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Evaluation of CHROM-Pal medium for the isolation and direct identification of Candida dubliniensis in primary cultures from the oral cavity

Ismail H. Sahand^1,, José L. Maza², Elena Eraso¹, Miguel Montejo³, María D. Moragues⁴, José M. Aguirre², Guillermo Quindós¹ and José Pontón¹

¹ Departamento de Inmunología, Microbiología y Parasitología, Facultad de Medicina y Odontología, Universidad del País Vasco-Euskal Herriko Unibersitatea, Apartado 699, 48080 Bilbao, Vizcaya, Spain

² Departamento de Estomatología, Facultad de Medicina y Odontología, Universidad del País Vasco, Barrio Sarriena s/n, 48940 Leioa, Vizcaya, Spain

³ Unidad de Enfermedades infecciosas, Hospital de Cruces, Universidad del País Vasco, Baracaldo, Vizcaya, Spain

⁴ Departamento de Enfermería 1, Universidad del País Vasco, Barrio Sarriena s/n, 48940 Leioa, Vizcaya, Spain

Correspondence
José Pontón
jose.ponton{at}ehu.es

Received March 23, 2009
Accepted July 15, 2009

Candida albicans is the species most frequently isolated from oral specimens, but the recovery of other Candida species such as Candida dubliniensis is increasing. Differentiation of C. dubliniensis from C. albicans requires special tests and both species are misidentified in some studies. CHROM-Pal (CH-P) is a novel chromogenic medium used in our laboratory for differentiation between C. albicans and C. dubliniensis on the basis of colony colour and morphology, and chlamydospore production. The performance of CH-P and CHROMagar Candida (CAC) was compared for primary isolation and presumptive identification of yeasts from oral specimens from human immunodeficiency virus (HIV)-infected and uninfected individuals. The identification of Candida species on both media was compared with two reference identification methods (API ID 32 C and multiplex PCR). A total of 137/205 oral swabs (66.8 %) plated onto CH-P and CAC media were positive by culture and resulted in the growth of 171 isolates of Candida species on CH-P, whilst only 159 isolates grew on CAC. C. albicans was the most frequently isolated species in both groups of patients, followed by Candida parapsilosis in the HIV-negative group, and by C. dubliniensis in the HIV-infected group. The other Candida species isolated were Candida guilliermondii, Candida glabrata, Candida krusei, Candida tropicalis, Candida famata, Candida rugosa, Candida kefyr, Candida pelliculosa and Candida pulcherrima. The sensitivity and specificity for identifying C. albicans, C. krusei, C. tropicalis and C. dubliniensis on CH-P were over 98.5 %, always equal to or higher than those obtained when CAC was used. CH-P is a simple reliable medium for primary isolation and presumptive identification of yeast isolates from oral samples. The ability of CH-P to discriminate between C. dubliniensis and C. albicans was significantly higher (P <0.05) than that of CAC.

Present address: Department of Microbiology, Faculty of Medicine, Hawler Medical University, Hawler, Kurdistan, Iraq.