The yeasts Candida krusei and Candida inconspicua have similar phenotypes, which may make discrimination of these organisms difficult. In this study we determined the karyotypes of 51 isolates of these two yeast species by contour-clamped homogeneous electric field electrophoresis. We found that the 43 isolates that had the C. krusei phenotype had three karyotype-specific characteristics. These isolates produced either two or three bands between 2,000 and 3,000 kb and no band between 1,300 and 2,000 kb, and there was either a single bright band at 1,300 or 1,200 kb or two separate bands at 1,300,1,200, or 1,100 kb. Using this technique, we were able to distinguish 27 different C. krusei types on the basis of band variations. The seven isolates identified as C. inconspicua on the basis of phenotype differed in that they produced at least one band between 1,300 and 2,000 kb. These isolates produced six to nine bands, in contrast to C. krusei strains, which produced three to six bands. The MIC of fluconazole for all of the isolates was at least 12.5 mg/liter, as determined by a broth dilution method.Candida krusei has recently emerged as an important opportunistic pathogen that causes infections, particularly in immunocompromised, critically ill, and human immunodeficiency virus (HIV)-positive patients (1, 4,8,13,15,21). When this organism is cultured from blood, the rate of mortality has been reported to be between 45 and 100% (6, 30). The increase in the rate of isolation of C. krusei may be due to the use of fluconazole both for prophylaxis and for treatment (1,4,13,25,32). C. krusei is resistant to fluconazole both in the laboratory and when the drug is used therapeutically (2,14).Isolates are identified as C. krusei strains on the basis of a set of phenotypic characteristics. These characteristics are sufficiently nondiscriminatory that in a clinical laboratory a member of a similar species, such as Candida inconspicua, could be misidentified as a C. knisei strain. The phenotypic characteristics used to identify C. krusei include colony morphology; the presence of pseudohyphae, true hyphae, and elongate blastoconidia; the absence of chlamydoconidia and germ tubes; surface growth that has the ability to form a climbing film on the sides of glass containers: glucose fermentation; assimilation of glucose, glycerol, DL-lactic acid, succinate, ethanol, and Nacetylglucosamine; lack of assimilation of galactose, L-sorbose, sucrose, D-ribose, L-rhamnose, maltose, cellobiose, trehalose, melibiose, raffinose, melezitose, inulin, starch, D-xylose, L-arabinose, D-arabinose, erythritol, ribitol, D-mannitol, salicin, inositol, lactose, galactitol, and glucosamine; failure to grow when potassium nitrate is the nitrogen source; and growth in a vitamin-free medium (28).C. inconspicua is distinguished from C. krusei by its failure to produce hyphae on corn meal agar, the presence of a primitive pseudomycelium, its inability to ferment glucose and assimilate N-acetylglucosamine, its ability to assimilate glucosamine, and its fai...