title: Identifying Candida and other yeast-like fungi: utility of an identification algorithm in resource limited setting.
abstract: OBJECTIVE
  The increasing recovery rates of unusual yeasts with innate drug resistance make accurate identification crucial for successful therapy and infection control measures. The current study was undertaken to study the utility of CHROMagar Candida (CC) and evaluate an identification algorithm, using germ tube test (GT), CC and a commercial identification kit, API ID 32C.
  
  
  METHODS
  The prospective study was carried out at a private laboratory in Mumbai, India.
  
  
  METHODS
  Identification of 533 yeast and yeast like isolates was carried out using an identification algorithm, comprising of the GT, CC and API tests.
  
  
  RESULTS
  CC was useful to detect mixed cultures. We were able to identify 393/533, i.e. 73.7 % of isolates using GT and CC Tests only. This was because C. albicans and C. tropicalis, which can be reliably identified using CC, constituted 75.2 % of the isolates. We were unable to identify 140 isolates, i.e. 26.3 %, using GT and CC tests only and performed additional testing using API ID 32C. CC was not found to be reliable in identifying C. krusei.
  
  
  CONCLUSIONS
  The diverse identification profile obtained in our study substantiates the need for all diagnostic microbiology laboratories to be better prepared for identifying unusual yeasts. Though GT or CC testing cannot alone suffice for identification of all clinically encountered Candida and yeast-like fungi, use of GT, CC and automated identification systems in a step-wise algorithm can enable the same in a more cost effective manner.
authors: Section Head-Microbiology, EIA & Serology, SRL Ltd. , Mumbai, India .
authors: Vidya
authors: V
authors: Nerurkar
authors: Senior Scientific Officer, SRL Ltd , Mumbai, India .
authors: Suveb
authors: S
authors: Khan
authors: Section Technical Manager, SRL Ltd . Mumbai, India .
authors: Sushma
authors: S
authors: Kattungal
authors: Laboratory Director, SRL Ltd . Mumbai, India .
authors: Simi
authors: S
authors: Bhatia
keywords: Algorithm; CHROMagarTMCandida; Candida; ID32C; Yeast
references: J Clin Microbiol. 1996 Jan;34(1):58-61
references: 8748273
references: Indian Pediatr. 2004 Jul;41(7):712-5
references: 15297686
references: Clin Microbiol Rev. 1995 Oct;8(4):462-78
references: 8665465
references: J Clin Microbiol. 2001 May;39(5):2015-6
references: 11326038
references: Mycoses. 1999 Apr;42(1-2):61-5
references: 10394850
references: Indian J Med Res. 2003 Mar;117:122-8
references: 14575178
references: Indian J Dent Res. 2012 Jul-Aug;23(4):490-7
references: 23257483
references: Ann Clin Microbiol Antimicrob. 2003 Oct 29;2:8
references: 14613587
references: J Med Microbiol. 1998 Jul;47(7):623-8
references: 9839567
references: Indian J Med Microbiol. 2011 Apr-Jun;29(2):172-7
references: 21654115
references: J Clin Microbiol. 1994 Aug;32(8):1923-9
references: 7989544
references: J Clin Pathol. 1997 Jul;50(7):563-5
references: 9306935