Use of CHROMagar Candida for the presumptive identification of Candida species directly from clinical specimens in resource-limited settings

Figures & data

Table 1. Growth and colonial characteristics of 487 yeast isolates incubated for 2 days on CHROMagar Candida and Corn meal–tween 80 agar at 37°C and identification of clinical yeast isolates by API 20C Aux Candida kits (Biomerieux)

Species	Total number. of isolates	Colony characteristics on CHROMagar Candida	Morphologic features on Corn meal–tween 80 agar	Identification by API 20C AUX
Candida albicans	201	Apple green colonies; consistent	Chlamydospores present; abundant pseudohyphae, and true hyphae, clusters of blastospores are present	Identified as C. albicans
Candida tropicalis	140	Dull blue, to purple color that diffused into surrounding agar with pale pink edges	Abundant pseudohyphae with blastoconidia	Identified as C. tropicalis
Candida parapsilosis	32	White to pale pink colonies	Clusters of blastospores were seen occasionally giant cells	Identified as C. parapsilosis
Candida krusei	30	Large, flat, spreading, pale pink colonies with matt surfaces	Branched pseudo mycelium with clusters and chains of blastospores	Identified as C. krusei
Candida glabrata	21	White large glossy pale pink to violet colonies	Pseudohyphae not present	Three isolates were not C. glabrata
Candida guilliermondii	21	Small pink to purple colonies	Pseudohyphae with clusters of blastospores	Identified as C. guilliermondii
Candida lusitaniae	21	Pink gray purple	Branched pseudohyphae present	Identified as C. lusitaniae
Candida famata	21	White to light pink colonies	Pseudohyphae not present	Identified as C. famata

Figure 1.  (A) Candida tropicalis bluish purple colonies. (B) The appearance of C. tropicalis after 72 hours of incubation on CHROMagar at 37°C. (C) Apple green color colonies of Candida albicans grown for 48 hours on CHROMagar Candida at 37°C. (D) Isolated green color colonies of C. albicans grown for 48 hours on CHROMagar Candida at 37°C. (E) Direct plating of sample on CHROMagar Candida for 48 hours at 37°C. Mix colonies of different species can also seen on this plate. (F) Smooth pink colonies of Candida glabrata grown for 48 hours on CHROMagar Candida at 37°C.

Table 2. Comparative specificity and sensitivity of three different cultural media for Candida spp.

Name of media	Specificity (N=487)	Sensitivity (N=487)	95% Confidence level	P-value
SDA	464 (95.3%)	467 (95.9%)	94.5–100%	<0.05
CHROMagar Candida	479 (98.4%)	478 (98.2%)	95.3–100%	<0.05
Corn meal agar with tween 80	470 (96.5%)	463 (95.0%)	92–99.4%	<0.05