1
|
Tanamachi C, Iwahashi J, Togo A, Ohta K, Miura M, Sakamoto T, Gotoh K, Horita R, Kamei K, Watanabe H. Molecular Analysis for Potential Hospital-Acquired Infection Caused by Aspergillus Tubingensis Through the Environment. Kurume Med J 2024; 69:185-193. [PMID: 38233176 DOI: 10.2739/kurumemedj.ms6934013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
The identification of Aspergillus species has been performed mainly by morphological classification. In recent years, however, the revelation of the existence of cryptic species has required genetic analysis for accurate identification. The purpose of this study was to investigate five Aspergillus section Nigri strains isolated from a patient and the environment in a university hospital. Species identification by matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry identified all five black Aspergillus strains as Aspergillus niger. However, calmodulin gene sequence analysis revealed that all five strains were cryptic species, four of which, including the clinical strain, were Aspergillus tubingensis. Hospital-acquired infection of the patient with the A. tubingensis strain introduced from the environment was suspected, but sequencing of six genes from four A. tubingensis strains revealed no environmental strain that completely matched the patient strain. The amount of in vitro biofilm formation of the four examples of the A. tubingensis strain was comparable to that of Aspergillus fumigatus. An extracellular matrix was observed by electron microscopy of the biofilm of the clinical strain. This study suggests that various types of biofilm-forming A. tubingensis exist in the hospital environment and that appropriate environmental management is required.
Collapse
Affiliation(s)
- Chiyoko Tanamachi
- Department of Clinical Laboratory Medicine, Kurume University Hospital
| | - Jun Iwahashi
- Department of Infection Control and Prevention, Kurume University School of Medicine
| | - Akinobu Togo
- Advanced Imaging Research Center, Kurume University School of Medicine
| | - Keisuke Ohta
- Advanced Imaging Research Center, Kurume University School of Medicine
| | - Miho Miura
- Division of Infection Control and Prevention, Kurume University Hospital
| | - Toru Sakamoto
- Division of Infection Control and Prevention, Kurume University Hospital
- Department of Infection Control and Prevention, Kurume University School of Medicine
| | - Kenji Gotoh
- Division of Infection Control and Prevention, Kurume University Hospital
- Department of Infection Control and Prevention, Kurume University School of Medicine
| | - Rie Horita
- Department of Clinical Laboratory Medicine, Kurume University Hospital
| | - Katsuhiko Kamei
- Division of Clinical Research, Medical Mycology Research Center, Chiba University
| | - Hiroshi Watanabe
- Division of Infection Control and Prevention, Kurume University Hospital
- Department of Infection Control and Prevention, Kurume University School of Medicine
| |
Collapse
|
2
|
Zhou YB, Rezaei-Matehkolaei A, Meijer M, Kraak B, Gerrits van den Ende B, Hagen F, Afzalzadeh S, Kiasat N, Takesh A, Hoseinnejad A, Houbraken J. Aspergillus hubkae, a Novel Species Isolated from a Patient with Probable Invasive Pulmonary Aspergillosis. Mycopathologia 2024; 189:44. [PMID: 38734862 DOI: 10.1007/s11046-024-00848-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/17/2024] [Indexed: 05/13/2024]
Abstract
A 50-year-old man, previously diagnosed with pulmonary tuberculosis and lung cavities, presented with symptoms including fever, shortness of breath, and cough. A pulmonary CT scan revealed multiple cavities, consolidation and tree-in-bud in the upper lungs. Further investigation through direct examination of bronchoalveolar lavage fluid showed septate hyphae with dichotomous acute branching. Subsequent isolation and morphological analysis identified the fungus as belonging to Aspergillus section Nigri. The patient was diagnosed with probable invasive pulmonary aspergillosis and successfully treated with a three-month oral voriconazole therapy. Phylogenetic analysis based on partial β-tubulin, calmodulin and RNA polymerase second largest subunit sequences revealed that the isolate represents a putative new species related to Aspergillus brasiliensis, and is named Aspergillus hubkae here. Antifungal susceptibility testing demonstrated that the isolate is resistant to itraconazole but susceptible to voriconazole. This phenotypic and genetic characterization of A. hubkae, along with the associated case report, will serve as a valuable resource for future diagnoses of infections caused by this species. It will also contribute to more precise and effective patient management strategies in similar clinical scenarios.
Collapse
Affiliation(s)
- Ya Bin Zhou
- Department of Dermatology, Beijing Children's Hospital, Capital Medical University, National Key Discipline of Pediatrics, Key Laboratory of Major Diseases in Children, Ministry of Education, National Center for Children's Health, Beijing, China
- Westerdijk Fungal Biodiversity Institute, Uppsalalaan 8, 3584 CT, Utrecht, The Netherlands
| | - Ali Rezaei-Matehkolaei
- Department of Medical Mycology, School of Medicine, Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Martin Meijer
- Westerdijk Fungal Biodiversity Institute, Uppsalalaan 8, 3584 CT, Utrecht, The Netherlands
| | - Bart Kraak
- Westerdijk Fungal Biodiversity Institute, Uppsalalaan 8, 3584 CT, Utrecht, The Netherlands
| | | | - Ferry Hagen
- Westerdijk Fungal Biodiversity Institute, Uppsalalaan 8, 3584 CT, Utrecht, The Netherlands
- Institute for Biodiversity and Ecosystem Dynamics, University of Amsterdam, Amsterdam, The Netherlands
- Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Sara Afzalzadeh
- Department of Infectious Diseases, Razi Teaching Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Neda Kiasat
- Department of Medical Mycology, School of Medicine, Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ameneh Takesh
- Department of Medical Mycology, School of Medicine, Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Akbar Hoseinnejad
- Department of Medical Mycology, School of Medicine, Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Jos Houbraken
- Westerdijk Fungal Biodiversity Institute, Uppsalalaan 8, 3584 CT, Utrecht, The Netherlands.
| |
Collapse
|
3
|
Geremia N, Giovagnorio F, Colpani A, De Vito A, Caruana G, Meloni MC, Madeddu G, Panese S, Parisi SG. What do We Know about Cryptic Aspergillosis? Microorganisms 2024; 12:886. [PMID: 38792716 PMCID: PMC11124275 DOI: 10.3390/microorganisms12050886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 04/24/2024] [Accepted: 04/26/2024] [Indexed: 05/26/2024] Open
Abstract
Cryptic Aspergillus species are increasingly recognized as pathogens involved in human disease. They are ubiquitarian fungi with high tenacity in their environment and can express various resistance mechanisms, often due to exposure to antifungal agents employed in agriculture and farming. The identification of such species is increasing thanks to molecular techniques, and a better description of this type of pathogen is granted. Nevertheless, the number of species and their importance in the clinical setting still need to be well studied. Furthermore, their cross-sectional involvement in animal disease, plants, and human activities requires a multidisciplinary approach involving experts from various fields. This comprehensive review aims to provide a sharp vision of the cryptic Aspergillus species, from the importance of correct identification to the better management of the infections caused by these pathogens. The review also accentuates the importance of the One Health approach for this kind of microorganism, given the interconnection between environmental exposure and aspergillosis, embracing transversely the multidisciplinary process for managing the cryptic Aspergillus species. The paper advocates the need for improving knowledge in this little-known species, given the burden of economic and health implications related to the diffusion of these bugs.
Collapse
Affiliation(s)
- Nicholas Geremia
- Unit of Infectious Diseases, Department of Clinical Medicine, Ospedale Dell’Angelo, 30174 Venice, Italy;
- Unit of Infectious Diseases, Department of Clinical Medicine, Ospedale Civile “S.S. Giovanni e Paolo”, 30122 Venice, Italy
| | - Federico Giovagnorio
- Department of Molecular Medicine, University of Padua, 35121 Padua, Italy; (F.G.); (S.G.P.)
| | - Agnese Colpani
- Unit of Infectious Diseases, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy; (A.C.); (A.D.V.); (M.C.M.); (G.M.)
| | - Andrea De Vito
- Unit of Infectious Diseases, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy; (A.C.); (A.D.V.); (M.C.M.); (G.M.)
- Biomedical Science Department, School in Biomedical Science, University of Sassari, 07100 Sassari, Italy
| | - Giorgia Caruana
- Department of Laboratory Medicine and Pathology, Institute of microbiology, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland;
- Infectious Diseases Service, Department of Medicine, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland
| | - Maria Chiara Meloni
- Unit of Infectious Diseases, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy; (A.C.); (A.D.V.); (M.C.M.); (G.M.)
| | - Giordano Madeddu
- Unit of Infectious Diseases, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy; (A.C.); (A.D.V.); (M.C.M.); (G.M.)
| | - Sandro Panese
- Unit of Infectious Diseases, Department of Clinical Medicine, Ospedale Dell’Angelo, 30174 Venice, Italy;
- Unit of Infectious Diseases, Department of Clinical Medicine, Ospedale Civile “S.S. Giovanni e Paolo”, 30122 Venice, Italy
| | | |
Collapse
|
4
|
Sen P, Vijay M, Kamboj H, Gupta L, Shankar J, Vijayaraghavan P. cyp51A mutations, protein modeling, and efflux pump gene expression reveals multifactorial complexity towards understanding Aspergillus section Nigri azole resistance mechanism. Sci Rep 2024; 14:6156. [PMID: 38486086 PMCID: PMC10940716 DOI: 10.1038/s41598-024-55237-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 02/21/2024] [Indexed: 03/18/2024] Open
Abstract
Black Aspergillus species are the most common etiological agents of otomycosis, and pulmonary aspergillosis. However, limited data is available on their antifungal susceptibility profiles and associated resistance mechanisms. Here, we determined the azole susceptibility profiles of black Aspergillus species isolated from the Indian environment and explored the potential resistance mechanisms through cyp51A gene sequencing, protein homology modeling, and expression analysis of selected genes cyp51A, cyp51B, mdr1, and mfs based on their role in imparting resistance against antifungal drugs. In this study, we have isolated a total of 161 black aspergilli isolates from 174 agricultural soil samples. Isolates had variable resistance towards medical azoles; approximately 11.80%, 3.10%, and 1.24% of isolates were resistant to itraconazole (ITC), posaconazole (POS), and voriconazole (VRC), respectively. Further, cyp51A sequence analysis showed that non-synonymous mutations were present in 20 azole-resistant Aspergillus section Nigri and 10 susceptible isolates. However, Cyp51A homology modeling indicated insignificant protein structural variations because of these mutations. Most of the isolates showed the overexpression of mdr1, and mfs genes. Hence, the study concluded that azole-resistance in section Nigri cannot be attributed exclusively to the cyp51A gene mutation or its overexpression. However, overexpression of mdr1 and mfs genes may have a potential role in drug resistance.
