{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T17:35:08Z","timestamp":1757612108216,"version":"3.44.0"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T00:00:00Z","timestamp":1755820800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100010724","name":"Health Systems Research Institute","doi-asserted-by":"publisher","award":["HSRI68-055"],"award-info":[{"award-number":["HSRI68-055"]}],"id":[{"id":"10.13039\/501100010724","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100016204","name":"Thailand Science Research and Innovation","doi-asserted-by":"publisher","award":["2.63\/2568"],"award-info":[{"award-number":["2.63\/2568"]}],"id":[{"id":"10.13039\/501100016204","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Lodderomyces elongisporus is an emerging, cryptic opportunistic yeast increasingly linked to fungemia, especially in immunocompromised patients and those with indwelling devices. Frequently misidentified as Candida parapsilosis due to phenotypic overlap, it escapes timely diagnosis, delaying effective therapy. Despite accounting for\u00a0&amp;lt;2% of candidemia cases, true prevalence is likely underestimated. Critically, L. elongisporus exhibits reduced susceptibility to echinocandins, making misidentification clinically dangerous. To develop and validate the LODDY Test\u2014a novel, cost-effective, pH-indicator-based culture medium for rapid, accurate identification of L. elongisporus, particularly in resource-limited settings. The LODDY Test integrates four differential carbohydrates (sucrose, maltose, lactose, and arabinose) with bromocresol purple. We tested 41\u00a0L. elongisporus isolates (1 reference, 40 internal transcribed spacer (ITS) region -confirmed environmental strains) and 40 comparator yeasts (C. parapsilosis sensu stricto, C. albicans, C. tropicalis, and Nakaseomyces glabratus) from urban\/peri-urban Thai sites. Species identity was confirmed by ITS sequencing. LODDY results were benchmarked against the Analytical Profile Index 20C Auxanographic assimilation test (API 20C AUX), CHROMagar\u2122 chromogenic medium, and Matrix-Assisted Laser Desorption\/Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS), and ITS-DNA sequencing. The LODDY Test achieved 100% sensitivity and specificity, distinctly identifying L. elongisporus (no color change) from yellow-producing Candida spp. and purple N. glabratus. Performance matched MALDI-TOF MS and ITS sequencing but required only basic equipment. The LODDY Test is a low-cost, high-accuracy diagnostic tool suitable for decentralized labs. Its clinical validation in bloodstream isolates is the next step toward improving candidemia outcomes in low-resource settings.<\/jats:p>","DOI":"10.1093\/mmy\/myaf076","type":"journal-article","created":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T11:44:34Z","timestamp":1755863074000},"source":"Crossref","is-referenced-by-count":0,"title":["Closing the diagnostic gap in medical mycology: The LODDY Test for identification of <i>Lodderomyces elongisporus<\/i>"],"prefix":"10.1093","volume":"63","author":[{"given":"Watcharamat","family":"Muangkaew","sequence":"first","affiliation":[{"name":"Faculty of Tropical Medicine, Mahidol University Department of Microbiology and Immunology, , Bangkok 10400 ,","place":["Thailand"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natthapaninee","family":"Thanomsridetchai","sequence":"additional","affiliation":[{"name":"Faculty of Allied Health Sciences, Burapha University Department of Medical Technology, , Chon Buri 20131 ,","place":["Thailand"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Panyawat","family":"Boontanom","sequence":"additional","affiliation":[{"name":"Educational Technology and Art Unit, Office of Dean, Faculty of Tropical Medicine, Mahidol University , Bangkok 10400 ,","place":["Thailand"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pornpan","family":"Khum-eam","sequence":"additional","affiliation":[{"name":"Faculty of Tropical Medicine, Mahidol University Department of Microbiology and Immunology, , Bangkok 10400 ,","place":["Thailand"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marut","family":"Tangwattanachuleeporn","sequence":"additional","affiliation":[{"name":"Faculty