A real‐time PCR assay for the differentiation of Candida species

Aims: We established a real‐time PCR assay for the detection and strain identification of Candida species and demonstrated the ability to differentiate between Candida albicans the most common species, and also Candida parapsilosis, Candida glabrata, Candida tropicalis and Candida dubliniensis by LightCycler PCR and melting curve analysis. Methods and Results: The DNA isolation from cultures and serum was established using the QIAmp Tissue Kit. The sensitivity of the assay was ≥ 2 genome equivalents/assay. It was possible to differentiate all investigated Candida species by melting curve analysis, and no cross‐reaction to human DNA or Aspergillus species could be observed. Conclusions: The established real‐time PCR assay is a useful tool for the rapid identification of Candida species and a base technology for more complex PCR assays. Significance and Impact of the Study: We carried out initial steps in validation of a PCR assay for the detection and differentiation of medically relevant Candida species. The PCR was improved by generating PCR standards, additional generation of melting curves for species identification and the possibility to investigate different specimens simultaneously.     

The genus Candida Berkhout

The properties of 53 fermentation type II strains of the genusCandida Berkhout were studied. The strains in question were originally identified asCandida tropicalis (Castellani) Berkhout,Candida pelliculosa Redaelli,Candida robusta Diddens et Lodder,Candida intermedia (Cif. et Ashf.) Langeron et Guerra,Candida langeroni Dietrichson,Candida obtusa (Dietrichson) v. Uden et Carmo Sousa and as various intermediate forms between these and other similar species. The classification criteria were extended by a number of very important characteristics, such as the degree of utilization of raffinose, the assimilation of lysine, xylose, cellobiose, maltotriose, maltotetraose and arabinose, virulence for mice, nutrient requirements, serological properties, etc. Actual classification was based on the numerical method of a similarity count. On the basis of this extension of the classification criteria, the characteristics of the speciesCandida tropicalis (Castellani) Berkhout andCandida pelliculosa Redaelli were defined in greater detail.Candida intermedia, evaluated on the basis of previously employed characteristics (lactose utilization, non-assimilation of KNO₃) does not appear to be a separate species, but a collection of different border-line forms of other species of this group.Candida robusta Diddens et Lodder is regarded as a member of the genusSaccharomyces, notCandida. The varietiesCandida tropicalis var.lambica andCandida pelliculosa var.cylindrica likewise do not seem to belong to the species concerned and will have to be studied in greater detail from the genetic aspect, in relation to other membrane-forming types ofCandida. The authors' extension of the classification criteria considerably reduced intraspecific variability, particularly in the speciesCandida tropicalis (Castellani) Berkhout, and led to greater accuracy in the practical diagnosis of this species, which is frequent in clinical material.     

Molecular Identification of <Emphasis Type="Italic">Candida orthopsilosis</Emphasis> Isolated from Blood Culture

The incidence of candidemia and invasive candidiasis have increased markedly due to the increasing number of immunocompromised patients. There are five major medically important species of Candida with their frequency of isolation in the diminishing order namely Candida albicans, Candida parapsilosis, Candida tropicalis, Candida glabrata and Candida krusei. In addition, there are numerous other species of Candida which differ in their genetic makeup, virulence properties, drug susceptibilities and sugar assimilation capabilities. In this report, an unusual Candida species was isolated from the blood of two leukaemic patients. Conventional culture and biochemical tests identified the Candida species as C. parapsilosis. Using fungal-specific oligonucleotide primers ITS1 and ITS4, we managed to amplify the ribosomal RNA gene and its internal transcribed spacer region from the genomic DNA of these isolates. The PCR products were then purified and subjected to automated DNA sequencing using BLAST and CLUSTAL sequence analysis identified these isolates to be Candida orthopsilosis. Candida orthopsilosis is a new species recently identified in 2005, being morphologically indistinguishable from C. parapsilosis and was previously classified as a subspecies of C. parapsilosis. This report highlights the importance of complementing traditional culture and biochemical-based identification methods with DNA-based molecular assays such as PCR as the latter is more superior in terms of its discriminatory power and speed.     

Two new amycelial Candida isolated from decayed wood in the evergreen rainy Valdivian forest of southern Chile

Two novel representatives of the yeast genus Candida, isolated from advanced stages of degradation from fallen trunks of Nothofagus dombeyii (Mirb.) Blume and Laurelia sempervirens Weim., in the evergreen rainy Valdivian forest of southern Chile, are described and illustrated. The strains differ from all accepted Candida species to warrant their establishment as two new species: Candida petrohuensis and Candida rancensis.     