Collapse
Affiliation(s)
- Pooja Sen
- Amity Institute of Biotechnology, Amity University Uttar Pradesh, Sector-125, Noida, Uttar Pradesh, India
| | - Mukund Vijay
- Amity Institute of Biotechnology, Amity University Uttar Pradesh, Sector-125, Noida, Uttar Pradesh, India
| | - Himanshu Kamboj
- Amity Institute of Biotechnology, Amity University Uttar Pradesh, Sector-125, Noida, Uttar Pradesh, India
| | - Lovely Gupta
- Amity Institute of Biotechnology, Amity University Uttar Pradesh, Sector-125, Noida, Uttar Pradesh, India
| | - Jata Shankar
- Department of Biotechnology and Bioinformatics, Jaypee University of Information Technology, Solan, India
| | - Pooja Vijayaraghavan
- Amity Institute of Biotechnology, Amity University Uttar Pradesh, Sector-125, Noida, Uttar Pradesh, India.
| |
Collapse
|
5
|
De Francesco MA. Drug-Resistant Aspergillus spp.: A Literature Review of Its Resistance Mechanisms and Its Prevalence in Europe. Pathogens 2023; 12:1305. [PMID: 38003770 PMCID: PMC10674884 DOI: 10.3390/pathogens12111305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 10/28/2023] [Accepted: 10/30/2023] [Indexed: 11/26/2023] Open
Abstract
Infections due to the Aspergillus species constitute an important challenge for human health. Invasive aspergillosis represents a life-threatening disease, mostly in patients with immune defects. Drugs used for fungal infections comprise amphotericin B, triazoles, and echinocandins. However, in the last decade, an increased emergence of azole-resistant Aspergillus strains has been reported, principally belonging to Aspergillus fumigatus species. Therefore, both the early diagnosis of aspergillosis and its epidemiological surveillance are very important to establish the correct antifungal therapy and to ensure a successful patient outcome. In this paper, a literature review is performed to analyze the prevalence of Aspergillus antifungal resistance in European countries. Amphotericin B resistance is observed in 2.6% and 10.8% of Aspergillus fumigatus isolates in Denmark and Greece, respectively. A prevalence of 84% of amphotericin B-resistant Aspergillus flavus isolates is reported in France, followed by 49.4%, 35.1%, 21.7%, and 20% in Spain, Portugal, Greece, and amphotericin B resistance of Aspergillus niger isolates is observed in Greece and Belgium with a prevalence of 75% and 12.8%, respectively. The prevalence of triazole resistance of Aspergillus fumigatus isolates, the most studied mold obtained from the included studies, is 0.3% in Austria, 1% in Greece, 1.2% in Switzerland, 2.1% in France, 3.9% in Portugal, 4.9% in Italy, 5.3% in Germany, 6.1% in Denmark, 7.4% in Spain, 8.3% in Belgium, 11% in the Netherlands, and 13.2% in the United Kingdom. The mechanism of resistance is mainly driven by the TR34/L98H mutation. In Europe, no in vivo resistance is reported for echinocandins. Future studies are needed to implement the knowledge on the spread of drug-resistant Aspergillus spp. with the aim of defining optimal treatment strategies.
Collapse
Affiliation(s)
- Maria Antonia De Francesco
- Department of Molecular and Translational Medicine, Institute of Microbiology, University of Brescia, ASST Spedali Civili, 25123 Brescia, Italy
| |
Collapse
|
6
|
Stemler J, Többen C, Lass-Flörl C, Steinmann J, Ackermann K, Rath PM, Simon M, Cornely OA, Koehler P. Diagnosis and Treatment of Invasive Aspergillosis Caused by Non- fumigatus Aspergillus spp. J Fungi (Basel) 2023; 9:jof9040500. [PMID: 37108955 PMCID: PMC10141595 DOI: 10.3390/jof9040500] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 03/27/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023] Open
Abstract
With increasing frequency, clinical and laboratory-based mycologists are consulted on invasive fungal diseases caused by rare fungal species. This review aims to give an overview of the management of invasive aspergillosis (IA) caused by non-fumigatus Aspergillus spp.-namely A. flavus, A. terreus, A. niger and A. nidulans-including diagnostic and therapeutic differences and similarities to A. fumigatus. A. flavus is the second most common Aspergillus spp. isolated in patients with IA and the predominant species in subtropical regions. Treatment is complicated by its intrinsic resistance against amphotericin B (AmB) and high minimum inhibitory concentrations (MIC) for voriconazole. A. nidulans has been frequently isolated in patients with long-term immunosuppression, mostly in patients with primary immunodeficiencies such as chronic granulomatous disease. It has been reported to disseminate more often than other Aspergillus spp. Innate resistance against AmB has been suggested but not yet proven, while MICs seem to be elevated. A. niger is more frequently reported in less severe infections such as otomycosis. Triazoles exhibit varying MICs and are therefore not strictly recommended as first-line treatment for IA caused by A. niger, while patient outcome seems to be more favorable when compared to IA due to other Aspergillus species. A. terreus-related infections have been reported increasingly as the cause of acute and chronic aspergillosis. A recent prospective international multicenter surveillance study showed Spain, Austria, and Israel to be the countries with the highest density of A. terreus species complex isolates collected. This species complex seems to cause dissemination more often and is intrinsically resistant to AmB. Non-fumigatus aspergillosis is difficult to manage due to complex patient histories, varying infection sites and potential intrinsic resistances to antifungals. Future investigational efforts should aim at amplifying the knowledge on specific diagnostic measures and their on-site availability, as well as defining optimal treatment strategies and outcomes of non-fumigatus aspergillosis.
Collapse
Affiliation(s)
- Jannik Stemler
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), European Diamond Excellence Center for Medical Mycology (ECMM), Faculty of Medicine, University Hospital of Cologne, University of Cologne, 50937 Cologne, Germany
- Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, 50923 Cologne, Germany
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, 50923 Cologne, Germany
| | - Christina Többen
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), European Diamond Excellence Center for Medical Mycology (ECMM), Faculty of Medicine, University Hospital of Cologne, University of Cologne, 50937 Cologne, Germany
- Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, 50923 Cologne, Germany
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, 50923 Cologne, Germany
| | - Cornelia Lass-Flörl
- Institute of Hygiene and Medical Microbiology, European Diamond Excellence Center for Medical Mycology (ECMM), Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Jörg Steinmann
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Paracelsus Medical University, Klinikum Nürnberg, 90419 Nuremberg, Germany
- Institute of Medical Microbiology, University Hospital Essen, European Diamond Excellence Center for Medical Mycology (ECMM), 45147 Essen, Germany
| | - Katharina Ackermann
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Paracelsus Medical University, Klinikum Nürnberg, 90419 Nuremberg, Germany
| | - Peter-Michael Rath
- Institute of Medical Microbiology, University Hospital Essen, European Diamond Excellence Center for Medical Mycology (ECMM), 45147 Essen, Germany
| | - Michaela Simon
- Institute for Medical Microbiology, Immunology and Hygiene, Faculty of Medicine, University Hospital of Cologne, University of Cologne, 50937 Cologne, Germany
| | - Oliver Andreas Cornely
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), European Diamond Excellence Center for Medical Mycology (ECMM), Faculty of Medicine, University Hospital of Cologne, University of Cologne, 50937 Cologne, Germany
- Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, 50923 Cologne, Germany
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, 50923 Cologne, Germany
- Clinical Trials Centre Cologne (ZKS Köln), University of Cologne, 50935 Cologne, Germany
| | - Philipp Koehler
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), European Diamond Excellence Center for Medical Mycology (ECMM), Faculty of Medicine, University Hospital of Cologne, University of Cologne, 50937 Cologne, Germany
- Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, 50923 Cologne, Germany
| |
Collapse
|
7
|
Chen B, Qian G, Yang Z, Zhang N, Jiang Y, Li D, Li R, Shi D. Virulence capacity of different Aspergillus species from invasive pulmonary aspergillosis. Front Immunol 2023; 14:1155184. [PMID: 37063826 PMCID: PMC10090689 DOI: 10.3389/fimmu.2023.1155184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 03/13/2023] [Indexed: 03/31/2023] Open
Abstract
IntroductionThe opportunistic filamentous fungus Aspergillus causes invasive pulmonary aspergillosis (IPA) that often turns into a fatal infection in immunocompromised hosts. However, the virulence capacity of different Aspergillus species and host inflammation induced by different species in IPA are not well understood.MethodsIn the present study, host inflammation, antimicrobial susceptibilities and virulence were compared among clinical Aspergillus strains isolated from IPA patients.ResultsA total of 46 strains were isolated from 45 patients with the invasive infection, of which 35 patients were diagnosed as IPA. Aspergillus flavus was the dominant etiological agent appearing in 25 cases (54.3%). We found that the CRP level and leukocyte counts (elevated neutrophilic granulocytes and monocytes, and reduced lymphocytes) were significantly different in IPA patients when compared with healthy individuals (P < 0.05). Antifungal susceptibilities of these Aspergillus isolates from IPA showed that 91%, 31%, 14%, and 14% were resistant to Fluconazole, Micafungin, Amphotericin B and Terbinafine, respectively. The survival rate of larvae infected by A. flavus was lower than larvae infected by A. niger or A. fumigatus (P < 0.05).DiscussionAspergillus flavus was the dominant clinical etiological agent. Given the prevalence of A. flavus in our local clinical settings, we may face greater challenges when treating IPA patients.
