Chapter 117 : , , and Other Yeasts of Medical Importance

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The chapter on , , and other yeasts of medical importance outlines the taxonomy, epidemiology, and clinical significance of species from as many as 12 yeast genera. The routine diagnostic methods of microscopic examination, culture, and identification are outlined and include commonly used tests such as germ tubes and biochemical profiling kits, as well as discussion on the application, advantages, and disadvantages of molecular methods such as peptide nucleic acid fluorescent in situ hybridization, real-time PCR, sequencing, and matrix-assisted laser desorption ionization–time-of-flight mass spectrometry (MALDI-TOF). Antigen/antibody tests provide rapid and clinically important results for species such as and and these are also reviewed. The chapter contains five tables containing key identification characteristics of yeasts, including the difficult-to-identify and species, a table listing the currently available rapid tests, and a table of antifungal susceptibility profiles.

Citation: Howell S, Hazen K, Brandt M. 2015. , , and Other Yeasts of Medical Importance, p 1984-2014. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch117
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Image of FIGURE 1

Morphological features of some yeast and yeast-like organisms on cornmeal agar at 24 to 48 hours and ambient temperature. (a) : extremely elongated, rarely branched pseudohyphae; few blastoconidia. (b) : blastoconidia formed at septa and between septa. (c) : arthroconidia. (d) : chains of blastoconidia forming sparse pseudohyphae in a young culture. (e) : short, distinctly curved pseudohyphae with blastoconidia formed at, and occasionally between, septa. (f) : true hyphae and annelloconidia resembling arthroconidia. (g) : blastoconidia, chlamydospores, true hyphae, and pseudohyphae. (h) : elongated, delicately curved pseudohyphae with blastoconidia at septa. (i) spp.: blastoconidia formed at the corners of arthroconidia. Magnification, ×370. (Courtesy of B. A. Davis.) doi:10.1128/9781555817381.ch117.f1

Citation: Howell S, Hazen K, Brandt M. 2015. , , and Other Yeasts of Medical Importance, p 1984-2014. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch117
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Image of FIGURE 3

India ink preparation of . Magnification, ×400. (Courtesy of E. S. Jacobson.) doi:10.1128/9781555817381.ch117.f3

Citation: Howell S, Hazen K, Brandt M. 2015. , , and Other Yeasts of Medical Importance, p 1984-2014. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch117
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Image of FIGURE 2

Diagnostic features of selected yeasts. (a) Ascus of containing hat-shaped ascospores; (b) sporangium of containing sporangiospores; (c) with vegetative cell and ascus containing four globose ascospores; (d) bottle-shaped, budding yeast demonstrating annelloconidium and collarette (arrow) of . Magnification, ×1,000. (Courtesy of B. A. Davis.) doi:10.1128/9781555817381.ch117.f2

Citation: Howell S, Hazen K, Brandt M. 2015. , , and Other Yeasts of Medical Importance, p 1984-2014. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch117
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Image of FIGURE 4

Scheme for identification of yeasts from clinical specimens. doi:10.1128/9781555817381.ch117.f4

Citation: Howell S, Hazen K, Brandt M. 2015. , , and Other Yeasts of Medical Importance, p 1984-2014. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch117
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Image of FIGURE 5

Germ tube test. (a) Germ tube formation of (b) blastoconidial germination with constriction (arrow) of not seen with true germ tubes of Magnification, ×400. (Courtesy of B. A. Davis.) doi:10.1128/9781555817381.ch117.f5

Citation: Howell S, Hazen K, Brandt M. 2015. , , and Other Yeasts of Medical Importance, p 1984-2014. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch117
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Cultural and biochemical characteristics of yeasts frequently isolated from clinical specimens

Citation: Howell S, Hazen K, Brandt M. 2015. , , and Other Yeasts of Medical Importance, p 1984-2014. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch117
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species phenotypic characteristics based on Cabanes et al. ( ) and Ashbee ( )

Citation: Howell S, Hazen K, Brandt M. 2015. , , and Other Yeasts of Medical Importance, p 1984-2014. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch117
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Characteristics of clinically important species

Citation: Howell S, Hazen K, Brandt M. 2015. , , and Other Yeasts of Medical Importance, p 1984-2014. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch117
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Microscopic appearance of several yeasts and yeast-like fungi on morphology agar

Citation: Howell S, Hazen K, Brandt M. 2015. , , and Other Yeasts of Medical Importance, p 1984-2014. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch117
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Anamorph/teleomorph names and appearance of asci/ascospores of ascomycetous yeasts

Citation: Howell S, Hazen K, Brandt M. 2015. , , and Other Yeasts of Medical Importance, p 1984-2014. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch117
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Rapid tests (<24 h) and semirapid tests (<48 h) available for presumptive or definitive identification of yeasts following colony formation

Citation: Howell S, Hazen K, Brandt M. 2015. , , and Other Yeasts of Medical Importance, p 1984-2014. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch117
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Antifungal susceptibilities

Citation: Howell S, Hazen K, Brandt M. 2015. , , and Other Yeasts of Medical Importance, p 1984-2014. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch117

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