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