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Chapter 8.8 : Full Identification of Yeasts

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Abstract:

In an era of increasing resistance of yeast species to antifungal agents and a widening range of species capable of causing diseases previously the domain of , there is almost no situation in which identification to species level is not warranted. This is especially true given the growth in the number of immune compromised patients in our society, which has provided more opportunities for yeast infections to occur and to complicate and prolong the recovery period. Molecular methods to identify yeasts directly in specimens and after growth in culture are under development. Since the last edition of this handbook, peptide nucleic acid fluorescence in situ hybridization (PNAFISH) technology (AdvanDx, Woburn, MA) has been developed, which allows identification of several yeasts directly from blood cultures. However, no commercially available method which identifies a broad range of species has been introduced. In this procedure, methods which take advantage of physiological characteristics of various yeast species are presented. Molecular methods are discussed in general terms.

Citation: Garcia L. 2010. Full Identification of Yeasts, p 442-455. In Clinical Microbiology Procedures Handbook, 3rd Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817435.ch8.8
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References

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Tables

Generic image for table
Table 8.8-1

Anamorph-teleomorph binomials of commonly encountered yeasts

Modified from reference .

Citation: Garcia L. 2010. Full Identification of Yeasts, p 442-455. In Clinical Microbiology Procedures Handbook, 3rd Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817435.ch8.8
Generic image for table
Table 8.8-2

General considerations of two commercial yeast identification systems

Citation: Garcia L. 2010. Full Identification of Yeasts, p 442-455. In Clinical Microbiology Procedures Handbook, 3rd Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817435.ch8.8
Generic image for table
Table 8.8-3

Examples of useful supplemental tests for yeasts

Note that some tests are components of commercial systems. They are listed because they are key tests.

+, positive; −, negative.

Fermentation tests require that the yeast first be grown on a sugar-free medium, such as malt extract agar or yeast morphology agar.

Citation: Garcia L. 2010. Full Identification of Yeasts, p 442-455. In Clinical Microbiology Procedures Handbook, 3rd Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817435.ch8.8
Generic image for table
Table 8.8-4

Culture and biochemical characteristics of yeasts frequently isolated from clinical specimens

Modified from Warren and Hazen ( ) and Pincus et al. ( ). +, positive; −, negative; *, some isolates may give the opposite reaction; R, rare; F, the sugar is fermented (i.e., gas was produced); W, weak fermentation.

+ growth greater than that of the negative control.

typically produces single and no more than two terminal chlamydospores, while some isolates of will produce terminal chlamydospore in pairs, triplets, and clusters.

assimilates erythritol; does not. Maximum growth temperatures, 43 to 45°C for and 33 to 37°C for .

assimilates rhamnose; usually does not.

assimilates L-arabinose; usually does not.

is a thermophilic yeast capable of growth at 40 to 42°C.

Rare strains of produce teardrop-shaped chlamydospores.

Not yeasts but may be confused with several yeast genera.

Citation: Garcia L. 2010. Full Identification of Yeasts, p 442-455. In Clinical Microbiology Procedures Handbook, 3rd Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817435.ch8.8
Generic image for table
Table 8.8-5

Characteristics of selected spp.

Modified from Hazen and Howell ( ) and Guého et al. ( ).

The carbohydrates are available from numerous chemical suppliers, including Sigma Chemical Co. (St. Louis, MO).

+, positive; −, negative; V, strain variation.

Also called an infection peg, which penetrates host tissue (hair).

Citation: Garcia L. 2010. Full Identification of Yeasts, p 442-455. In Clinical Microbiology Procedures Handbook, 3rd Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817435.ch8.8
Generic image for table
Table 8.8-6

Fermentation reactions for some Candida spp.

Note that and produce distinctively different morphologies on morphology media. and are physiologically very similar. The difficulty in distinguishing these organisms is that no single differential test (e.g., growth at 45°C, color formation on CHROMagar, or assimilation profile) is definitive. However, several (at least three) differential tests in combination provide sufficient information to identify an organism as one or the other species. Otherwise, molecular techniques should be employed to distinguish the species.

−, negative; +, positive; o, not tested routinely; v, rare negatives; V, strain variation; w, weak.

Citation: Garcia L. 2010. Full Identification of Yeasts, p 442-455. In Clinical Microbiology Procedures Handbook, 3rd Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817435.ch8.8
Generic image for table
Table 8.8-7

Key characteristics to differentiate species

All species except require lipid supplementation for growth. +, positive; −, negative.

This test is performed as described in references and .

w, weak. This test is performed by placing a drop of HO (10%) either directly on the plate culture or onto a smear of the culture on a glass slide ( ).

Growth of is inhibited by high concentrations of Tween 20. At lower concentrations, the organism exhibits Tween 20 assimilation ( ).

and can be distinguished by their morphologies. is globose, whereas produces long, cylindrical cells.

Citation: Garcia L. 2010. Full Identification of Yeasts, p 442-455. In Clinical Microbiology Procedures Handbook, 3rd Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817435.ch8.8

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