Collapse
Affiliation(s)
- Biao Chen
- Laboratory of Medical Mycology, Jining No. 1 People’s Hospital, Jining, Shandong, China
- Central Laboratory, Jining No.1 People’s Hospital, Jining, Shandong, China
| | - Guocheng Qian
- Laboratory of Medical Mycology, Jining No. 1 People’s Hospital, Jining, Shandong, China
| | - Zhiya Yang
- Laboratory of Medical Mycology, Jining No. 1 People’s Hospital, Jining, Shandong, China
| | - Ning Zhang
- Laboratory of Medical Mycology, Jining No. 1 People’s Hospital, Jining, Shandong, China
| | - Yufeng Jiang
- Laboratory of Medical Mycology, Jining No. 1 People’s Hospital, Jining, Shandong, China
| | - Dongmei Li
- Georgetown University Medical Center, Department of Microbiology & Immunology, Washington, DC, United States
| | - Renzhe Li
- Laboratory of Medical Mycology, Jining No. 1 People’s Hospital, Jining, Shandong, China
| | - Dongmei Shi
- Laboratory of Medical Mycology, Jining No. 1 People’s Hospital, Jining, Shandong, China
- *Correspondence: Dongmei Shi,
| |
Collapse
|
8
|
Bosetti D, Neofytos D. Invasive Aspergillosis and the Impact of Azole-resistance. CURRENT FUNGAL INFECTION REPORTS 2023; 17:1-10. [PMID: 37360857 PMCID: PMC10024029 DOI: 10.1007/s12281-023-00459-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2023] [Indexed: 06/28/2023]
Abstract
Purpose of Review IA (invasive aspergillosis) caused by azole-resistant strains has been associated with higher clinical burden and mortality rates. We review the current epidemiology, diagnostic, and therapeutic strategies of this clinical entity, with a special focus on patients with hematologic malignancies. Recent Findings There is an increase of azole resistance in Aspergillus spp. worldwide, probably due to environmental pressure and the increase of long-term azole prophylaxis and treatment in immunocompromised patients (e.g., in hematopoietic stem cell transplant recipients). The therapeutic approaches are challenging, due to multidrug-resistant strains, drug interactions, side effects, and patient-related conditions. Summary Rapid recognition of resistant Aspergillus spp. strains is fundamental to initiate an appropriate antifungal regimen, above all for allogeneic hematopoietic cell transplantation recipients. Clearly, more studies are needed in order to better understand the resistance mechanisms and optimize the diagnostic methods to identify Aspergillus spp. resistance to the existing antifungal agents/classes. More data on the susceptibility profile of Aspergillus spp. against the new classes of antifungal agents may allow for better treatment options and improved clinical outcomes in the coming years. In the meantime, continuous surveillance studies to monitor the prevalence of environmental and patient prevalence of azole resistance among Aspergillus spp. is absolutely crucial.
Collapse
Affiliation(s)
- Davide Bosetti
- Division of Infectious Diseases, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, Geneva, Switzerland
| | - Dionysios Neofytos
- Division of Infectious Diseases, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, Geneva, Switzerland
| |
Collapse
|
9
|
Resistance of Black Aspergilli Species from Grape Vineyards to SDHI, QoI, DMI, and Phenylpyrrole Fungicides. J Fungi (Basel) 2023; 9:jof9020221. [PMID: 36836335 PMCID: PMC9961879 DOI: 10.3390/jof9020221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/04/2023] [Accepted: 02/06/2023] [Indexed: 02/11/2023] Open
Abstract
Fungicide applications constitute a management practice that reduces the size of fungal populations and by acting as a genetic drift factor, may affect pathogen evolution. In a previous study, we showed that the farming system influenced the population structure of the Aspergillus section Nigri species in Greek vineyards. The current study aimed to test the hypothesis that the differences in the population structure may be associated with the selection of fungicide-resistant strains within the black aspergilli populations. To achieve this, we determined the sensitivity of 102, 151, 19, and 22 for the A. uvarum, A. tubingensis, A. niger, and A. carbonarious isolates, respectively, originating either from conventionally-treated or organic vineyards to the fungicides fluxapyroxad-SDHIs, pyraclostrobin-QoIs, tebuconazole-DMIs, and fludioxonil-phenylpyrroles. The results showed widespread resistance to all four fungicides tested in the A. uvarum isolates originating mostly from conventional vineyards. In contrast, all the A. tubingensis isolates tested were sensitive to pyraclostrobin, while moderate frequencies of only lowly resistant isolates were identified for tebuconazole, fludioxonil, and fluxapyroxad. Sequencing analysis of the corresponding fungicide target encoding genes revealed the presence of H270Y, H65Q/S66P, and G143A mutations in the sdhB, sdhD, and cytb genes of A. uvarum resistant isolates, respectively. No mutations in the Cyp51A and Cyp51B genes were detected in either the A. uvarum or A. tubingensis isolates exhibiting high or low resistance levels to DMIs, suggesting that other resistance mechanisms are responsible for the observed phenotype. Our results support the initial hypothesis for the contribution of fungicide resistance in the black aspergilli population structure in conventional and organic vineyards, while this is the first report of A. uvarum resistance to SDHIs and the first documentation of H270Y or H65Q/S66P mutations in sdhB, sdhD, and of the G143A mutation in the cytb gene of this fungal species.
Collapse
|
10
|
Bian C, Kusuya Y, Sklenář F, D’hooge E, Yaguchi T, Ban S, Visagie C, Houbraken J, Takahashi H, Hubka V. Reducing the number of accepted species in Aspergillus series Nigri. Stud Mycol 2022; 102:95-132. [PMID: 36760462 PMCID: PMC9903907 DOI: 10.3114/sim.2022.102.03] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022] Open
Abstract
The Aspergillus series Nigri contains biotechnologically and medically important species. They can produce hazardous mycotoxins, which is relevant due to the frequent occurrence of these species on foodstuffs and in the indoor environment. The taxonomy of the series has undergone numerous rearrangements, and currently, there are 14 species accepted in the series, most of which are considered cryptic. Species-level identifications are, however, problematic or impossible for many isolates even when using DNA sequencing or MALDI-TOF mass spectrometry, indicating a possible problem in the definition of species limits or the presence of undescribed species diversity. To re-examine the species boundaries, we collected DNA sequences from three phylogenetic markers (benA, CaM and RPB2) for 276 strains from series Nigri and generated 18 new whole-genome sequences. With the three-gene dataset, we employed phylogenetic methods based on the multispecies coalescence model, including four single-locus methods (GMYC, bGMYC, PTP and bPTP) and one multilocus method (STACEY). From a total of 15 methods and their various settings, 11 supported the recognition of only three species corresponding to the three main phylogenetic lineages: A. niger, A. tubingensis and A. brasiliensis. Similarly, recognition of these three species was supported by the GCPSR approach (Genealogical Concordance Phylogenetic Species Recognition) and analysis in DELINEATE software. We also showed that the phylogeny based on benA, CaM and RPB2 is suboptimal and displays significant differences from a phylogeny constructed using 5 752 single-copy orthologous proteins; therefore, the results of the delimitation methods may be subject to a higher than usual level of uncertainty. To overcome this, we randomly selected 200 genes from these genomes and performed ten independent STACEY analyses, each with 20 genes. All analyses supported the recognition of only one species in the A. niger and A. brasiliensis lineages, while one to four species were inconsistently delimited in the A. tubingensis lineage. After considering all of these results and their practical implications, we propose that the revised series Nigri includes six species: A. brasiliensis, A. eucalypticola, A. luchuensis (syn. A. piperis), A. niger (syn. A. vinaceus and A. welwitschiae), A. tubingensis (syn. A. chiangmaiensis, A. costaricensis, A. neoniger and A. pseudopiperis) and A. vadensis. We also showed that the intraspecific genetic variability in the redefined A. niger and A. tubingensis does not deviate from that commonly found in other aspergilli. We supplemented the study with a list of accepted species, synonyms and unresolved names, some of which may threaten the stability of the current taxonomy. Citation: Bian C, Kusuya Y, Sklenář F, D'hooge E, Yaguchi T, Ban S, Visagie CM, Houbraken J, Takahashi H, Hubka V (2022). Reducing the number of accepted species in Aspergillus series Nigri. Studies in Mycology 102: 95-132. doi: 10.3114/sim.2022.102.03.
