Novel Chromogenic Medium CHROMagar Candida Plus for Detection of and Other Species from Surveillance and Environmental Samples: A Multicenter Study.

Epidemiological trends show a dramatic increase in the prevalence of fungal infections, and in the isolation of multidrug-resistant species, such as CHROMagar Candida (CC; CHROMagar, Paris, France) and other chromogenic media, which are widely used in the clinical laboratory because they allow a rapid identification of most species. Recently, CHROMagar Candida Plus (CC-Plus; CHROMagar, Paris, France) was developed to detect and differentiate in addition to other major clinical species, such as , . , , or display a differential light blue color with a blue halo. A multicentric study was designed to evaluate the performance of the CC-Plus medium in the detection of species in patients' surveillance and environmental samples from three Spanish hospitals with active outbreaks. A total of 364 patients' surveillance samples and 212 environmental samples were tested. Samples were inoculated in CC and CC-Plus in parallel, and the plates were read at 24 and 48 h. All recovered colonies were presumptively identified according to colony color described by manufacturer, and the definitive identification was performed by mass spectrometry at 48 h. A total of 134 isolates were obtained (101 from patients' surveillance samples, and 33 from environmental samples). Sensitivity, specificity, and predictive positive and negative values were 99.5%, 100%, 100%, and 99.1%, respectively, for the main clinical species, showing that CC-Plus is comparable to CC, with the advantage of being able to differentiate from . Furthermore, CC-Plus was able to detect one , one , and eight that did not grow in CC. Additionally, the yeast colonies were generally larger, suggesting that this novel medium could be a richer medium, and suitable for surveillance and environmental cultures of and other clinically relevant species.