title: Rhodotorula spp. isolated from blood cultures: clinical and microbiological aspects.
abstract: 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).
authors.affiliation: Microbiology Laboratory, Division of Central Laboratory, LIM 03 Department of Pathology, University of São Paulo, São Paulo, Brazil. gmduboc@hcnet.usp.br
authors.forename: Gisele M Duboc
authors.initials: GM
authors.lastname: De Almeida
authors.forename: Silvia Figueiredo
authors.initials: SF
authors.lastname: Costa
authors.forename: Marcia
authors.initials: M
authors.lastname: Melhem
authors.forename: Adriana L
authors.initials: AL
authors.lastname: Motta
authors.forename: Maria Walderez
authors.initials: MW
authors.lastname: Szeszs
authors.forename: Fumiko
authors.initials: F
authors.lastname: Miyashita
authors.forename: Ligia C
authors.initials: LC
authors.lastname: Pierrotti
authors.forename: Flávia
authors.initials: F
authors.lastname: Rossi
authors.forename: Marcelo N
authors.initials: MN
authors.lastname: Burattini
mesh_terms: 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
chemical_list: D000935:Antifungal Agents; D000666:Amphotericin B