Objective: The aim of the study was to compare the compatibility, cost-effectiveness and practicality of cornmeal agar, chromogenic agar and semi-automated system for the identification of non-albicans Candida spp.

Material and Methods: Forty- two non-albicans Candida strains isolated from blood cultures between January 2011 and December 2014 at Baskent University Hospital Laboratory, Ankara, Turkey, were examined in this study. Cornmeal agar (morphologic evaluation by microscopy), chromogenic agar (visual evaluation with color change) and a semi-automated system (API 20C AUX; BioMérieux, France; evaluation by carbohydrate assimilation reactions) were used for strain identification.

Results: Among the 42 strains identified by the three different test methods, 24 (57.1%) were identified as the same species by all three tests, 11 (26.2%) strains identified as the same species by using cornmeal agar and chromogenic agar (k=0.58) and 6 (14.3%) by semi-automated system and cornmeal agar system (k=0.44). The highest concordance was found between chromogenic agar and semi-automated system (k=0.73). One strain exhibited different identification results with the three methods. When species level identification was considered, identification of C. parapsilosis, C. tropicalis and C. krusei revealed consistency between the three methods. Cornmeal agar method was found to be the most cost-effective method.

Conclusion: The results of this study revealed only 57.1% concordance between cornmeal agar, chromogenic agar and semi-automated system for the identification of non-albicans Candida spp. However, strains with intrinsic antifungal resistance such as C. krusei, were identified accurately by all three methods. Although the most effective method was found to be the cornmeal agar, its use in routine laboratories seemed to be questionable since evaluation needed experienced laboratory personel.