Three new filamentous,fermenting Candida isolated from decayed wood in the evergreen rainy Valdivian forest of southern Chile

Three unusual representatives of the genus Candida, isolated from advanced stages of decay from fallen trunks of Laurelia sempervirens Weim., Laurelia philippiana Weim., and Nothofagus obliqua (Mirb.) Blume, in the evergreen rainy Valdivian forest of southern Chile, are described and illustrated. The three yeasts differ from all accepted Candida species to warrant their establishment as three new species: Candida sophiae-reginae sp. nov., Candida pilmaiquenensis sp. nov., and Candida rignihuensis sp. nov.     

Two new filamentous,fermenting Candida isolated from decayed wood in the evergreen rainy Valdivian forest of southern Chile

Two unusual representatives of the genus Candida, isolated from advanced stages of decay from fallen trunks of Laurelia sempervirens Weim., and Nothophagus obliqua (Mirb.) Blume, in the evergreen rainy Valdivian forest of southern Chile, are described and illustrated. The two yeasts differ from all accepted Candida species to warrant their establishment as two new species: Candida sophiae-reginae sp. nov., and Candida rignihuensis sp. nov.     

Five new filamentous,glucose-fermenting Candida isolated from decayed wood in the evergreen rainy Valdivian forest of southern Chile

Five novel representatives of the yeast genus Candida isolated from advanced stages of wood degradation from fallen trunks of Eucryphia cordifolia Cav., Laurelia sempervirens Weim., Laurelia philippiana Weim., Nothofagus dombeyii (Mirb.) Blume, and Nothofagus obliqua (Mirb.) Blume, in the evergreen rainy Valdivian forest of southern Chile, are described and illustrated. They clearly differ from all accepted Candida species to warrant their establishment as five new species of yeasts: Candida coipomensis sp. nov., Candida ralunensis sp. nov., Candida laureliae sp. nov., Candida osornensis sp. nov., and Candida llanquihuensis sp. nov.     

Phenotypic variability and therapeutic implications of Candida species in patients with oral lichen planus

We investigated the prevalence and phenotypic variation of Candida species in oral lichen planus (OLP) and the therapeutic implications of our findings. Eighty patients with clinically and histopathologically confirmed cases of OLP (64 non-erosive, 16 erosive) and a control group of 80 healthy individuals with no predisposing factors for oral candidiasis were examined for evidence of Candida infection. Oral swabs and smears were obtained for cytology and culture. Identification, speciation and antifungal susceptibility tests of Candida isolates were performed using an automated microbial identification system. Fifty percent of erosive OLP cases, 28% of non-erosive cases and none of the controls showed evidence of Candida. Candida albicans was found predominantly in non-erosive OLP, while other Candida species were predominate in erosive OLP. Non-Candida albicans isolates (C. glabrata, C. krusei) were resistant to the commonly used antifungals, clotrimazole and fluconazole. Candida infection is common in cases of OLP. We recommend antifungal sensitivity testing prior to antifungal therapy for the erosive form of OLP.     

Epidemiology and molecular typing of Candida isolates from burn patients

This study, spread over a span of 2 years describes Candida infections in burn patients of an Indian hospital. A total of 220 burn patients were monitored and Candida could be isolated from 138 patients. A total of 228 different Candida species were obtained from various body locations of these patients. Species identification revealed that Candida albicans was the most predominant (45) followed by Candida tropicalis(33), Candida glabrata (13.5), C. parapsilosis (4), C. krusei (2.75) and C. kefyr (1.75). DNA fingerprinting of all C. albicans isolates was done by using CARE-2 probe. Fingerprinting analyses of all the C. albicans strains revealed that strains collected from different patients were different. It is noteworthy that patients with disseminated candidiasis had a similar, but unique strain isolated from all body locations, suggesting a possibility that commensal isolates might be turning pathogenic. Taken together, this is probably the first ever detailed survey of Candidainfections in burn patients in India and is expected to lead to better clinical management of this group of patients.     

New anamorphic yeast species: Candida infanticola sp. nov., Candida polysorbophila sp. nov., Candida transvaalensis sp. nov. and Trigonopsis californica sp. nov

Three new species of Candida and a new species of Trigonopsis are described based on their recognition from phylogenetic analysis of gene sequences from large subunit ribosomal RNA, ITS1/ITS2 rRNA, mitochondrial small subunit rRNA and cytochrome oxidase II. Candida infanticola sp. nov. (type strain NRRL Y-17858, CBS 7922) was isolated from the ear of an infant in Germany and is closely related to Candida sorbophila. Candida polysorbophila sp. nov. (type strain NRRL Y-27161, CBS 7317) is a member of the Zygoascus clade and was isolated in South Africa as a contaminant from an emulsion of white oil and polysorbate. Candida transvaalensis sp. nov. (type strain NRRL Y-27140, CBS 6663) was obtained from forest litter, the Transvaal, South Africa, and forms an isolated clade with Candida santjacobensis. Trigonopsis californica sp. nov. (type strain NRRL Y-27307, CBS 10351) represents a contaminant from wine in California, and forms a well-supported clade with Trigonopsis cantarellii, Trigonopsis variabilis and Trigonopsis vinaria.     

