Isolation of Rhodotorula mucilaginosa from blood cultures in a tertiary care hospital

Mycoses. 2018 Jan;61(1):35-39. doi: 10.1111/myc.12703. Epub 2017 Oct 13.

Abstract

Rhodotorula species have traditionally been considered as one of common non-virulent environmental inhabitant. They have emerged as an opportunistic pathogen, particularly in immunocompromised hosts and most infections have been associated with intravenous catheters in these patients. We review the isolates in blood cultures of Rhodotorula mucilaginosa in our Hospital. We describe the demographic and clinical features of the cases and the antifungal susceptibility profiles of the isolates. Selected patients had an isolation of R. mucilaginosa in blood cultures in our tertiary care Hospital. All data were collected retrospectively from clinical records during 5 years. We report 8 isolates in blood, two of them were considered contaminants. Immunosuppression, surgery, previous antibiotic therapy were common clinical features. For all the isolates, minimum inhibitory concentration (MIC) values were high for echinocandins and azoles and low for amphotericin B and 5-flucytosine. One strain showed atypical susceptibility profile. Rhodotorula mucilaginosa may be present on the skin and blood cultures can be contaminated. Fungaemia due to R. mucilaginosa is a rare clinical entity which requires risk factors but clinically relevant because of the multiresistant profile. Rhodotorula mucilaginosa shows high MIC values for azoles and echinocandins, therefore amphotericin B and flucytosine must be administered as antifungal therapy.

Keywords: Rhodotorula mucilaginosa; antifungal susceptibility; fluconazole resistance; fungaemia; immunodeficiency; systemic infection.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Amphotericin B / pharmacology
  • Antifungal Agents / pharmacology*
  • Antifungal Agents / therapeutic use
  • Azoles / pharmacology
  • Blood Culture*
  • Child, Preschool
  • Echinocandins / pharmacology
  • Female
  • Flucytosine / pharmacology
  • Fungemia / drug therapy
  • Fungemia / microbiology*
  • Humans
  • Immunocompromised Host*
  • Infant
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Retrospective Studies
  • Rhodotorula / drug effects
  • Rhodotorula / growth & development
  • Rhodotorula / isolation & purification*
  • Spain
  • Tertiary Care Centers

Substances

  • Antifungal Agents
  • Azoles
  • Echinocandins
  • Amphotericin B
  • Flucytosine