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. 2023 Jan 8;13(2):231.
doi: 10.3390/diagnostics13020231.

Usefulness of Chromogenic Media with Fluconazole Supplementation for Presumptive Identification of Candida auris

Alba Ruiz-Gaitán  1   2 , Ignacio Sigona-Giangreco  2 , José Manuel Pérez-Royo  2 , Victor Garcia-Bustos  2   3 , Marta García-Hita  2 , Eulogio Valentín-Gómez  4 , Salvador Giner Almaraz  1 , Piet W J de Groot  5 , Javier Pemán  1   2
Affiliations

Usefulness of Chromogenic Media with Fluconazole Supplementation for Presumptive Identification of Candida auris

Alba Ruiz-Gaitán et al. Diagnostics (Basel). .

Abstract

Introduction:Candida auris is a major threat to public health. Rapid detection is essential for early treatment and transmission control. The use of chromogenic media allows the presumptive identification of this new species. The aim of this study is to describe the morphological characteristics of C. auris colonies on three commercial chromogenic media. Methods: Nineteen C. auris isolates from different countries/clades and 18 isolates of other species were cultivated in CHROMagarTM Candida Plus, HiCromeTM Candida, CHROMagar-Candida, and fluconazole-supplemented (32 mg/L) CHROMagar-Candida media. Results: On CHROMagarTM Candida Plus and HiCromeTM Candida, C. auris isolates from Colombia, Venezuela, India, Korea, and Japan displayed blue-shaded colonies, while isolates from Spain and Germany exhibited light pink shades with a bluish halo. All isolates showed white to pink colonies on CHROMagar-Candida. On CHROMagar Candida supplemented with fluconazole, whilst C. auris, C. glabrata, or C. krusei showed a similar pink color at 48 h incubation, phenotypic differentiation was possible by the rough, paraffin-like texture or the intense purple color acquired by C. krusei and C. glabrata, respectively. Moreover, in this medium, the presence of C. auris in combination with other species of similar color was not limiting for its early identification, due to this medium selecting only strains resistant to this antifungal. Conclusions: The use of chromogenic media such as CHROMagarTM Candida Plus facilitates a presumptive identification of C. auris. However, this identification can be difficult in the presence of mixed cultures. In these cases, the use of CHROMagarTM Candida medium with 32 mg/L fluconazole offers better performance for the identification of C. auris by inhibiting fluconazole-susceptible strains and selecting rare or high fluconazole MIC (>32 mg/L) isolates.

Keywords: CHROMagar™ Candida Plus; Candida auris; HiCromeTM Candida; chromogenic media; fluconazole supplementation; yeast identification.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Appearance of Candida auris colonies of the four clades described on CHROMagar™ Candida Plus medium, CHROMagar™ Candida medium, and HiCromeTM Candida after 48 h incubation at 35 °C.
Figure 2
Figure 2
Appearance of colonies of most pathogenic Candida species on CHROMagar™ Candida Plus medium, CHROMagar™ Candida medium, and HiCromeTM Candida after 48 h incubation at 35 °C.
Figure 3
Figure 3
Colony appearance of five non-Candida species on CHROMagar™ Candida Plus, CHROMagar™ Candida, and HiCromeTM Candida after 48 h incubation at 35 °C.
Figure 4
Figure 4
Appearance of Candida species and other yeast species colonies from mixed cultures on CHROMagar™ Candida Plus, CHROMagar™ Candida, CHROMagar™ Candida plus fluconazole, and HiCromeTM Candida after 48 h incubation at 35 °C.
See this image and copyright information in PMC

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