Clinical Significance of Non-candidal Yeast like Genera with Special Reference to Trichosporon and Malassezia DC28-DC31
Dr. Savita Vivekanad Jadhav,
Professor, Department of Microbiology, Dr. D.Y. Patil Medical College, Hospital and Research Centre [Dr. D.Y. Patil Vidyapeeth Pune], Pimpri Pune, Maharashtra, India.
Introduction: The incidence of opportunistic fungal infections is increasing world over. This is mainly due to increase in risk factors like prolonged antimicrobial use, prolonged catheterisations both urinary and vascular, increased patients with immune compromised conditions, co-morbidities like hypoalbuminemia or anaemia to name a few. Along with these newer aetiological agents are emerging as pathogens. Over the years, the predominance of C. albicans changed to non-albicans Candida and now Non-Candidal Yeast-like Genera (NCYG) are slowly emerging as pathogens. They include Trichosporon, Malassezia and others. Recently these are implicated in superficial, mucosal and systemic infections from immunocompetent patients also. Hence, this study was carried out to determine the incidence of NCYG in immunocompetent patients.
Aim: To isolate and identify NCYG in clinical samples.
Materials and Methods: This retrospective study included clinical specimen received over a one-year period from immunocompetent patients from suspected fungal infections. All samples were processed for fungal follow-up as per standard protocol. This included microscopy, culture on Sabouraud Dextrose agar with and without antibiotics. Incubations were carried out at 37°C and at room temperature. Identification of growth was carried out as per follow-up for yeasts and automated VITEK ID was used for all isolates.
Results: Among various clinical specimens, fungal growth was obtained in 30.42% of samples. Of the yeast isolates, 85.47% were Candidal isolates. NCYG were isolated in 13.72%. Trichosporon was isolated in 46.15% of these NCYG. Malassezia was isolated in 26.93%. Sporothrix, Pichia, Rhodotorula, Stephanoascus and Prototheca were the other genera isolated.
Conclusion: The study highlights the presence of NCYG in clinical samples from immunocompetent patients. Identification and speciation of these emerging pathogenic yeasts should be done for better therapeutic management.