Collapse
Affiliation(s)
- C. Bian
- Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Chiba, Japan
| | - Y. Kusuya
- Medical Mycology Research Center, Chiba University, Chiba, Japan;, Biological Resource Center, National Institute of Technology and Evaluation, Kisarazu, Japan
| | - F. Sklenář
- Department of Botany, Faculty of Science, Charles University, Prague, Czech Republic;, Laboratory of Fungal Genetics and Metabolism, Institute of Microbiology, Czech Academy of Sciences, Prague, Czech Republic
| | - E. D’hooge
- BCCM/IHEM collection, Mycology and Aerobiology, Sciensano, Bruxelles, Belgium
| | - T. Yaguchi
- Medical Mycology Research Center, Chiba University, Chiba, Japan
| | - S. Ban
- Medical Mycology Research Center, Chiba University, Chiba, Japan
| | - C.M. Visagie
- Department of Biochemistry, Genetics, and Microbiology, Forestry and Agricultural Biotechnology Institute, University of Pretoria, Pretoria, South Africa
| | - J. Houbraken
- Westerdijk Fungal Biodiversity Institute, Utrecht, the Netherlands
| | - H. Takahashi
- Medical Mycology Research Center, Chiba University, Chiba, Japan;, Molecular Chirality Research Center, Chiba University, Chiba, Japan;, Plant Molecular Science Center, Chiba University, Chiba, Japan,*Corresponding authors: H. Takahashi, ; V. Hubka,
| | - V. Hubka
- Medical Mycology Research Center, Chiba University, Chiba, Japan;, Department of Botany, Faculty of Science, Charles University, Prague, Czech Republic;, Laboratory of Fungal Genetics and Metabolism, Institute of Microbiology, Czech Academy of Sciences, Prague, Czech Republic;,*Corresponding authors: H. Takahashi, ; V. Hubka,
| |
Collapse
|
11
|
Isolation, Characterization, and Antifungal Sensitivity Pattern of Fungal Species with Potential Resistance to Antifungal Drugs in Patients with Otomycosis. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2022. [DOI: 10.5812/archcid-129169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Background: Otomycosis is defined as a superficial fungal infection, accounting for about 10% of infectious otitis externa cases. Objectives: This study investigated patients with suspicious symptoms through the examination of their demographic information, isolate etiological agents, and in vitro antifungal susceptibility patterns. Methods: The samples of 170 patients with otitis externa symptoms were collected and confirmed for otomycosis by mycological examination (e.g., potassium hydroxide, methylene blue staining, and fungal culture) and molecular sequencing. In vitro antifungal susceptibility tests against miconazole, fluconazole, itraconazole, voriconazole, posaconazole, amphotericin B, and caspofungin were performed according to the Clinical and Laboratory Standards Institute (M27-A3/S4 and M38-A2). Results: Out of 170 patients, 145 subjects (85.29%) showed positive mycological findings. In this study, 55.8% of the patients were male, and the most common age group affected was 50 - 59 years (26.2%). Hearing loss and pruritus were the most common clinical manifestations. The most common occupation was being a housewife (47.5%), and most cases occurred during the winter (40%). Aspergillus niger was the most common species, followed by Aspergillus fumigatus, Candida albicans, and Candida glabrata. Caspofungin showed the highest activity against Aspergillus and Candida isolates; nevertheless, itraconazole demonstrated the lowest activity against Aspergillus isolates. Fluconazole showed the weakest power against Candida species. Conclusions: Due to climatic conditions, humidity, and dust, otomycosis has a high occurrence in Iran. Although otomycosis needs long-term antifungal therapy and recurrence is high in some cases, it is rarely life-threatening, and eardrop antifungals are usually enough to eradicate the infection. Local information about the antifungal pattern is useful for the control, prevention, and treatment of otomycosis.
Collapse
|
12
|
Matsumoto Y, Suzuki M, Nihei H, Matsumoto S. Discovery of Tolerance to Itraconazole in Japanese Isolates of Aspergillus Section Nigri, Aspergillus tubingensis and Aspergillus welwitschiae, by Microscopic Observation. Med Mycol J 2022; 63:65-69. [PMID: 36047184 DOI: 10.3314/mmj.22-00006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Aspergillus section Nigri, a group of black Aspergillus, has several cryptic species that were recently discovered to be intrinsically resistant to azole antifungals. In this study, susceptibility testing of 35 clinical isolates of Aspergillus tubingensis and Aspergillus welwitschiae in Japan was carried out using microdilution method. Strains tolerant to itraconazole in A. tubingensis (14/17 strains) and A. welwitschiae (6/18 strains) were discovered with hyphal growth and conidial germination above the minimal inhibitory concentration by microscopic observation, while no resistant strain was observed macroscopically. In contrast, no strain with reduced susceptibility to voriconazole, posaconazole, and amphotericin-B was found. Further examination may be required to determine the susceptibility of cryptic species in Aspergillus section Nigri to antifungals.
Collapse
Affiliation(s)
- Yasunobu Matsumoto
- Infectious Diseases Testing Department, Microbiological Testing Group, LSI Medience Corporation
| | - Makoto Suzuki
- Infectious Diseases Testing Department, Microbiological Testing Group, LSI Medience Corporation
| | - Hiroyoshi Nihei
- Infectious Diseases Testing Department, Microbiological Testing Group, LSI Medience Corporation
| | - Satoru Matsumoto
- Infectious Diseases Testing Department, Microbiological Testing Group, LSI Medience Corporation
| |
Collapse
|
13
|
Fakhim H, Badali H, Dannaoui E, Nasirian M, Jahangiri F, Raei M, Vaseghi N, Ahmadikia K, Vaezi A. Trends in the Prevalence of Amphotericin B-Resistance (AmBR) among Clinical Isolates of Aspergillus Species. J Mycol Med 2022; 32:101310. [PMID: 35907396 DOI: 10.1016/j.mycmed.2022.101310] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 07/11/2022] [Accepted: 07/12/2022] [Indexed: 11/29/2022]
Abstract
The challenges of the invasive infections caused by the resistant Aspergillus species include the limited access to antifungals for treatment and high mortality. This study aimed to provide a global perspective of the prevalence of amphotericin B resistance (AmBR), geographic distribution, and the trend of AmBR from 2010 to 2020. To analyze the prevalence of in vitro AmBR in clinical Aspergillus species, we reviewed the literature and identified a total of 72 articles. AmBR was observed in 1128 out of 3061 Aspergillus terreus (36.8%), 538 out of 3663 Aspergillus flavus (14.9%), 141 out of 2691 Aspergillus niger (5.2%), and 353 out of 17,494 Aspergillus fumigatus isolates (2.01%). An increasing trend in AmB-resistant isolates of A. fumigatus and a decreasing trend in AmB-resistant A. terreus and A. flavus isolates were observed between 2016 and 2020. AmB-resistant A. terreus and A. niger isolates, accounting for 40.4% and 20.9%, respectively, were the common AmB-resistant Aspergillus species in Asian studies. However, common AmB-resistant Aspergillus species reported by European and American studies were A. terreus and A. flavus isolates, accounting for 40.1% and 14.3% in 31 studies from Europe and 25.1% and 11.7% in 14 studies from America, respectively. The prevalence of AmB-resistant A. niger in Asian isolates was higher than in American and European. We found a low prevalence of A. terreus in American isolates (25.1%) compared to Asian (40.4%) and European (40.1%). Future studies should focus on analyzing the trend of AmBR on a regional basis and using the same methodologies.
Collapse
Affiliation(s)
- Hamed Fakhim
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamid Badali
- Department of Molecular Microbiology & Immunology/South Texas Center for Emerging Infectious Diseases, The University of Texas at San Antonio, San Antonio, Texas, USA
| | - Eric Dannaoui
- Université de Paris, Faculté de Médecine, APHP, Hôpital Européen Georges Pompidou, Unité de Parasitologie-Mycologie, Service de Microbiologie, Paris, France
| | - Maryam Nasirian
- Infectious Diseases and Tropical Medicine Research Center; and Epidemiology and Biostatistics Department, Health School, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fateme Jahangiri
- Department of Medical Laboratory Science, School of Allied Medical Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Maedeh Raei
- Faculty of medicine, Sari branch, Islamic Azad University, Sari, Iran
| | - Narges Vaseghi
- Department of Pathobiology, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Kazem Ahmadikia
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Afsane Vaezi
- Department of Medical Laboratory Science, School of Allied Medical Sciences, Iran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
14
|
Fernandez-Pittol M, Alejo-Cancho I, Rubio-García E, Cardozo C, Puerta-Alcalde P, Moreno-García E, Garcia-Pouton N, Garrido M, Villanueva M, Alastruey-Izquierdo A, Pitart C, Garcia-Vidal C, Marco F. Aspergillosis by cryptic Aspergillus species: A case series and review of the literature. Rev Iberoam Micol 2022; 39:44-49. [PMID: 35753971 DOI: 10.1016/j.riam.2022.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 03/10/2022] [Accepted: 04/13/2022] [Indexed: 10/17/2022] Open
Abstract
BACKGROUND The cryptic Aspegillus species are rare, these microorganisms are usually more resistant to common antifungal therapies. Therefore, a correct identification is important when evaluating the impact of such species in aspergillosis. AIMS We aimed to describe the frequency, clinical and microbiological characteristics, and the outcomes of those cases of aspergillosis caused by cryptic species in a tertiary hospital. METHODS We retrospectively identified all microbiologically documented cases of aspergillosis between January 2013 and December 2018. Definitive species identification of clinically significant isolates was achieved via sequencing methods. The polymerase chain reaction (PCR) products were sequenced, and the results obtained were compared to sequences deposited in GenBank. Antifungal susceptibility testing was performed using the Sensititre® YeastOne® panel. RESULTS A total of 679 Aspergillus isolates were recovered from 489 patients, of which 109 were clinically relevant. Ten (9.2%) isolates were identified as cryptic species: Aspergillus arcoverdensis (2), Aspergillus lentulus (2), Aspergillus ellipticus (2), Aspergillus alliaceus (1), Aspergillus nomius (1), Aspergillus tubingensis (1) and Aspergillus montevidensis (1). Most patients already suffered some type of immunosuppression. Half of these patients had required intensive care before the infection showed up, and most of them had a pulmonary infection. Mortality at the 100-day follow-up was 40%. Antifungal susceptibility testing was performed on three of the isolates (A. arcoverdensis, A. tubingensis and A. nomius), which showed high minimum inhibitory concentrations (MIC) for azoles and amphotericin B. CONCLUSIONS The frequency of cryptic species in our centre was 9.2%. Most patients had some degree of immunosuppression, and the mortality rate was 40%.
