Organisms in the genus Kocuria are Gram-positive, coagulase-negative, coccoid actinobacteria belonging to the family Micrococcaceae, suborder Micrococcineae, order Actinomycetales. Sporadic reports in the literature have dealt with infections by Kocuria species, mostly in compromised hosts with serious underlying conditions. Nonetheless, the number of infectious processes caused by such bacteria may be higher than currently believed, given that misidentification by phenotypic assays has presumably affected estimates of the prevalence over the years. As a further cause for concern, guidelines for therapy of illnesses involving Kocuria species are lacking, mostly due to the absence of established criteria for evaluating Kocuria replication or growth inhibition in the presence of antibiotics. Therefore, breakpoints for staphylococci have been widely used throughout the literature to try to understand this pathogen's behaviour under drug exposure; unfortunately, this has sometimes created confusion, thus higlighting the urgent need for specific interpretive criteria, along with a deeper investigation into the resistance determinants within this genus. We therefore review the published data on cultural, genotypic and clinical aspects of the genus Kocuria, aiming to shed some light on these emerging nosocomial pathogens. IntroductionThe genus Kocuria was named after Miroslav Kocur, a Slovakian microbiologist, and belongs to the family Micrococcaceae, suborder Micrococcineae, order Actinomycetales, class Actinobacteria (Takarada et al., 2008;Zhou et al., 2008;Lee et al., 2009;Stackebrandt et al., 1995). It includes Gram-positive, strictly aerobic (a few exceptions are Kocuria kristinae, which is facultatively anaerobic, Kocuria marina, which may grow in 5 % CO 2 , and Kocuria rhizophila strain DC2201, which can proliferate anaerobically), catalasepositive, coagulase-negative, non-haemolytic cocci. These are also non-encapsulated, non-endospore-forming, non-halophilic, mesophilic, non-motile and Voges-Proskauer (production of indole and acetoin)-negative, and do not possess mycolic or teichoic acids. Kocuria species can be differentiated from other members of the Actinomycetales based on the presence of galactosamine and glucosamine as main cell wall amino sugars, the peptidoglycan type L-Lys-Ala 3/4 , the fatty acid anteisio-C 15 : 0 , the polar lipids diphosphatidylglycerol and phosphatidylglycerol, MK-7(H 2 ) and MK-8(H 2 ) as major menaquinones and a DNA G+C content of 60.0-75.3 mol%, depending on the species. Organisms in the genus are environmental bacteria, as well as human skin and oropharynx mucosa commensals; nevertheless, they can be responsible for infectious processes which mostly complicate severe underlying diseases. Owing to misidentification by phenotypic typing over the years, clinical syndromes caused by these agents are believed to be rare; however, the prevalence of such infectious pathologies is presumably higher and will surely increase in the coming years, as soon as genome-based identification i...

Candida guilliermondii is an uncommon isolate throughout most of the world, the behaviour of which as an environmental fungus, a human saprophyte and an agent of serious infections has been emphasised over the years. Notably, illnesses caused by this pathogen mostly involve compromised cancer hosts and commonly lead patients to unfavourable outcomes. It is of concern that the yeast may acquire or inherently express reduced in vitro sensitivity to all antifungal classes, although widespread resistance has not yet been described, and poor correlation exists between MICs and clinical outcome. However, the organism appears as constitutively less susceptible to polyenes and echinocandins than other yeast-like fungi, so that the emergence of such pathogen in the clinical settings is of concern and may appear as a new challenge in the context of mycoses and antifungal therapy.

Isolation of Candida non-albicans yeasts as commensals or pathogens from hospitalised hosts is acquiring increasing importance, due to the frequent drug resistance expressed by such organisms.Particularly, the recover of antifungal resistant C. guilliermondii is of worrisome concern, even if recovered as a saprophyte, since commensal yeasts may behave as reservoirs for resistance elements;furthermore, they may enter the bloodstream after chemotherapy-related mucosal damage has developed,thus causing life-threatening and difficult-to-treat fungemias. This communication deals with the unusual isolation of a pan-azole resistant C. guilliermondii strain from a leukaemic patient with silent candiduria and emphasizes the importance of monitoring less recurring species within the nosocomial setting to better understand fungal epidemiology within the wards and face the spread of resistance determinants. Also, we highlight the controversial significance of silent candiduria, clinical relevance of which should be investigated case by case, to exclude and/or prevent candiduria as well as renal impairment.

A yeast strain was isolated from the sputum sample of a leukaemia patient in the Spirito Santo Hospital of Pescara, Italy. The fungus produced a pigment that formed a reddish halo around colonies, and was identified and deposited as a Metschnikowia spp. (accession number IHEM 25107-GenBank accession number JQ921016) in the BCCM/IHEM collection of biomedical fungi and yeasts (Bruxelles, Belgium). Although the physiology of the strain was close to that of Metschnikowia sinensis, the D1/D2 sequence did not correspond to any previously described Metschnikowia species. Phylogeny of the genus Metschnikowia is complex and requires far more analysis. We present the first non-M. pulcherrima Metschnikowia spp. isolate recovered from a human, and emphasize the role of man as a transient carrier of environmental yeasts, the pathogenicity of which still needs to be defined.

Geotrichum capitatum (formerly Blastoschizomyces capitatus; teleomorph, Dipodascus capitatus) is an uncommon, but emerging cause of invasive and disseminated infections; these mostly affect immune-compromised haematology patients, although solid tumour-associated pathologies and onychomycosis in immunocompetent hosts have been observed (Christakis G et al., Mycoses 2005; 48: 216-220; DÕAntonio D et al., J Clin Microbiol 1999; 37: 2927-30).The organism is largely distributed in soil, woods and poultry faeces and is a part of the saprophyte human respiratory, digestive and skin flora. It has been isolated from brain focal lesions and abscesses, meninges, osteomyelitis, endocarditis, as well as bloodstream, pancreas, kidney and epidydimis infections. Contamination of venous catheter and prosthetic valves has been described too (Pfaller MA et al., J Clin Microbiol