Figure 1: Colonies of Rhodotorula glutinis
Table 1: Relative Frequency of Different Clinical Manifestations of Rhodotorula Species Infection
Species |
All infections |
Fungemia |
CNS^ infection |
Ocular infection |
Peritonitis |
Endocarditis |
Miscellaneous infections* |
R. mucilaginosa |
75.4% |
61.7% |
4.6% |
2.3% |
4.0% |
1.1% |
1.7% |
R. glutinis |
6.9% |
3.4% |
1.7% |
0.6% |
0.0% |
0.6% |
0.6% |
R. minuta |
2.8% |
1.1% |
0.0% |
1.1% |
0.0% |
0.0% |
0.6% |
Not identified |
14.9% |
10.9% |
0.0% |
1.1% |
0.6% |
2.3% |
0.0% |
Total |
100.0% |
77.1% |
6.3% |
5.1% |
4.6% |
4.0% |
2.9% |
^CNS = central nervous system
*Orthopedic prosthesis infections (n=2), hydrosalpingitis (n=1), lymphadenitis (n=1), disseminated infection (n=1)
Table 2: Summary of Four Reports on Susceptibility Data of Rhodotorula Species
Reference and publication year |
Method |
Species (Number) |
Antifungal agent |
MIC range (µg/mL) |
MIC90 (µg/mL) |
Galan-Sanchez et al., 1999 (15) |
Sensititre YeastOne |
All Rhodotorula isolates, including R. mucilaginosa (14), R. glutinis (13), R. minuta (6)
|
Amphotericin B |
0.125 - 0.5 |
N/A |
Flucytosine |
0.064 - 0.25 |
N/A |
|||
Fluconazole |
32 - 256 |
N/A |
|||
Itraconazole |
0.25 - 1 |
N/A |
|||
Ketoconazole |
0.125 - 0.25 |
N/A |
|||
Zaas et al., 2003 (52) |
NCCLS* M-27A |
R. mucilaginosa (8) |
Amphotericin B |
0.25 - 1 |
N/A |
Flucytosine |
0.125 - 0.25 |
N/A |
|||
Fluconazole |
32 - >64 |
N/A |
|||
Itraconazole |
0.5 - 4 |
N/A |
|||
Voriconazole |
1 - >8 |
N/A |
|||
Posaconazole |
0.5 - 2 |
N/A |
|||
Caspofungin |
16 - >16 |
N/A |
|||
Micafungin |
>64 |
N/A |
|||
R. glutinis (2) |
Amphotericin B |
0.5 - 1 |
N/A |
||
Flucytosine |
0.125 - 0.25 |
N/A |
|||
Fluconazole |
32 - >64 |
N/A |
|||
Itraconazole |
1 - 4 |
N/A |
|||
Voriconazole |
4 - 8 |
N/A |
|||
Posaconazole |
1 - 2 |
N/A |
|||
Caspofungin |
16 - >16 |
N/A |
|||
Micafungin |
>64 |
N/A |
|||
Diekema et al., 2005 (9) |
NCCLS* M-27A2 |
All Rhodotorula isolates, including R. mucilaginosa (24) and R. glutinis (29)
|
Amphotericin B |
0.5 - 2 |
1 |
Flucytosine |
<0.06 - 0.5 |
0.25 |
|||
Fluconazole |
32 - >64 |
>64 |
|||
Itraconazole |
0.5 - 16 |
16 |
|||
Voriconazole |
0.25 - 16 |
4 |
|||
Posaconazole |
0.5 - 16 |
4 |
|||
Ravuconazole |
<0.06 - 2 |
1 |
|||
Caspofungin |
8-16 |
16 |
|||
Gomez-Lopez et al., 2005 (19) |
Modified EUCAST |
All Rhodotorula isolates, including R. mucilaginosa (25) and R. glutinis (4)
|
Amphotericin B |
0.03 - 8 |
1 |
Flucytosine |
0.06 - >64 |
2 |
|||
Fluconazole |
8 - >64 |
>64 |
|||
Itraconazole |
0.06 - >8 |
>8 |
|||
Voriconazole |
0.25 - 8 |
8 |
|||
Ravuconazole |
0.03 - 8 |
4 |
*Now Clinical and Laboratory Standard Institute (CLSI)
Table 3: Recommended Antifungals for Rhodotorula Species
Drug |
Route and Dosage |
Amphotericin B |
0.7-1.0 mg/kg intravenously daily |
OR |
|
Amphotericin B lipid complex |
3 to 5 mg/kg intravenously daily |
OR |
|
Liposomal Amphotericin B |
3 to 5 mg/kg intravenously daily |
+/- |
|
Flucytosine |
25 mg/kg orally every 6 hours |