title: An emerging issue of mixed yeast cultures.
abstract: BACKGROUND
  Different yeast species have different susceptibilities to commonly prescribed antifungal drugs. Thus, it is important to accurately determine the species of pathogenic yeasts, especially when more than one species are in a specimen.
  
  
  METHODS
  Clinically significant yeast isolates were collected via the Taiwan Surveillance of Antimicrobial Resistance of Yeasts from July to September in 2010. The identifications of isolates were assessed in the core laboratory at the National Health Research Institutes.
  
  
  RESULTS
  Of the 1127 isolates recovered, 1088 were of Candida genus, accounting for 96.53% of the total isolates, followed by Cryptococcus (15, 1.33%), Trichosporon (12, 1.06%), Kodamaea (4, 0.35%), Pichia (4, 0.35%), and three others. In all, 38 out of 1116 (3.4%) specimens had mixed yeast cultures. One ascites specimen had three species, Candida albicans, Candida glabrata, and Candida tropicalis. In the remaining 37 specimens, 16 had a combination of C. albicans and C. glabrata, eight C. albicans and C. tropicalis, five C. glabrata and C. tropicalis, three Candida krusei and C. tropicalis, and five with different combinations.
  
  
  CONCLUSIONS
  The high prevalence of cultures with mixed yeasts may be an emerging issue. Thus, to determine mixed yeast cultures in the same specimen, we highly recommend CHROMagar Candida medium to culture yeast isolates directly from the specimen.
authors.affiliation: Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan; Institute of Molecular Medicine and Bioengineering, National Chiao Tung University, Hsinchu, Taiwan.
authors.forename: Yun-Liang
authors.initials: YL
authors.lastname: Yang
authors.affiliation: National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Miaoli, Taiwan.
authors.forename: Wen-Li
authors.initials: WL
authors.lastname: Chu
authors.affiliation: National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Miaoli, Taiwan.
authors.forename: Chih-Chao
authors.initials: CC
authors.lastname: Lin
authors.affiliation: Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan; National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Miaoli, Taiwan.
authors.forename: Sheng-Hua
authors.initials: SH
authors.lastname: Tsai
authors.affiliation: National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Miaoli, Taiwan.
authors.forename: Te-Pin
authors.initials: TP
authors.lastname: Chang
authors.affiliation: National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Miaoli, Taiwan; School of Dentistry, China Medical University, Taichung, Taiwan. Electronic address: hjlo@nhri.org.tw.
authors.forename: Hsiu-Jung
authors.initials: HJ
authors.lastname: Lo
mesh_terms: D003428:Cross Infection; D006801:Humans; D059013:Microbial Consortia; D016533:Mycological Typing Techniques; D009181:Mycoses / Q000453:epidemiology / Q000382:microbiology; D062486:Public Health Surveillance; D013624:Taiwan / Q000453:epidemiology; D015003:Yeasts / Q000145:classification / Q000187:drug effects / Q000254:growth & development* / Q000302:isolation & purification
keywords: CHROMagar Candida medium; Candida species; Germ tube test; Identification