Heteroduplex mobility assay of the 26S rDNA D1/D2 region for differentiation of clinically relevant Candida species

The Heteroduplex Mobility Assay (HMA) method using the PCR amplified D1/D2 region of the 26S rDNA was tested for the differentiation of clinically relevant Candida species. Strains belonging to the same species are not expected to form heteroduplexes in this assay when their PCR products are mixed. D1/D2 HMA experiments between all Candida type strains tested showed heteroduplex formation, including Candida albicans and Candida dubliniensis. There was no heteroduplex formation when most clinical and non-type strains were tested against the type strain of their presumptive species, except when C. albicans WVE and C.␣dubliniensis TAI were analysed. Additional HMA experiments, phenotypic characterisation, and D1/D2 sequencing identified these isolates as Candida tropicalis and Candida parapsilosis, respectively. HMA provides a rapid and relatively simple molecular tool for the differentiation of potentially pathogenic Candida species.     

Candida vanriji nova species a new yeast from Swedish soils

Summary A new species of Candida is described: it was isolated from soils of Sweden. This species is named Candida vanriji nova species in honour of Mrs. N. W. Kreger-Van Rij of the C. B. S. of Delft.     

Three new,non-fermenting,and nitrate-negative Candida species isolated from decayed wood in the evergreen rainy Valdivian forest of southern Chile

Three unusual species of yeasts have been isolated from decayed wood palo podrido (12) in the evergreen rainy Valdivian forest of southern Chile. According to their morphological characteristics, they were assigned to the genus Candida Berkhout (8). They differ from all recently accepted Candida species, and are described and illustrated with the names of Candida antillancae, Candida bondarzewiae, and Candida castrensis.     

Prevalence and antifungal drug sensitivity of non‐albicans Candida in oral rinse samples of self‐caring elderly

doi: 10.1111/j.1741‐2358.2010.00407.x
Prevalence and antifungal drug sensitivity of non‐albicans Candida in oral rinse samples of self‐caring elderly Aim: To assess the prevalence and antifungal drug sensitivity of non‐albicans Candida (NAC) species in elderly outpatients. Materials and methods: We investigated oral rinse samples of 194 self‐caring elderly population (mean age 83 years) with emphasis on background factors for harbouring NAC. Susceptibility of Candida species to antifungal drugs was determined using standard methodology. Multiple logistic regression analysis was performed taking positive NAC count as the dependent variable and a number of known Candida risk factors as independent variables. Results: Prevalence of candidal carriage of the population was 78.4%, of which 0.5% of the subjects were NAC positive. Candida dubliniensis was the most prevalent NAC species, followed by Candida glabrata and Candida parapsilosis. The NAC positive elderly were more often edentulous with dental prostheses or had fewer teeth than Candida albicans‐positive or yeast‐negative subjects. Dental caries slightly increased the risk for having NAC strains (odds ratio 1.08), whilst greater age appeared to lower the risk (odds ratio 0.77). Candida species were susceptible to the commonly used antifungal agents in general, but with considerable variation among species. Occasionally, some NAC exhibited lower antifungal susceptibility. Conclusion: The possibility of oral reservoirs of NAC strains which are resistant to common antifungals should be noted in elderly outpatients.     

Oral Candida carriage of patients attending a dental clinic in Braga,Portugal

BackgroundThe ability of the Candida species to colonize surfaces can be considered as a risk factor for oral infection.AimsTo establish oral Candida carriage in patients attending a dental clinic in Braga, Portugal.MethodsA total of 97 patients were analysed. Swab samples were collected and directly cultured onto CHROMagar Candida. Representative yeasts were identified by polymerase chain reaction.ResultsFrom the samples analysed 54.6% (n=53) were Candida positive, and Candida albicans was the most frequently isolated species, accounting for 79% of all the species identified. Non-C. albicans Candida (NCAC) species recovered included Candida parapsilosis, Candida glabrata, Candida tropicalis, and Candida guilliermondii. There was a lack of association between the presence of C. albicans or NCAC species, and age, gender, or prostheses wearing in this population. In 17% of the cases (n=9), polymicrobial cultures, with two different Candida species, were identified.ConclusionsThis study shows a high Candida carriage rate among this population, thus pointing to the relevance of an accurate diagnostic approach in Candida species identification.     

