Rhodotorula spp. isolated from blood cultures: clinical and microbiological aspects

• Published in: Medical mycology (Oxford) 2008-01, Vol.46 (6), p.547-556
• Main Authors: Duboc De Almeida, Gisele M., Figueiredo Costa, Silvia, Melhem, Marcia, Motta, Adriana L., Walderez Szeszs, Maria, Miyashita, Fumiko, Pierrotti, Ligia C., Rossi, Flávia, Burattini, Marcelo N.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Amphotericin B - pharmacology; Antifungal Agents - pharmacology; Brazil; Candidiasis - drug therapy; Candidiasis - microbiology; Candidiasis - mortality; Child; Child, Preschool; Female; Follow-Up Studies; Fungemia - drug therapy; Fungemia - microbiology; Fungemia - mortality; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Retrospective Studies; Rhodotorula; Rhodotorula - drug effects; Rhodotorula - isolation & purification; Young Adult
• ISSN: 1369-3786; 1460-2709
• DOI: 10.1080/13693780801972490

The emergence of less common fungal pathogens has been increasingly reported in the last decade. We describe 25 cases of Rhodotorula spp. isolated from blood cultures at a large Brazilian tertiary teaching hospital from 1996-2004. We also investigated the in vitro activity of four antifungal drugs, using a standardized method. The median age of patients was 43 years. The majority of patients (88%) had a central venous catheter (CVC) and 10 (40%) were recipients of a bone marrow transplant. The episode was classified as a bloodstream infection (BSI) in 80% of the patients. Amphotericin B deoxycholate was the most common antifungal used and CVC was removed in 89.5% of the patients. Death occurred in four patients (17.4%), all classified as BSI. All strains were identified as R. mucilaginosa by conventional methods. Misidentification of the species was observed in 20% and 5% of the strains with the Vitek Yeast Biochemical Card and API 20C AUX systems, respectively. Amphotericin B demonstrated good in vitro activity (MIC50/90, 0.5 µg/ml) and the MICs for fluconazole were high for all strains (MIC50/90, >64 µg/ml).