Collapse
Affiliation(s)
- Mariana Fernandez-Pittol
- Department of Microbiology, Hospital Clinic, Barcelona, Spain; ISGlobal, Barcelona, Institute for Global health, Universitat de Barcelona, Barcelona, Spain.
| | | | - Elisa Rubio-García
- Department of Microbiology, Hospital Clinic, Barcelona, Spain; ISGlobal, Barcelona, Institute for Global health, Universitat de Barcelona, Barcelona, Spain
| | - Celia Cardozo
- Infectious Disease Department, Hospital Clinic of Barcelona, IDIBAPS, Barcelona, Spain
| | - Pedro Puerta-Alcalde
- Infectious Disease Department, Hospital Clinic of Barcelona, IDIBAPS, Barcelona, Spain
| | - Estela Moreno-García
- Infectious Disease Department, Hospital Clinic of Barcelona, IDIBAPS, Barcelona, Spain
| | - Nicole Garcia-Pouton
- Infectious Disease Department, Hospital Clinic of Barcelona, IDIBAPS, Barcelona, Spain
| | - Miriam Garrido
- Department of Microbiology, Hospital Clinic, Barcelona, Spain
| | | | - Ana Alastruey-Izquierdo
- Mycology Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III, Majadahonda, Spain
| | - Cristina Pitart
- Department of Microbiology, Hospital Clinic, Barcelona, Spain; ISGlobal, Barcelona, Institute for Global health, Universitat de Barcelona, Barcelona, Spain
| | - Carolina Garcia-Vidal
- Infectious Disease Department, Hospital Clinic of Barcelona, IDIBAPS, Barcelona, Spain; Universitat de Barcelona, Barcelona, Spain
| | - Francesc Marco
- Department of Microbiology, Hospital Clinic, Barcelona, Spain; ISGlobal, Barcelona, Institute for Global health, Universitat de Barcelona, Barcelona, Spain; Universitat de Barcelona, Barcelona, Spain
| |
Collapse
|
15
|
Javidnia J, Ghotbi Z, Ghojoghi A, Solhjoo K, Alshahni MM, Jeddi SA, Ahmadi B, Nouripour-Sisakht S, Ansari S, Shokoohi G. Otomycosis in the South of Iran with a High Prevalence of Tympanic Membrane Perforation: A Hospital-Based Study. Mycopathologia 2022; 187:225-233. [PMID: 35347533 DOI: 10.1007/s11046-022-00626-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 03/07/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Otomycosis is a superficial infection of the external ear caused by fungal pathogens. The genera Aspergillus and Candida are considered the main fungal causative agents, with the predominance of Aspergillus section Nigri. The present study aimed to evaluate the clinical symptoms of patients with otomycosis and predisposing factors and to identify fungal etiological agents using molecular approaches. We also present an overview of published papers on tympanic membrane perforation (TMP) secondary to otomycosis. MATERIALS AND METHODS An otorhinolaryngologist collected specimens from external ear canals of patients with suspected otomycosis based on the patient's history and clinical examinations. The specimens were collected using sterile swabs. Fungal isolates were confirmed in clinical specimens by direct microscopy and culture methods. Fungal isolates were identified based on molecular approaches. RESULTS In total, specimens from 211 patients with suspected otomycosis were examined. The presence of fungi was confirmed in about 51% of patients based on fungal elements in direct microscopy and culture-positive fungi. Aspergillus tubingensis was the most commonly isolated species (52.77%), followed by Aspergillus niger (25.92%). Otomycosis due to infection with Candida species was observed in 16% of cases. Of note, in 36.11% of cases, otomycosis was associated with TMP. CONCLUSION A mycological examination is indispensable for a correct diagnosis in patients with otitis extern. TMP should be considered in patients with otomycosis, as it appears to be relatively common in this population.
Collapse
Affiliation(s)
- Javad Javidnia
- Student Research Committee Center, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Zahra Ghotbi
- Zoonosis Research Center, Jahrom University of Medical Sciences, Jahrom, Iran.,Department of Medical Parasitology and Mycology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Aynaz Ghojoghi
- Department of Medical Mycology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Kavous Solhjoo
- Zoonosis Research Center, Jahrom University of Medical Sciences, Jahrom, Iran.,Department of Medical Parasitology and Mycology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| | | | - Seyed Ali Jeddi
- Department of Laboratory Sciences, School of Allied Medical Sciences, Abadan University of Medical Sciences, Abadan, Iran
| | - Bahram Ahmadi
- Department of Medical Laboratory Sciences, Faculty of Paramedical, Bushehr University of Medical Sciences, Bushehr, Iran
| | | | - Saham Ansari
- Department of Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Gholamreza Shokoohi
- Zoonosis Research Center, Jahrom University of Medical Sciences, Jahrom, Iran. .,Department of Medical Parasitology and Mycology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
| |
Collapse
|
16
|
Born T, Aruanno M, Kampouri E, Mombelli M, Monney P, Tozzi P, Lamoth F. Aspergillus tubingensis Endocarditis: A Case Report and Review of the Literature. Mycopathologia 2022; 187:249-258. [PMID: 35267153 PMCID: PMC9124170 DOI: 10.1007/s11046-022-00621-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 02/12/2022] [Indexed: 11/30/2022]
Abstract
Aspergillus endocarditis is a rare infection that may affect immunocompetent patients following heart valve replacement or heart surgery. We report the case of a 39 year old woman with a history of intravenous drug use who developed endocarditis with direct examination of the resected valve and vegetation showing the presence of mycelia. Cultures were positive for an Aspergillus of section Nigri, which was subsequently identified as Aspergillus tubingensis by sequencing. The clinical course was favorable following surgery and prolonged antifungal therapy (8 months in total). Antifungal susceptibility testing showed good in vitro activity of amphotericin B, voriconazole and echinocandins against planktonic cells of this A. tubingensis isolate. However, only amphotericin B displayed significant activity against biofilms. In vitro combinations of voriconazole or amphotericin B with echinocandins did not meet the criteria of synergism. Our review of the literature identified 17 other cases of endocarditis attributed to Aspergillus of section Nigri with an overall mortality rate of 57% (100% in the absence of surgery). Endocarditis caused by Aspergillus niger and related cryptic species are rare events, for which surgical management appears to be crucial for outcome. While amphotericin B was the only antifungal drug displaying significant anti-biofilm activity, the type and duration of antifungal therapy remain to be determined.
Collapse
Affiliation(s)
- Tristan Born
- Infectious Diseases Service, Department of Medicine, Lausanne University Hospital and University of Lausanne, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Marion Aruanno
- Infectious Diseases Service, Department of Medicine, Lausanne University Hospital and University of Lausanne, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.,Institute of Microbiology, Department of Laboratories, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland
| | - Eleftheria Kampouri
- Infectious Diseases Service, Department of Medicine, Lausanne University Hospital and University of Lausanne, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Matteo Mombelli
- Service of Internal Medicine, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Pierre Monney
- Cardiology Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Piergiorgio Tozzi
- Cardiac Surgery Division, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Frederic Lamoth
- Infectious Diseases Service, Department of Medicine, Lausanne University Hospital and University of Lausanne, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. .,Institute of Microbiology, Department of Laboratories, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland.
| |
Collapse
|
17
|
Stengel A, Stanke KM, Quattrone AC, Herr JR. Improving Taxonomic Delimitation of Fungal Species in the Age of Genomics and Phenomics. Front Microbiol 2022; 13:847067. [PMID: 35250961 PMCID: PMC8892103 DOI: 10.3389/fmicb.2022.847067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 01/28/2022] [Indexed: 01/04/2023] Open
Abstract
Species concepts have long provided a source of debate among biologists. These lively debates have been important for reaching consensus on how to communicate across scientific disciplines and for advancing innovative strategies to study evolution, population biology, ecology, natural history, and disease epidemiology. Species concepts are also important for evaluating variability and diversity among communities, understanding biogeographical distributions, and identifying causal agents of disease across animal and plant hosts. While there have been many attempts to address the concept of species in the fungi, there are several concepts that have made taxonomic delimitation especially challenging. In this review we discuss these major challenges and describe methodological approaches that show promise for resolving ambiguity in fungal taxonomy by improving discrimination of genetic and functional traits. We highlight the relevance of eco-evolutionary theory used in conjunction with integrative taxonomy approaches to improve the understanding of interactions between environment, ecology, and evolution that give rise to distinct species boundaries. Beyond recent advances in genomic and phenomic methods, bioinformatics tools and modeling approaches enable researchers to test hypothesis and expand our knowledge of fungal biodiversity. Looking to the future, the pairing of integrative taxonomy approaches with multi-locus genomic sequencing and phenomic techniques, such as transcriptomics and proteomics, holds great potential to resolve many unknowns in fungal taxonomic classification.
