showing (a) culture, (b) chlamydospores and (c) macroconidia.
DOI: 10.1079/9781800622340.0030
(b)
15 ˜m
15 ˜m
© CAB International 2023. Descriptions of Medical Fungi (eds S. Kidd, C.Halliday and D. Ellis) 98
Lodder & Kreger-van Rij.
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Synonymy: Candida famata (Harrison) S.A. Meyer & Yarrow.
Debaryomyces hansenii is a common environmental isolate. It may be isolated from human skin and is
only rarely recovered from blood stream infections (Desnos-Ollivier et al., 2008).
RG-1 organism
Culture: Colonies (SDA) white to cream coloured, smooth, glabrous, yeast-like.
Microscopy: Ovoid to broadly ellipsoidal budding blastoconidia, 3.5-5 x 2-3.5 μm in size. No pseudohyphae
produced. Asci when present are spherical, persistent, containing one to two spherical ascospores with rough
walls.
India ink preparation: Negative - no capsules present.
Dalmau plate culture: Spherical to ovoid budding yeast cells only. Pseudohyphae are usually lacking.
Molecular identification: ITS sequencing recommended.
MALDI-ToF MS: Able to accurately identify this species.
Germ tube formation: Negative.
Physiological tests: (+ Positive, – Negative, v Variable, w Weak, s Slow, n not done).
Fermentation:
Glucose −,+ Sucrose −,w Lactose −
Galactose −,w Maltose −,w Trehalose −,w
Growth reactions:
Glucose + L-Sorbose v myo-Inositol −
Sucrose + L-Rhamnose v DL-Lactate v
Raffinose + D-Xylose + D-Gluconate +,w
Melibiose v L-Arabinose +,w 2-Keto-D-gluconate +
Galactose + D-Arabinose v D-Glucosamine v
Lactose v D-Ribose v N-Acetyl-D-glucosamine v
Trehalose + Glycerol + D-Glucuronate v
Maltose + Erythritol v Nitrate −
Melezitose v Ribitol + Urease −
Methyl-α-D-glucoside + Galactitol v 0.1% Cycloheximide v
Soluble starch v D-Mannitol + Growth at 37oC −
Cellobiose + D-Glucitol +,w
© CAB International 2023. Descriptions of Medical Fungi (eds S. Kidd, C.Halliday and D. Ellis)
99
Key features: Germ tube negative yeast and sugar assimilation pattern.
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Antifungal susceptibility: (Table 31.1).
Table 31.1. Debaryomyces hansenii (Diekema et al., 2009; Beyda et al., 2013; Espinel-Ingroff et al., 2014; and
Australian national data); MIC μg/mL.
Antifungal No. ≤0.016 0.03 0.06 0.125 0.25 0.5 1 2 4 8 16 32 ≥64
AmB 29 2 3 7 14 2 1
FLU 78 9 18 14 9 9 11 2 3 3
VORI 81 20 28 16 9 4 2 1 1
POSA 75 8 12 22 10 8 10 2 3
ITRA 14 2 2 1 4 3 2
ANID 26 1 2 3 1 9 10
MICA 25 1 4 1 2 8 6 3
5FC 14 1 7 1 1 2 2
References: Suzuki et al. (2011).
DOI: 10.1079/9781800622340.0031
Descriptions of Medical Fungi 100
Several species previously classified within the genus Candida have now been transferred to the genus
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Diutina, including Diutina catenulata (formerly Candida catenulata) and Diutina rugosa (formerly Candida
rugosa). D. rugosa is a complex of four highly similar species, and is referred to as the D. rugosa complex
(Khunnamwong et al., 2015; Ming et al., 2019).
32.1. Diutina catenulata (Diddens & Lodder) Khunnamwong et al.
Synonymy: Candida catenulata Diddens & Lodder.
Although most isolates of Diutina 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 m.
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.
Germ tube formation: Negative.
Physiological tests: (+ Positive, - Negative, v Variable, w Weak, s Slow).
