Two possible cases of Trichosporon infections in bone-marrow-transplanted children: the first case of T. japonicum isolated from clinical specimens.

Trichosporon spp. are emerging as opportunistic agents that cause systemic diseases in immunocompromised hosts. Trichosporonosis carries a poor prognosis in neutropenic patients. Trichosporon japonicum was isolated from the air and named by Sugita et al. Here we present the first case of T. japonicum isolated from a clinical specimen. Two cases of acute myeloid leukemia who had Trichosporon isolates are discussed because of their rarity and growing importance. T. asahii was isolated from the throat, feces and urine of the first patient. T. japonicum was isolated from the sputum of the second patient. Both cases produced high MICs to itraconazole, and low MICs to fluconazole and voriconazole. In virulance factor investigations there was (++) biofilm formation in T. japonicum but not in T. asahii. Conventional mycological studies were not adequate for the identification of the isolate at the species level. In our second case as in the first one, the isolate was identified as T. asahii with 99.9% accuracy by API 20C AUX. Although two T. asahii isolates from the same patient yielded identical typing profiles by arbitrary primed-PCR, the isolates of the two different patients showed different arbitrary primed-PCR typing profiles. However, the genetic identification of the other patient's strain gave the result of T. japonicum.

Efficiency of the TK Culture System in the diagnosis of tuberculosis.

We have evaluated the efficiency of the TK Rapid Mycobacterial Culture System in isolating mycobacteria from clinical samples and in susceptibility testing. The TK Medium indicates mycobacterial growth by changing its color from red to yellow. During a 1-year period, 16,303 clinical samples were inoculated to TK selective (TK SLC) and Löwenstein-Jensen media (LJ). Mycobacteria were isolated in 2150 (13.04%) samples in at least 1 type of medium. While LJ isolated mycobacteria from 1920 (11.69%) of all samples, TK SLC isolated 2070 (12.63%). Among all positives, the isolation rates for LJ and TK SLC were 89.30% and 96.27%, respectively. Contamination of cultures by other organisms was observed in 878 (5.33%) LJ tubes and in 90 (0.55%) TK SLC tubes. On average, time-to-growth detection was 15.57 days in TK SLC and 25.14 days in LJ. The modes of time-to-growth detection were 12 and 25 days for TK SLC and LJ, respectively. The reliability of antimycobacterial susceptibility testing was checked by 36 Mycobacterium tuberculosis strains with known susceptibility patterns which were obtained from the World Health Organization collection and by participating in an external quality control program. All susceptibility results, except for a few borderline-resistant strains, were consistent with the expected susceptibility patterns. The TK Rapid Mycobacterial Culture System is a practical and reliable automated system that shortens the time required for both culture and susceptibility results. All types of TK Media are ready to use, saving time and effort as well as drastically reducing contamination during testing.