of Allied Health Sciences, Burapha University Department of Medical Science, , Chon Buri 20131 ,","place":["Thailand"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sumate","family":"Ampawong","sequence":"additional","affiliation":[{"name":"Faculty of Tropical Medicine, Mahidol University Department of Tropical Pathology, , Bangkok 10400 ,","place":["Thailand"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5590-0688","authenticated-orcid":false,"given":"Passanesh","family":"Sukphopetch","sequence":"additional","affiliation":[{"name":"Faculty of Tropical Medicine, Mahidol University Department of Microbiology and Immunology, , Bangkok 10400 ,","place":["Thailand"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,8,22]]},"reference":[{"issue":"1","key":"2025090403513377600_bib1","doi-asserted-by":"crossref","first-page":"566","DOI":"10.22207\/JPAM.19.1.46","article-title":"Fungal blood stream infection: The emerging nosocomial mayhem in intensive care unit","volume":"19","author":"Kamaljeet","year":"2025","journal-title":"J Pure Appl Microbiol"},{"issue":"4","key":"2025090403513377600_bib2","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1007\/s00134-024-07341-7","article-title":"Invasive fungal diseases in adult patients in intensive care unit (FUNDICU): 2024 consensus definitions from ESGCIP, EFISG, ESICM, ECMM, MSGERC, ISAC, and ISHAM","volume":"50","author":"Bassetti","year":"2024","journal-title":"Intensive Care Med"},{"issue":"3","key":"2025090403513377600_bib3","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1016\/j.jointm.2024.01.005","article-title":"Fungal infections in immunocompromised critically ill patients","volume":"4","author":"Garnacho-Montero","year":"2024","journal-title":"J Intensive Med"},{"key":"2025090403513377600_bib4","doi-asserted-by":"crossref","first-page":"1386161","DOI":"10.3389\/fmed.2024.1386161","article-title":"Identifying the risk factors of ICU-acquired fungal infections: Clinical evidence from using machine learning","volume":"11","author":"Zhao","year":"2024","journal-title":"Front Med (Lausanne)"},{"issue":"1","key":"2025090403513377600_bib5","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1186\/s12879-025-10722-y","article-title":"Epidemiology and risk factors of fungal pathogens in sepsis: A prospective nationwide multicenter cohort study","volume":"25","author":"Lee","year":"2025","journal-title":"BMC Infect Dis"},{"issue":"5","key":"2025090403513377600_bib6","doi-asserted-by":"crossref","first-page":"e280","DOI":"10.1016\/S1473-3099(24)00749-7","article-title":"Global guideline for the diagnosis and management of candidiasis: An initiative of the ECMM in cooperation with ISHAM and ASM","volume":"25","author":"Cornely","year":"2025","journal-title":"Lancet Infect Dis"},{"issue":"1","key":"2025090403513377600_bib7","doi-asserted-by":"crossref","first-page":"11597","DOI":"10.1038\/s41598-024-61813-w","article-title":"Antifungal susceptibility and virulence determinants profile of Candida species isolated from patients with candidemia","volume":"14","author":"Dawoud","year":"2024","journal-title":"Sci Rep"},{"issue":"2","key":"2025090403513377600_bib8","doi-asserted-by":"crossref","first-page":"51","DOI":"10.4103\/apjtm.apjtm_559_24","article-title":"Trends of Candida species causing bloodstream infections in South-Eastern Asia: A systematic review and meta-analysis","volume":"18","author":"Yamin","year":"2025","journal-title":"Asian Pac J Trop Med"},{"issue":"6","key":"2025090403513377600_bib9","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1007\/s11046-024-00901-x","article-title":"Unveiling Lodderomyces elongisporus as an emerging yeast pathogen: A holistic approach to microbiological diagnostic strategies","volume":"189","author":"Muangkaew","year":"2024","journal-title":"Mycopathologia"},{"issue":"3","key":"2025090403513377600_bib10","doi-asserted-by":"crossref","first-page":"101410","DOI":"10.1016\/j.mycmed.2023.101410","article-title":"Four uncommon clinical fungi, Lodderomyces elongisporus, Kodamaea ohmeri, Cyberlindnera fabianii and Wickerhamomyces anomalus, isolated in superficial samples from C\u00f4te