Fermentation:
Glucose v Sucrose − Lactose −
Galactose −,s Maltose −,s Trehalose −
Growth reactions:
Glucose + L-Sorbose − myo-Inositol −
Sucrose − L-Rhamnose − DL-Lactate −
Raffinose − D-Xylose v D-Gluconate v
Melibiose − L-Arabinose − 2-Keto-D-gluconate v
Galactose + D-Arabinose − D-Glucosamine v
Lactose − D-Ribose v N-Acetyl-D-glucosamine +
Trehalose v Glycerol + D-Glucuronate −
Maltose v Erythritol − Nitrate −
Melezitose − Ribitol v Urease −
Methyl-α-D-glucoside − Galactitol − 0.1% Cycloheximide +
Soluble starch v D-Mannitol + Growth at 30oC +
Cellobiose - D-Glucitol v Growth at 37oC v
© CAB International 2023. Descriptions of Medical Fungi (eds S. Kidd, C.Halliday and D. Ellis)
101
Key features: Separation from most physiologically similar species can be accomplished based on positive
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growth responses on -mannitol, -glucitol and resistance to 0.1% cycloheximide, combined with negative
responses for sorbose and erythritol utilisation or growth in vitamin-free medium.
Antifungal susceptibility: (Table 32.1).
Table 32.1. Diutina catenulata very limited data (Australian national data); MIC μg/mL.
Antifungal No. ≤0.016 0.03 0.06 0.125 0.25 0.5 1 2 4 8 16 32 ≥64
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 3
32.2. Diutina rugosa complex
Synonymy: Candida rugosa (Anderson) Diddens & Lodder.
Diutina rugosa is a complex of at least four species, including D. rugosa, D. pararugosa, D. neorugosa, and
D. pseudorugosa (Khunnamwong et al., 2015; Ming et al., 2019). This group has been associated with cath-
eter related fungaemia and has been isolated from human and bovine faeces, sea water and soil (Sugar and
Stevens, 1985).
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 m. Sometimes short pseudohyphae
may be produced.
India ink preparation: Negative - no capsules present.
Dalmau plate culture: Densely branched pseudohyphae produced.
Germ tube formation: Negative.
Physiological tests: (+ Positive, - Negative, v Variable, w Weak, s Slow, n not done).
Fermentation: Absent.
Growth reactions:
Glucose + L-Sorbose v myo-Inositol −
Sucrose − L-Rhamnose − DL-Lactate v
Raffinose − D-Xylose v D-Gluconate v
Melibiose − L-Arabinose − 2-Keto-D-gluconate −
Galactose v D-Arabinose − D-Glucosamine −
Lactose − D-Ribose − N-Acetyl-D-glucosamine +
Trehalose − Glycerol + D-Glucuronate −
Maltose − Erythritol − Nitrate −
Melezitose − Ribitol v Urease −
Methyl-α-D-glucoside − Galactitol − 0.1% Cycloheximide −
Soluble starch − D-Mannitol v Growth at 37oC +
Cellobiose − D-Glucitol v
Descriptions of Medical Fungi 102
Key features: Germ tube negative yeast and sugar assimilation pattern (-xylose and glycerol +ve; ribitol –ve).
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Antifungal susceptibility: (Table 32.2).
Table 32.2. Diutina rugosa (Diekema et al., 2009; Espinel-Ingroff et al., 2014; and Australian national data); MIC μg/mL.
Antifungal No. ≤0.016 0.03 0.06 0.125 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 12 2
ISAV 1 1
VORI 80 50 16 4 7 3
POSA 17 12 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
References: Lachance et al. (2011).
DOI: 10.1079/9781800622340.0032
Descriptions of Medical Fungi 103
33 Drechslera Ito
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McGinnis et al. (1986b) reviewed the isolates from human and animal disease purported to be Drechslera or
Helminthosporium and concluded that all pathogenic isolates examined belong to the genera Bipolaris (and
more recently to Curvularia) or Exserohilum.
RG-1 organism
Morphological genus description: Colonies are fast growing, suede-like to downy, brown to blackish-brown
with a black reverse. Conidia are pale to dark brown, usually cylindrical or subcylindrical, straight, smooth-walled,
and are formed apically through a pore (poroconidia) in a sympodially elongating, geniculate conidiophore.