Collapse
Affiliation(s)
- Ashley Stengel
- Complex Biosystems Interdisciplinary Life Sciences, University of Nebraska-Lincoln, Lincoln, NE, United States.,Department of Agronomy and Horticulture, University of Nebraska-Lincoln, Lincoln, NE, United States.,Department of Plant Pathology, University of Nebraska-Lincoln, Lincoln, NE, United States
| | - Kimberly M Stanke
- Complex Biosystems Interdisciplinary Life Sciences, University of Nebraska-Lincoln, Lincoln, NE, United States.,Department of Chemical and Biomolecular Engineering, University of Nebraska-Lincoln, Lincoln, NE, United States
| | - Amanda C Quattrone
- Complex Biosystems Interdisciplinary Life Sciences, University of Nebraska-Lincoln, Lincoln, NE, United States.,School of Biological Sciences, University of Nebraska-Lincoln, Lincoln, NE, United States.,Center for Plant Science Innovation, University of Nebraska-Lincoln, Lincoln, NE, United States
| | - Joshua R Herr
- Department of Plant Pathology, University of Nebraska-Lincoln, Lincoln, NE, United States.,School of Biological Sciences, University of Nebraska-Lincoln, Lincoln, NE, United States.,Center for Plant Science Innovation, University of Nebraska-Lincoln, Lincoln, NE, United States
| |
Collapse
|
18
|
Sarvestani HK, Ghazvini RD, Hashemi SJ, Rezaie S, Mahmoudi S, Shoar MG, Elahi M, Izadi A, Getso MI, Rafat Z, Tajdini A, Hedayati MT. First molecular report of causative agent of otomycosis due to Aspergillus luchuensis. J Wound Care 2021; 30:XIVi-XIViii. [PMID: 34597173 DOI: 10.12968/jowc.2021.30.sup9a.xiv] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Otomycosis is a fungal infection of the external auditory canal caused mainly by the genus Aspergillus. Aspergillus luchuensis, an industrially important fungus, is a member of Aspergillus section Nigri. In this report, we present a case of otomycosis due to Aspergillus luchuensis in a 43-year-old female patient. We performed a partial PCR-sequencing of β-tubulin and calmodulin genes to identify the isolate to the species level. Further, we determined the in vitro susceptibility of the isolate to nystatin, clotrimazole and itraconazole according to the Clinical & Laboratory Standards Institute (CLSI) M38-A2 protocol. Accordingly, the minimum inhibitory concentrations of clotrimazole, nystatin and itraconazole were 0.25μg/mL, 0.5μg/mL and 1μg/mL, respectively. This is the first report of clinically relevant isolation of Aspergillus luchuensis identified by a molecular technique as a causative agent of otomycosis.
Collapse
Affiliation(s)
- Hasti Kamali Sarvestani
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Roshanak Daie Ghazvini
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Jamal Hashemi
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Sassan Rezaie
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahram Mahmoudi
- Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mohsen Gerami Shoar
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Miad Elahi
- Department of Head and Neck Surgery, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Izadi
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Muhammad Ibrahim Getso
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Department of Medical Microbiology and Parasitology, Faculty of Clinical Sciences, College of Health Sciences, Bayero University Kano, PMB 3011, Kano-Nigeria
| | - Zahra Rafat
- Department of Medical Microbiology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Ardavan Tajdini
- Department of Head and Neck Surgery, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Taghi Hedayati
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Mazandaran, Iran
| |
Collapse
|
19
|
Endo R, Tanaka R, Kamei K, Takase T, Nomura T, Kanzaki M. Primary cutaneous aspergillosis caused by Aspergillus welwitschiae: A case report. J Dermatol 2021; 48:e554-e555. [PMID: 34402536 DOI: 10.1111/1346-8138.16121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/29/2021] [Accepted: 08/05/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Ruriko Endo
- Department of Dermatology, Mito Saiseikai General Hospital, Mito, Japan.,Department of Dermatology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Ryota Tanaka
- Department of Dermatology, Mito Saiseikai General Hospital, Mito, Japan.,Department of Dermatology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Katsuhiko Kamei
- Division of Clinical Research, Medical Mycology Research Center, Chiba University, Chiba, Japan
| | | | - Toshifumi Nomura
- Department of Dermatology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Mirei Kanzaki
- Department of Dermatology, Mito Saiseikai General Hospital, Mito, Japan
| |
Collapse
|
20
|
In Vitro Antifungal Activity of Luliconazole, Efinaconazole, and Nine Comparators Against Aspergillus and Candida Strains Isolated from Otomycosis. Jundishapur J Microbiol 2021. [DOI: 10.5812/jjm.115902] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background: Aspergillus and Candida species are the most commonly identified fungal pathogens in otomycosis. However, we usually encounter some difficulties in its treatment because many patients show resistance to antifungal agents and present a high recurrence rate. Objectives: The current research was conducted to compare the in vitro activities of luliconazole (LUL), and efinaconazole (EFN) and the nine comparators on Aspergillus and Candida strains isolated from otomycosis. Methods: The in vitro activities of nine common antifungal drugs (amphotericin B (AMB), voriconazole (VRC), fluconazole (FLU), itraconazole (ITC), ketoconazole (KTO), clotrimazole (CLO), nystatin (NYS), terbinafine (TRB), and caspofungin (CAS)) and two novel new azoles (LUL and EFN) against 108 clinical isolates of Aspergillus and Candida species obtained from otomycosis were assessed according to the CLSI broth microdilution document. Results: The LUL and EFN had the geometric mean minimum inhibitory concentrations (GM MICs) of 0.098 and 0.109 μg/mL against all Aspergillus strains, respectively. Furthermore, the GM MICs of all Candida isolates for LUL, EFN, CAS, CLO, VRC, AMB, ITC, KTO, FLU, NYS, and TRB were calculated to be 0.133, 0.144, 0.194, 0.219, 0.475, 0.537, 0.655, 1.277, 4.905, 9.372, and 13.592 μg/mL, respectively. Additionally, 6 (35.29%), 2 (11.7%), and 1 (5.88%) Candida isolates were resistant to FLU, CAS, and VRC, respectively. Conclusions: As the findings indicated, LUL and EFN showed the lowest GM MIC values against the examined species. Accordingly, these novel imidazole and triazole antifungal agents can be regarded as proper candidates for the treatment of otomycosis caused by Aspergillus and Candida strains.
Collapse
|
21
|
Abstract
Pathogenic fungi have several mechanisms of resistance to antifungal drugs, driven by the genetic plasticity and versatility of their homeostatic responses to stressful environmental cues. We critically review the molecular mechanisms of resistance and cellular adaptations of pathogenic fungi in response to antifungals and discuss the factors contributing to such resistance. We offer suggestions for the translational and clinical research agenda of this rapidly evolving and medically important field. A better understanding of antifungal resistance should assist in developing better detection tools and inform optimal strategies for preventing and treating refractory mycoses in the future.
Collapse
Affiliation(s)
- Ronen Ben-Ami
- Infectious Diseases Department, Sackler School of Medicine, Tel Aviv University, Tel Aviv Sourasky Medical Center, 6 Weizmann, Tel Aviv 64239, Israel
| | - Dimitrios P Kontoyiannis
- Infectious Diseases, University of Texas M D Anderson Cancer Center, 1515 Holcombe, Houston, TX 77030, USA.
| |
Collapse
|
22
|
Cadena J, Thompson GR, Patterson TF. Aspergillosis: Epidemiology, Diagnosis, and Treatment. Infect Dis Clin North Am 2021; 35:415-434. [PMID: 34016284 DOI: 10.1016/j.idc.2021.03.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The spectrum of disease produced by Aspergillus species ranges from allergic syndromes to chronic pulmonary conditions and invasive infections. Invasive aspergillosis is a major cause of morbidity and mortality in immunocompromised patients. Risk factors continue to evolve and include newer biological agents that target the immune system and postinfluenza infection; and it has been observed following COVID-19 infection. Diagnosis remains a challenge but non-culture-based methods are available. Antifungal resistance has emerged. Voriconazole remains the treatment of choice but isavuconazole and posaconazole have similar efficacy with less toxicity. Combination therapy is used with extensive infection and in severe immunosuppression.
Collapse
Affiliation(s)
- Jose Cadena
- Department of Medicine, Division of Infectious Diseases, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive - MSC 7881, San Antonio, TX 78229-3900, USA
| | - George R Thompson
- Department of Internal Medicine, Division of Infectious Diseases, University of California - Davis Health; Department of Medical Microbiology and Immunology, University of California - Davis Health.
| | - Thomas F Patterson
- Department of Medicine, Division of Infectious Diseases, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive - MSC 7881, San Antonio, TX 78229-3900, USA
| |
Collapse
|
23
|
Treviño-Rangel RDJ, Villanueva-Lozano H, Bonifaz A, Castañón-Olivares LR, Andrade A, Becerril-García MA, Martínez-Reséndez MF, Ayala-Gaytán J, Montoya AM, González GM. Species distribution and antifungal susceptibility patterns of Aspergillus isolates from clinical specimens and soil samples in Mexico. Med Mycol 2021; 59:1006-1014. [PMID: 34021564 DOI: 10.1093/mmy/myab031] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 05/05/2021] [Accepted: 05/19/2021] [Indexed: 01/13/2023] Open
Abstract
This study aimed to assess the species distribution and antifungal susceptibility patterns of 200 strains of Aspergillus isolated from clinical specimens (n = 146) and soil samples (n = 54) in Mexico. ITS, β-tubulin, and calmodulin DNA sequencing was performed for species identification. Broth microdilution susceptibility testing for amphotericin B, voriconazole, posaconazole, itraconazole, isavuconazole, anidulafungin, caspofungin, and micafungin was done according to CLSI for all strains. A. fumigatus was most frequently recovered from clinical specimens, while A. niger was commonly encountered in soil, both followed by A. flavus in second place. A total of 60 (30%) cryptic species were identified, with A. tubingensis and A. tamarii being the most commonly found. The decreased susceptibility to amphotericin B and azoles was 32% for both, and were mainly led by A. fumigatus, whereas this percentage decreased to 9% for caspofungin particularly in A. terreus. More than 75% of cryptic species were susceptible in vitro to all antifungals. Multi-azole decreased susceptibility was detected only in 7 isolates. Given that antifungal resistance in Aspergillus spp. is an increasing worldwide threat that causes major challenges in the clinical management of aspergillosis, these data highlight the need for continuous epidemiological surveillance of these pathogens for the implementation of locally-adequate treatment strategies.