d'Ivoire","volume":"33","author":"Ira","year":"2023","journal-title":"J Mycol Med"},{"issue":"4","key":"2025090403513377600_bib11","doi-asserted-by":"crossref","first-page":"1076","DOI":"10.3390\/microorganisms11041076","article-title":"Three successfully treated cases of Lodderomyces elongisporus fungemia: Case reports and a review of the literature","volume":"11","author":"Asai","year":"2023","journal-title":"Microorganisms"},{"issue":"9","key":"2025090403513377600_bib12","doi-asserted-by":"crossref","first-page":"e1011613","DOI":"10.1371\/journal.ppat.1011613","article-title":"Lodderomyces elongisporus: An emerging human fungal pathogen","volume":"19","author":"Wang","year":"2023","journal-title":"PLoS Pathog"},{"issue":"1","key":"2025090403513377600_bib13","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1128\/JCM.01790-07","article-title":"Lodderomyces elongisporus masquerading as Candida parapsilosis as a cause of bloodstream infections","volume":"46","author":"Lockhart","year":"2008","journal-title":"J Clin Microbiol"},{"key":"2025090403513377600_bib14","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.mmcr.2020.03.007","article-title":"Concurrent bloodstream infection with Lodderomyces elongisporus and Candida parapsilosis","volume":"28","author":"Koh","year":"2020","journal-title":"Med Mycol Case Rep"},{"issue":"3","key":"2025090403513377600_bib15","doi-asserted-by":"crossref","first-page":"e0063623","DOI":"10.1128\/mbio.00636-23","article-title":"Genomic analyses of a fungemia outbreak caused by Lodderomyces elongisporus in a neonatal intensive care unit in Delhi, India","volume":"14","author":"Yadav","year":"2023","journal-title":"mBio"},{"issue":"8","key":"2025090403513377600_bib16","doi-asserted-by":"crossref","first-page":"e0182653","DOI":"10.1371\/journal.pone.0182653","article-title":"MTL genotypes, phenotypic switching, and susceptibility profiles of Candida parapsilosis species group compared to Lodderomyces elongisporus","volume":"12","author":"D\u00f6\u011fen","year":"2017","journal-title":"PLoS One"},{"key":"2025090403513377600_bib17","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/j.nmni.2018.07.004","article-title":"Lodderomyces elongisporus: A bloodstream pathogen of greater clinical significance","volume":"26","author":"Al-Obaid","year":"2018","journal-title":"New Microbes New Infect"},{"issue":"17","key":"2025090403513377600_bib18","doi-asserted-by":"crossref","first-page":"9266","DOI":"10.3390\/ijms25179266","article-title":"Neonatal fungemia by non-Candida rare opportunistic yeasts: A systematic review of literature","volume":"25","author":"Mpakosi","year":"2024","journal-title":"Int J Mol Sci"},{"issue":"9","key":"2025090403513377600_bib19","doi-asserted-by":"crossref","first-page":"906","DOI":"10.3390\/jof8090906","article-title":"Fatal Lodderomyces elongisporus fungemia in a premature, extremely low-birth-weight neonate","volume":"8","author":"Asadzadeh","year":"2022","journal-title":"J Fungi (Basel)"},{"key":"2025090403513377600_bib20","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.mmcr.2023.03.002","article-title":"Lodderomyces elongisporus fungemia in a patient with previous cardiac surgery: Case report and review of literature","volume":"40","author":"Gourav","year":"2023","journal-title":"Med Mycol Case Rep"},{"issue":"1","key":"2025090403513377600_bib21","doi-asserted-by":"crossref","first-page":"101459","DOI":"10.1016\/j.mycmed.2023.101459","article-title":"Lodderomyces elongisporus as causative organism of oropharyngeal infections: Two case reports","volume":"34","author":"Freitas","year":"2024","journal-title":"J Mycol Med"},{"issue":"1","key":"2025090403513377600_bib22","first-page":"e01427","article-title":"Molecular diagnostics of arthroconidial yeasts, frequent pulmonary opportunists","volume":"56","author":"Kaplan","year":"2017","journal-title":"J Clin Microbiol"},{"key":"2025090403513377600_bib23","doi-asserted-by":"crossref","first-page":"1181377","DOI":"10.3389\/fpubh.2023.1181377","article-title":"Subacute infective endocarditis due to Lodderomyces elongisporus: A case report and review of the literature","volume":"11","author":"Qiu","year":"2023","journal-title":"Front Public Health"},{"issue":"3","key":"2025090403513377600_bib24","first-page":"221","article-title":"The first described case of Lodderomyces elongisporus meningitis","volume":"6","author":"Dear","year":"2021","journal-title":"J Assoc Med Microbiol Infect Dis Can"},{"issue":"4","key":"2025090403513377600_bib25","doi-asserted-by":"crossref","first-page":"116077","DOI":"10.1016\/j.diagmicrobio.2023.116077","article-title":"Neonatal fungemia caused by Lodderomyces elongisporus: First case report in Latin America","volume":"107","author":"Silva","year":"2023","journal-title":"Diagn Microbiol Infect Dis."