Two new species and one variety of nitrate-utilizing mycelial Candida isolated from decayed wood in the evergreen rainy Valdivian forest of southern Chile

Two unusual species of Candida and one variety of one of them, isolated from decayed wood (palo podrido) (12) in the ultimate stages of degradation, are described and illustrated. They differ sufficiently from all accepted Candida species to warrant their establishment as two new species and one variety: Candida railenensis, Candida bertae, and Candida bertae var. chiloensis.The DNA base composition of these yeasts was not calculated, since our laboratory is not properly equipped for that purpose.     

Four new Candida species from geographically diverse locations

Four new species of Candida are described based on their unique nucleotide sequences in the D1/D2 domain of large subunit (26S) ribosomal DNA. Candida peoriaensis (type strain NRRL YB-1497, CBS 8800) and C. ponderosae (type strain NRRL YB-2307, CBS 8801) are members of the Pichia anomala clade and were isolated in the U.S. from, respectively, the stump of an elm tree (Ulmus sp.) and from insect frass of a Ponderosa pine (Pinus ponderosa). Candida ghanaensis (type strain NRRL YB-1486, CBS 8798) is a phylogenetically divergent species from soil in Ghana and appears related to the Dipodascus/Geotrichum clade. Candida litsaeae (type strain NRRL YB-3246, CBS 8799) was isolated from the frass of an insect-infested Litsaea polyantha tree from India, and is a divergent species that is most closely related to Candida ontarioensis.     

Flocculation phenomenon of Candida albicans by lysozyme

Young colonies of Sabouraud's glucose agar room temperature culture ofCandida species from human isolation were suspended in distilled water. The suspension was mixed with a solution of lysozyme and incubated in a 37° C water bath. Within 3–5 hours, various species ofCandida cells showed flocculation to varying degrees which occurred at varying periods of onset. Among sevenCandida species,Candida albicans andCandida stellatoidea showed the strongest flocculation, earliest onset and most solution clarity than did any other species.Candida stellatoidea was indistinguishable fromCandida albicans in its degree of flocculation, and in the clarity of solution.Candida species may be arranged in the following order according to their decreasing positivity in flocculation:

1. Candida albicans
2. Candida stellatoidea
3. Candida tropicalis
4. Candida krusei
5. Candida pseudotropicalis
6. Candida parapsilosis
7. Candida guilliermondii
8. Saccharomyces species may be placed afterCandida guilliermondii.

It seems possible to separate theCandida species into 3 groups by the rate of flocculation, and clarity of solution. Group I.Candida albicans andCandida stellatoidea. Group II.Candida tropicalis, C. krusei andCandida pseudotropicalis. Group III.Candida parapsilosis andCandida guilliermondii. Saccharomyces specimens (S. cerevisiae and others) were placed after group III.     

Genero Candida: Especies Que Asimilan La Lactosa

Resumen El grupo lactosa positiva del géneroCandida actualmente está compuesto por especies que asimilan el nitrato de potasio y otras que no lo asimilan. En el género estructurado porLodder &Kregervan Rij solo existen especies que son nitrato negativo cuando son lactosa positivas.Entre las especies de este último grupo genérico dos de ellas han sido declaradas sinónimos. (C. humicola yC. curvata).Entre las nuevas especies pertenecientes al grupo de las que no utilizan el nitrato de potasioCandida pseudotumoralis yCandida vanrijii aparecen como especies muy vecinas.En el grupo de las que utilizan el nitrato de potasio sucede algo semejante conCandida muscorum yCandida yokotsukaensis.Solo el estudio de mayor número de cepas de estas especies podrá dar solución para considerar la validez o sinonimia de ellas.

---

Summary In the GenusCandida sensuLodder &Kreger-van Rij there are species which assimilate lactose but not nitrate.With the addition of eight new species two groups can be formed:1) one which assimilates nitrate and 2) one which does not. Candida humicola andCandida curvata can be considered synonymous. Candida pseudotropicalis andCandida vanrijii, on one hand, andCandida muscorum andCandida yokotsukaensis, on the other, are similar species.

     

The emergence of non-albicans Candida species as causes of invasive candidiasis and candidemia

The last three decades have seen an expanding pool of high-risk patients susceptible to the opportunistic pathogen Candida. Accordingly, a dramatic increase in nosocomial blood stream infections (BSIs) due to Candida spp has been reported throughout the world, starting in tertiary care centers and spreading to community hospitals. This absolute increase in Candida BSIs was accompanied by both an absolute and then a proportional increase in invasive infection caused by reduced fluconazole-susceptible non-albicans Candida spp. Currently, the incidence trend of BSI has stabilized, and Candida albicans remains the most common species causing fungal BSI. Clinicians must be aware of the importance and implications of non-albicans Candida spp when selecting antifungal drugs, although most studies have not shown significant outcome differences with use of the various antifungal classes.