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Volume 47, Number 4, August 2014

An emerging issue of mixed yeast cultures 

Yun-Liang Yang, Wen-Li Chu, Chih-Chao Lin, Sheng-Hua Tsai, Te-Pin Chang, Hsiu-Jung Lo

Received: August 8, 2012    Revised: November 19, 2012    Accepted: December 22, 2012   


Corresponding author:

Hsiu-Jung Lo,National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Miaoli, Taiwan
School of Dentistry, China Medical University, Taichung, Taiwan
Corresponding Author InformationCorresponding author. 35, Keyan Road, Zhunan Town, Miaoli County 350, Taiwan. 


Background and purpose: 

Different yeast species have different susceptibilities to commonly prescribed antifungal drugs. Thus, it is important to accurately determine the species of pathogenic yeasts, especially when more than one species are in a specimen. 



Clinically significant yeast isolates were collected via the Taiwan Surveillance of Antimicrobial Resistance of Yeasts from July to September in 2010. The identifications of isolates were assessed in the core laboratory at the National Health Research Institutes. 



Of the 1127 isolates recovered, 1088 were of Candida genus, accounting for 96.53% of the total isolates, followed by Cryptococcus (15, 1.33%), Trichosporon (12, 1.06%), Kodamaea (4, 0.35%), Pichia (4, 0.35%), and three others. In all, 38 out of 1116 (3.4%) specimens had mixed yeast cultures. One ascites specimen had three species, Candida albicans, Candida glabrata, and Candida tropicalis. In the remaining 37 specimens, 16 had a combination of C. albicans and C. glabrata, eight C. albicans and C. tropicalis, five C. glabrata and C. tropicalis, three Candida krusei and C. tropicalis, and five with different combinations. 



The high prevalence of cultures with mixed yeasts may be an emerging issue. Thus, to determine mixed yeast cultures in the same specimen, we highly recommend CHROMagar Candida medium to culture yeast isolates directly from the specimen. 


Key words:

Candida species, CHROMagar Candida medium, Germ tube test, Identification