Conidia are transversely septate (phragmoconidia), with the septum delimiting the basal cell formed first during
conidium maturation. Germinating is from any or all cells and the hilum is not protuberant (Fig. 33.1).
Key features: Darkly pigmented mould producing sympodial, pale brown, cylindrical or subcylindrical,
transversely septate poroconidia.
Molecular identification: GAPDH gene sequencing recommended.
References: Ellis (1971,1976); Luttrell (1978); McGinnis (1980); Sivanesan (1987); Rippon (1988); Domsch
et al. (2007); de Hoog et al. (2015).
20 ˜m
Fig. 33.1. Drechslera dictyoides conidia (photograph courtesy John Alcorn, Plant Pathology Herbarium (BRIP),
Brisbane, Australia).
DOI: 10.1079/9781800622340.0033
© CAB International 2023. Descriptions of Medical Fungi (eds S. Kidd, C.Halliday and D. Ellis) 104
34 Emergomyces Dukik, Sigler & de
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Hoog
The genus, Emergomyces, has recently been created to accommodate a number of novel dimorphic human
pathogens that had previously been described in the genus Emmonsia. Five species are recognised:
Emergomyces pasteurianus, E. africanus, E. orientalis, E. canadensis and E. europaeus (Dukik et al., 2017;
Wang et al., 2017; Jiang et al., 2018; Schwartz et al., 2019). A review of the genus was provided by Samaddar
and Sharma (2021).
Almost all reported cases of Emergomyces infection (emergomycosis) have occurred in HIV-infected indi-
viduals, often presenting as disseminated disease with cutaneous lesions. Note: Clinical features mimic those
of histoplasmosis. To date, Emergomyces infections have been reported from four continents: Asia, Africa,
Europe and North America. The most extensive burden of disease has been observed among HIV-infected
patients from South Africa attributed to E. africanus (Moodley et al., 2019).
RG-2 organism
Morphological genus description: Emergomyces species exhibit thermal dimorphism growing in living tissue
or in culture at 37
Colonies at 25
yellow reverse. Conidia are borne on slender stalks alongside hyphae or in groups on inflated cells. They are
small, thin-walled, one-celled, sub-globose, and 2-4 μm in diameter. Colonies at 37°C on brain heart infusion
(BHI) agar containing blood are moist, white to cream coloured and yeast-like. Microscopically, numerous
small, oval shaped, narrow based budding yeast-like cells, 2-5 μm in size are observed. Note: Histopathological
features of emergomycosis also mimic histoplasmosis. In fact, these infections are indistinguishable from one
another, both showing intracellular narrow based budding yeasts, measuring 2-5 μm in size.
o
C as a budding yeast-like fungus and in culture at temperatures below 30oC as a mould.
o
C are slow growing, yellowish-white to tan, initially glabrous, becoming powdery, with a pale
Molecular identification: ITS sequencing is necessary for accurate identification of species (Jiang et al., 2018;
Samaddar and Sharma, 2021).
Key features: Clinical history, tissue morphology culture identification by ITS sequencing.
Antifungal susceptibility: (Table 34.1).
Table 34.1. Emergomyces africanus (Maphanga et al., 2017); MIC μg/mL.
Mould form Yeast form
Antifungal Range MIC
AmB ≤0.008-1 0.25 ≤0.008-1 0.25
FLU 0.12-8 0.5 0.12-1 0.5
ITRA 0.008-0.5 0.06 0.008-0.12 0.008
VORI 0.008-0.06 0.03 0.008-0.015 0.015
POSA 0.008-1 0.06 0.008-0.25 0.03
References: Kenyon et al. (2013); Dukik et al. (2017); Wang et al. (2017); Jiang et al. (2018); Schwartz et al.
(2018a,b, 2019); Samaddar and Sharma (2021).
DOI: 10.1079/9781800622340.0034
© CAB International 2023. Descriptions of Medical Fungi (eds S. Kidd, C.Halliday and D. Ellis)
90
Range MIC
105
90
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