Characterization of the Candida parapsilosis complex in East China: species distribution differs among cities.

Candida parapsilosis, which was previously considered to be a complex of three genetically distinct groups, has emerged as a significant agent of nosocomial infections. Recently, this complex was separated into three species: C. parapsilosis sensu stricto, C. orthopsilosis and C. metapsilosis. In China, data pertaining to these fungi are limited. In this study, we examined 57 isolates of members of the C. parapsilosis complex collected from four cities in East China, i.e., Nanjing (n = 22), Nanchang (n = 20), Shanghai (n = 12) and Jinan (n = 3). C. parapsilosis sensu stricto represented 71.9% of all isolates, while C. metapsilosis accounted for the remaining 28.1%. C. orthopsilosis could not be identified. A significantly high prevalence of C. metapsilosis was observed in strains recovered from Nanchang, 60% (12/20) of the isolates were C. metapsilosis. Sequence analysis of internal transcribed spacer region revealed two unevenly distributed genotypes among the C. metapsilosis strains. A PCR-restriction fragment length polymorphism assay was described for rapid identification. The strains were susceptible to fluconazole, voriconazole, amphoterincin B and micafungin. Six (15%) isolates of C. parapsilosis sensu stricto and three (18.8%) of C. metapsilosis were found to be dose-dependent susceptible to itraconazole. C. parapsilosis sensu stricto strains were less susceptible to micafungin than C. metapsilosis.

First report of subcutaneous phaeohyphomycosis caused by Ochroconis tshawytschae in an immunocompetent patient.

We report the first case and clinical course of a case of human subcutaneous phaeohyphomycosis caused by Ochroconis tshawytschae, a rare fish pathogen. The diagnosis was based upon histopathological and mycological examinations of clinical samples. Identification of the etiologic agent was assessed on its phenotypic characteristics and subsequently, confirmed by molecular data. In vitro antifungal susceptibility of the isolate was investigated and a comparison was prepared of all of its features to those of its two most relevant related species, O. gallopava and O. humicola.

Phaeohyphomycosis caused by a plant pathogen, Corynespora cassiicola.

We report a case of subcutaneous phaeohyphomycosis caused by Corynespora cassiicola. Molecular identification of this pathogen on grasses confirms that it may be involved in human infection, as previously reported once in pre-molecular literature. In vitro antifungal susceptibility data of the strain are provided. The patient was successfully treated with oral terbinafine with topical povidone iodine in accordance with the results obtained through in vitro susceptibility testing.

First isolation of Candida dubliniensis from oral cavities of dermatological patients in Nanjing, China.

Candida dubliniensis is an emerging pathogen capable of causing both superficial and systemic infections. Although C. dubliniensis and C. albicans are phenotypically similar, the two species differ in terms of epidemiology and the ability to rapidly develop resistance to fluconazole. C. dubliniensis is primarily associated with oral candidiasis of human immunodeficiency virus (HIV)-infected individuals. In this study, we describe the first recovery of C. dubliniensis from oral cavities of non-HIV-infected patients with dermatological diseases in Nanjing, China. The isolates were phenotypically characterized as C. dubliniensis by their production of brown rough colonies and chlamydospores on tobacco agar and their inability to grow on hypertonic Sabouraud dextrose agar or to assimilate xylose or α-methyl-D-glycoside. The species identification was subsequently confirmed by amplification and sequencing of the internal transcribed spacer region (ITS). Three C. dubliniensis isolates out of 128 (2.3%) presumptive C. albicans/C. dubliniensis ones were finally identified. Further sequence analysis separated the three isolates into two of the four reported ITS genotypes. Antifungal susceptibility testing showed that they were susceptible to fluconazole, itraconazole, voriconazole, micafungin, and amphotericin B. This study adds to the accumulating evidence that C. dubliniensis is widely distributed in non-HIV-infected populations worldwide.