CLSI-recommended quality control strains Candida krusei ATCC 6258 and Candida parapsilosis ATCC 22019 were used. The minimum inhibitory concentration (MIC) end points were defined as the lowest drug concentration that caused a prominent decrease in growth (50%) vis-à-vis the controls and read visually after 48 h for fluconazole, voriconazole, itraconazole, isavuconazole, posaconazole and flucytosine and after 24 h for echinocandins. For amphotericin B, the MIC was defined as the lowest concentration at which there was 100%
inhibition of growth compared with the drug-free control wells. The isolate was susceptible to amphotericin B (MIC, 0.03 μg ml−1), itraconazole (MIC, 0.03 μg ml−1), posaconazole (MIC, NSC 683864 0.03 μg ml−1), voriconazole (MIC, 0.06 μg ml−1) and isavuconazole (MIC, 0.25 μg ml−1). However, it had high MICs of fluconazole
(MIC, 8 μg ml−1), and was resistant to anidulafungin (MIC, 8 μg ml−1), caspofungin (MIC, 8 μg ml−1), micafungin (MIC, >8 μg ml−1) and flucytosine (MIC, >64 μg ml−1). The genus Pseudozyma contains 18 described species which are phylogenetically related to Ustilago maydis and other smut fungi.[1, 6-9] Pseudozyma aphidis is either epiphytic or saprophytic Ruxolitinib manufacturer and is known from secretions of insects (family: Aphididae) on leaves. It has been reported from leaves of apple, cherry, apricot and grasses.[10, 11] Of the 18 species only four are reported as human pathogens till date and little is known about their pathogenicity.[2, 3, 12-14] The analysis of the global distribution of eight cases of human infection due to Pseudozyma species Rho including the present case is shown in Table 1.[2, 3, 12-14] It
is pertinent to mention that barring a solitary case of mycetoma all other infections due to this pathogen are invasive. The present case represents the first case of fungaemia due to P. aphidis in a neonate reported so far. In another case of fungaemia in a 7-year-old paediatric patient due to P. aphidis, the patient had received parenteral nutrition through a long-term indwelling central venous catheter (CVC) due to her short bowel syndrome. Her CVC had been replaced three times since birth due to line infections and the possible entry of P. aphidis through CVC was considered. Another case of pulmonary mycosis reported by Parahym et al.  occurred in a 17-year-old male under treatment for Burkitt’s lymphoma who presented with febrile neutropenia. The pleural fluid culture yielded P. aphidis, sensitive to amphotericin B and azoles but resistant to caspofungin.