Collapse
Affiliation(s)
- Rogelio de J Treviño-Rangel
- Departamento de Microbiología, Facultad de Medicina and Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Hiram Villanueva-Lozano
- Departamento de Microbiología, Facultad de Medicina and Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Alexandro Bonifaz
- Servicio de Dermatología and Departamento de Micología, Hospital General de México "Dr. Eduardo Liceaga", Mexico City, Mexico
| | - Laura R Castañón-Olivares
- Unidad de Micología, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Angel Andrade
- Departamento de Microbiología, Facultad de Medicina and Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Miguel A Becerril-García
- Departamento de Microbiología, Facultad de Medicina and Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | | | - Jacobo Ayala-Gaytán
- Unidad de Vigilancia Epidemiológica, Hospital San José-Tec Salud, Monterrey, Mexico
| | - Alexandra M Montoya
- Departamento de Microbiología, Facultad de Medicina and Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Gloria M González
- Departamento de Microbiología, Facultad de Medicina and Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Mexico
| |
Collapse
|
24
|
Gits-Muselli M, Hamane S, Verillaud B, Cherpin E, Denis B, Bondeelle L, Touratier S, Alanio A, Garcia-Hermoso D, Bretagne S. Different repartition of the cryptic species of black aspergilli according to the anatomical sites in human infections, in a French University hospital. Med Mycol 2021; 59:985-992. [PMID: 34022772 DOI: 10.1093/mmy/myab027] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 01/25/2021] [Accepted: 04/27/2021] [Indexed: 02/04/2023] Open
Abstract
Black aspergilli of the section Nigri are rarely differentiated at the species level when originating from human specimens. We wondered whether some cryptic species could be more frequently observed in some clinical entities. We analyzed the 198 black isolates consecutively collected from the external ear canal (EEC; n = 66), respiratory specimens (n = 99), and environment (n = 33). DNA was extracted and species identification was performed upon the partial calmodulin gene. We identified by decreasing frequency: Aspergillus welwitschiae (35.3%), Aspergillus tubingensis (34.3%), Aspergillus niger (17.2%), Aspergillus luchuensis (4%), Aspergillus aff. welwitschiae (3%), Aspergillus neoniger (2%), Aspergillus piperis (1.5%), Aspergillus japonicus (1.0%), Aspergillus vadensis (0.5%), and two Aspergillus tubingensis clade (1%). The distribution of the three main cryptic species was different between EEC and respiratory samples (P < 0.001) but not different between respiratory and environment samples (P = 0.264). Aspergillus welwitschiae was more often associated with EEC (54.5%), whereas A. tubingensis and A. niger were predominant in respiratory samples (39.4 and 26.3%, respectively). Among the 99 respiratory isolates, only 10 were deemed responsible for probable invasive aspergillosis, of which six were mixed with other pathogenic moulds. This study shows the interest to pursue the identification of clinical isolates in the Aspergillus section Nigri to unravel some specific associations with clinical entities. The association of A. welwitschiae with otomycosis suggests a better fitness to infect/colonize the ear canal. Also, members of the Aspergillus section Nigri alone are rarely responsible for invasive aspergillosis. LAY SUMMARY We analyzed 198 black aspergilli isolates collected from different samples type to determine their species identification. We observe a different distribution of species between ear canal and respiratory samples (P < 0.001), suggesting a better fitness of A. welwitschiae to infect the ear canal.
Collapse
Affiliation(s)
- Maud Gits-Muselli
- Laboratoire de Parasitologie-Mycologie, Hôpital Lariboisière Saint-Louis Fernand Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), France.,Institut Pasteur, CNRS, Unité de Mycologie Moléculaire, Centre National de Référence Mycologie et Antifongiques, UMR2000, France.,Université de Paris, France
| | - Samia Hamane
- Laboratoire de Parasitologie-Mycologie, Hôpital Lariboisière Saint-Louis Fernand Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), France
| | - Benjamin Verillaud
- Université de Paris, France.,Département d'Otorhinolaryngologie, Hôpital Lariboisière Saint-Louis Fernand Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), France.,Institut National de la Santé et de la Recherche Médicale U1141, France
| | - Elisa Cherpin
- Laboratoire de Parasitologie-Mycologie, Hôpital Lariboisière Saint-Louis Fernand Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), France
| | - Blandine Denis
- Département de Maladies infectieuses, Hôpital Lariboisière Saint-Louis Fernand Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), France
| | - Louise Bondeelle
- Université de Paris, France.,Pneumologie, Hôpital Lariboisière Saint-Louis Fernand Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), France
| | - Sophie Touratier
- Pharmacie, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris (AP-HP), France
| | - Alexandre Alanio
- Laboratoire de Parasitologie-Mycologie, Hôpital Lariboisière Saint-Louis Fernand Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), France.,Institut Pasteur, CNRS, Unité de Mycologie Moléculaire, Centre National de Référence Mycologie et Antifongiques, UMR2000, France.,Université de Paris, France
| | - Dea Garcia-Hermoso
- Laboratoire de Parasitologie-Mycologie, Hôpital Lariboisière Saint-Louis Fernand Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), France
| | - Stéphane Bretagne
- Laboratoire de Parasitologie-Mycologie, Hôpital Lariboisière Saint-Louis Fernand Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), France.,Institut Pasteur, CNRS, Unité de Mycologie Moléculaire, Centre National de Référence Mycologie et Antifongiques, UMR2000, France.,Université de Paris, France
| |
Collapse
|
25
|
Osman M, Bidon B, Abboud C, Zakaria A, Hamze B, Achcar ME, Mallat H, Dannaoui E, Dabboussi F, Papon N, Bouchara JP, Hamze M. Species distribution and antifungal susceptibility of Aspergillus clinical isolates in Lebanon. Future Microbiol 2021; 16:13-26. [PMID: 33438473 DOI: 10.2217/fmb-2020-0141] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Aim: We sought to provide first insights into the epidemiology and antifungal susceptibility patterns of the aspergilli in Lebanon. Materials & methods: After species identification, antifungal susceptibility was investigated according to EUCAST recommendations. CYP51A gene was sequenced in resistant isolates and its expression level was evaluated by Reverse transcription-quantitative PCR. Results: Among the 73 Aspergillus isolates studied (mostly from ears), the predominant species was Aspergillus niger (54.8%). The overall drug resistance was highest for amphotericin B (38.4%), followed by itraconazole (31.5%), posaconazole (30.1%) and voriconazole (23.3%). In addition, CYP51A gene mutations were not the major cause of azole resistance among these isolates. Conclusion: Our findings indicate the paramount need for an integral One Health strategy and a national reference center for invasive mycoses and antifungals.
Collapse
Affiliation(s)
- Marwan Osman
- Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Science & Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - Baptiste Bidon
- Groupe d'Etude des Interactions Hôte-Pathogène, GEIHP, EA3142, SFR 4208 ICAT, Univ Angers, Univ Brest, Angers, France
| | - Cynthia Abboud
- Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Science & Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon.,Groupe d'Etude des Interactions Hôte-Pathogène, GEIHP, EA3142, SFR 4208 ICAT, Univ Angers, Univ Brest, Angers, France
| | - Ayate Zakaria
- Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Science & Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - Baraa Hamze
- Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Science & Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | | | - Hassan Mallat
- Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Science & Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - Eric Dannaoui
- Paris-Descartes University, Faculty of Medicine, APHP, European Georges Pompidou Hospital, Parasitology-Mycology Unit, Microbiology department, Paris, France
| | - Fouad Dabboussi
- Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Science & Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - Nicolas Papon
- Groupe d'Etude des Interactions Hôte-Pathogène, GEIHP, EA3142, SFR 4208 ICAT, Univ Angers, Univ Brest, Angers, France
| | - Jean-Philippe Bouchara
- Groupe d'Etude des Interactions Hôte-Pathogène, GEIHP, EA3142, SFR 4208 ICAT, Univ Angers, Univ Brest, Angers, France
| | - Monzer Hamze
- Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Science & Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| |
Collapse
|
26
|
da Silva JJ, Iamanaka BT, Ferranti LS, Massi FP, Taniwaki MH, Puel O, Lorber S, Frisvad JC, Fungaro MHP. Diversity within Aspergillus niger Clade and Description of a New Species: Aspergillus vinaceus sp. nov. J Fungi (Basel) 2020; 6:jof6040371. [PMID: 33348541 PMCID: PMC7767288 DOI: 10.3390/jof6040371] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 12/13/2020] [Accepted: 12/14/2020] [Indexed: 11/29/2022] Open
Abstract
Diversity of species within Aspergillus niger clade, currently represented by A. niger sensu stricto and A. welwitshiae, was investigated combining three-locus gene sequences, Random Amplified Polymorphic DNA, secondary metabolites profile and morphology. Firstly, approximately 700 accessions belonging to this clade were investigated using calmodulin gene sequences. Based on these sequences, eight haplotypes were clearly identified as A. niger (n = 247) and 17 as A. welwitschiae (n = 403). However, calmodulin sequences did not provide definitive species identities for six haplotypes. To elucidate the taxonomic position of these haplotypes, two other loci, part of the beta-tubulin gene and part of the RNA polymerase II gene, were sequenced and used to perform an analysis of Genealogical Concordance Phylogenetic Species Recognition. This analysis enabled the recognition of two new phylogenetic species. One of the new phylogenetic species showed morphological and chemical distinguishable features in comparison to the known species A. welwitschiae and A. niger. This species is illustrated and described as Aspergillus vinaceus sp. nov. In contrast to A. niger and A. welwitschiae, A. vinaceus strains produced asperazine, but none of them were found to produce ochratoxin A and/or fumonisins. Sclerotium production on laboratory media, which does not occur in strains of A. niger and A. welwitschiae, and strictly sclerotium-associated secondary metabolites (14-Epi-hydroxy-10,23-dihydro-24,25-dehydroaflavinine; 10,23-Dihydro-24,25-dehydroaflavinine; 10,23-Dihydro-24,25-dehydro-21-oxo-aflavinine) were found in A. vinaceus. The strain type of A. vinaceus sp. nov. is ITAL 47,456 (T) (=IBT 35556).
