Rhodotorula spp. isolated from blood cultures: clinical and microbiological aspects.
The emergence of less common fungal pathogens has been increasingly reported in the last decade. We describe 25 cases of Rhodotorula spp. isolated from blood cultures at a large Brazilian tertiary teaching hospital from 1996-2004. We also investigated the in vitro activity of four antifungal drugs, using a standardized method. The median age of patients was 43 years. The majority of patients (88%) had a central venous catheter (CVC) and 10 (40%) were recipients of a bone marrow transplant. The episode was classified as a bloodstream infection (BSI) in 80% of the patients. Amphotericin B deoxycholate was the most common antifungal used and CVC was removed in 89.5% of the patients. Death occurred in four patients (17.4%), all classified as BSI. All strains were identified as R. mucilaginosa by conventional methods. Misidentification of the species was observed in 20% and 5% of the strains with the Vitek Yeast Biochemical Card and API 20C AUX systems, respectively. Amphotericin B demonstrated good in vitro activity (MIC50/90, 0.5 microg/ml) and the MICs for fluconazole were high for all strains (MIC50/90, >64 microg/ml).
De Almeida
Gisele M Duboc
GM
Microbiology Laboratory, Division of Central Laboratory, LIM 03 Department of Pathology, University of São Paulo, São Paulo, Brazil. gmduboc@hcnet.usp.br
Costa
Silvia Figueiredo
SF
Melhem
Marcia
M
Motta
Adriana L
AL
Szeszs
Maria Walderez
MW
Miyashita
Fumiko
F
Pierrotti
Ligia C
LC
Rossi
Flávia
F
Burattini
Marcelo N
MN
D000293:Adolescent; D000328:Adult; D000368:Aged; D000666:Amphotericin B / Q000494:pharmacology; D000935:Antifungal Agents / Q000494:pharmacology; D001938:Brazil; D002177:Candidiasis / Q000188:drug therapy / Q000382:microbiology* / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D016469:Fungemia / Q000188:drug therapy / Q000382:microbiology* / Q000401:mortality; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D012189:Retrospective Studies; D012248:Rhodotorula / Q000187:drug effects / Q000302:isolation & purification*; D055815:Young Adult
D000935:Antifungal Agents; D000666:Amphotericin B