},{"issue":"2","key":"2025090403513377600_bib26","first-page":"e01227","article-title":"Closing the brief case: A case of prosthetic valve endocarditis due to Lodderomyces elongisporus","volume":"59","author":"Thompson","year":"2021","journal-title":"J Clin Microbiol"},{"issue":"9","key":"2025090403513377600_bib27","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1128\/EC.00062-15","article-title":"Characterization of virulence-related phenotypes in Candida species of the CUG clade","volume":"14","author":"Priest","year":"2015","journal-title":"Euk Cell"},{"issue":"1","key":"2025090403513377600_bib28","doi-asserted-by":"crossref","first-page":"foaa005","DOI":"10.1093\/femsyr\/foaa005","article-title":"Transcriptional control of hyphal morphogenesis in Candida albicans","volume":"20","author":"Villa","year":"2020","journal-title":"FEMS Yeast Res"},{"issue":"6","key":"2025090403513377600_bib29","doi-asserted-by":"crossref","first-page":"e0331721","DOI":"10.1128\/mbio.03317-21","article-title":"Interactions of both pathogenic and nonpathogenic CUG clade Candida species with macrophages share a conserved transcriptional landscape","volume":"12","author":"Pountain","year":"2021","journal-title":"mBio"},{"issue":"5","key":"2025090403513377600_bib30","doi-asserted-by":"crossref","first-page":"e00656","DOI":"10.1128\/mSphere.00656-19","article-title":"Filamentation is associated with reduced pathogenicity of multiple non-albicans Candida species","volume":"4","author":"Banerjee","year":"2019","journal-title":"mSphere"},{"volume-title":"Lodderomyces elongisporus [Internet]","year":"2025","author":"University of Adelaide","key":"2025090403513377600_bib32"},{"issue":"6","key":"2025090403513377600_bib33","doi-asserted-by":"crossref","first-page":"375","DOI":"10.2323\/jgam.25.375","article-title":"A comparative taxonomic study on forms of Candida parapsilosis and related species","volume":"25","author":"Nakase","year":"1979","journal-title":"J Gen Appl Microbiol"},{"issue":"2","key":"2025090403513377600_bib34","doi-asserted-by":"crossref","first-page":"182","DOI":"10.3343\/alm.2018.38.2.182","article-title":"Catheter-related bloodstream infection due to Lodderomyces elongisporus in a patient with lung cancer","volume":"38","author":"Lee","year":"2018","journal-title":"Ann Lab Med"},{"key":"2025090403513377600_bib35","doi-asserted-by":"crossref","first-page":"100644","DOI":"10.1016\/j.ijmmb.2024.100644","article-title":"Clinico-mycological characteristics and outcomes of rare yeast infections","volume":"50","author":"Chowdhury","year":"2024","journal-title":"Indian J Med Microbiol"}],"container-title":["Medical Mycology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/mmy\/advance-article-pdf\/doi\/10.1093\/mmy\/myaf076\/64110938\/myaf076.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/mmy\/article-pdf\/63\/9\/myaf076\/64110938\/myaf076.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/mmy\/article-pdf\/63\/9\/myaf076\/64110938\/myaf076.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T07:51:46Z","timestamp":1756972306000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/mmy\/article\/doi\/10.1093\/mmy\/myaf076\/8239784"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,22]]},"references-count":34,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2025,9,2]]}},"URL":"https:\/\/doi.org\/10.1093\/mmy\/myaf076","relation":{},"ISSN":["1369-3786","1460-2709"],"issn-type":[{"type":"print","value":"1369-3786"},{"type":"electronic","value":"1460-2709"}],"subject":[],"published-other":{"date-parts":[[2025,9]]},"published":{"date-parts":[[2025,8,22]]},"article-number":"myaf076"}}