Collapse
Affiliation(s)
- Josué J. da Silva
- Centro de Ciências Biológicas, Universidade Estadual de Londrina, Londrina, Paraná 86057-970, Brazil; (J.J.d.S.); (L.S.F.); (F.P.M.)
| | - Beatriz T. Iamanaka
- Centro de Ciência e Qualidade de Alimentos, Instituto de Tecnologia de Alimentos, Campinas, São Paulo 13070-178, Brazil; (B.T.I.); (M.H.T.)
| | - Larissa S. Ferranti
- Centro de Ciências Biológicas, Universidade Estadual de Londrina, Londrina, Paraná 86057-970, Brazil; (J.J.d.S.); (L.S.F.); (F.P.M.)
| | - Fernanda P. Massi
- Centro de Ciências Biológicas, Universidade Estadual de Londrina, Londrina, Paraná 86057-970, Brazil; (J.J.d.S.); (L.S.F.); (F.P.M.)
| | - Marta H. Taniwaki
- Centro de Ciência e Qualidade de Alimentos, Instituto de Tecnologia de Alimentos, Campinas, São Paulo 13070-178, Brazil; (B.T.I.); (M.H.T.)
| | - Olivier Puel
- Toxalim (Research Centre in Food Toxicology), INRAE, ENVT, INP-Purpan, 31027 Toulouse, France; (O.P.); (S.L.)
| | - Sophie Lorber
- Toxalim (Research Centre in Food Toxicology), INRAE, ENVT, INP-Purpan, 31027 Toulouse, France; (O.P.); (S.L.)
| | - Jens C. Frisvad
- Department of Biotechnology and Biomedicine, Technical University of Denmark, 2800 Lyngby, Denmark;
| | - Maria Helena P. Fungaro
- Centro de Ciências Biológicas, Universidade Estadual de Londrina, Londrina, Paraná 86057-970, Brazil; (J.J.d.S.); (L.S.F.); (F.P.M.)
- Correspondence: ; Tel.: +55-4399-955-4100
| |
Collapse
|
27
|
Multilaboratory Evaluation of the MALDI-TOF Mass Spectrometry System, MicroIDSys Elite, for the Identification of Medically Important Filamentous Fungi. Mycopathologia 2020; 186:15-26. [PMID: 33180204 DOI: 10.1007/s11046-020-00507-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 10/30/2020] [Indexed: 12/17/2022]
Abstract
With the increasing number of fungal infections and immunocompromised patients, rapid and accurate fungal identification is required in clinical microbiology laboratories. We evaluated the applicability of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) system, MicroIDSys Elite (ASTA Corp., South Korea) for the identification of medically important filamentous fungi. A total of 505 strains comprising 37 genera and 90 species collected from 11 Korean hospitals were sent to the microbiology laboratory of International St. Mary's Hospital. All isolates were tested using MicroIDSys Elite, and data were analyzed using the MoldDB v.1.22 database (ASTA). Correct identification rates were compared with the multigene sequencing results. MicroIDSys Elite correctly identified 86.5% (437/505) and 88.9% (449/505) of all tested isolates at the species and genus level, respectively. About 98.2% of Aspergillus isolates were identified at the species level, including cryptic and rare species of A. calidoustus, A. tamarii, A. lentulus, A. versicolor and A. aculeatus. MicroIDSys Elite identified 75.0% of basidiomycetes, including Schizophyllum commune, and 84.3% of the dermatophytes. It also distinguished Sprothrix globosa at the species level. The mean scores of total isolates corresponding to correct species identification were significantly higher than those obtained for genus-level identification (253.5 ± 50.7 vs. 168.6 ± 30.3, P < 0.001). MicroIDSys Elite showed high accuracy for the identification of filamentous fungi, including cryptic and rare Aspergillus species. It is suitable for use in clinical laboratories as a rapid and efficient tool for clinical mold identification. Further evaluations are recommended for MicroIDSys Elite as a rapid and efficient tool for the identification of medically important filamentous fungi.
Collapse
|
28
|
In vitro Antifungal Activity of Psidium Guajava Based Silver Nanoparticles. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2020. [DOI: 10.22207/jpam.14.3.48] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
To prepare and characterize silver nanoparticles from Guava leaves (Psidium guajava), extracts (chloroform and ethanol). The fabricated silver nanoparticles were tested on resistant fungal strains, Aspergillus niger and Candida glabrata. Psidium guajava leaf extracts were obtained by cold maceration method, by using Chloroform and Ethanol. To one mL of extract 2mM silver nitrate solution was added. The mixture was kept overnight in a dark chamber at room temperature. The solution was centrifuged at 10,000 rpm for 15 minutes and filtered by wattman filter paper after centrifugation. Psidium guajava leaf extract based silver nanoparticles were prepared and evaluated for anti-fungal activity by microtitre well plate method on resistant strains Aspergillus niger and Candida glabrata. The silver nanoparticles showed significant activity at 120 µL, Nystatin was used as standard.
Collapse
|
29
|
Melo AM, Poester VR, Trapaga M, Nogueira CW, Zeni G, Martinez M, Sass G, Stevens DA, Xavier MO. Diphenyl diselenide and its interaction with antifungals against Aspergillus spp. Med Mycol 2020; 59:myaa072. [PMID: 32844203 DOI: 10.1093/mmy/myaa072] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 07/16/2020] [Accepted: 08/20/2020] [Indexed: 02/06/2023] Open
Abstract
Given the few antifungal classes available to treat aspergillosis, this study aimed to evaluate the in vitro antifungal activity of diphenyl diselenide (PhSe)2 alone and in combination with classical antifungals against Aspergillus spp., and its in vivo activity in a systemic experimental aspergillosis model. We performed in vitro broth microdilution assay of (PhSe)2 against 32 Aspergillus isolates; and a checkboard assay to test the interaction of this compound with itraconazole (ITC), voriconazole (VRC), amphotericin B (AMB), and caspofungin (CAS), against nine Aspergillus isolates. An experimental model of invasive aspergillosis in mice was studied, and survival curves were compared between an untreated group and groups treated with 100 mg/kg ITC, or (PhSe)2 in different dosages (10 mg/kg, 50 mg/kg and 100 mg/kg). All Aspergillus non-fumigatus and 50% of A. fumigatus were inhibited by (PhSe)2 in concentrations ≤ 64 µg/ml, with significant differences in MICs between the sections. Synergism or additive effect in the in vitro (PhSe)2 interaction with VRC and CAS was observed against the majority of isolates, and with ITC against the non-fumigatus strains. In addition to the inhibitory interaction, (PhSe)2 was able to add a fungicidal effect to CAS. Survival curves from the systemic experimental aspergillosis model demonstrated that the inoculum caused an acute and lethal infection in mice, and no treatment applied significantly prolonged survival over that of the control group. The results highlight the promising activity of (PhSe)2 against Aspergillus species, but more in vivo studies are needed to determine its potential applicability in aspergillosis treatment. LAY SUMMARY The activity of diphenyl diselenide (PhSe)2 alone and in combination with itraconazole, voriconazole, and caspofungin, is described against three of the most pathogenic Aspergillus sections. (PhSe)2 may prove useful in therapy of infection in future; further study is required.
Collapse
Affiliation(s)
- Aryse Martins Melo
- Microbiology and Parasitology Post-graduation program, Institute of Biology, Federal University of Pelotas, Pelotas, RS, Brazil
- Department of Infectious Diseases/Reference Unit for Parasitic and Fungal Infections, National Institute of Health, Dr. Ricardo Jorge, Lisbon, Portugal
- Mycology Laboratory, College of Medicine, Federal University of Rio Grande, Rio Grande, RS, Brazil
| | - Vanice Rodrigues Poester
- Mycology Laboratory, College of Medicine, Federal University of Rio Grande, Rio Grande, RS, Brazil
- Health Science Post-graduation program, College of Medicine, Federal University of Rio Grande, Rio Grande, RS, Brazil
| | - Mariana Trapaga
- Mycology Laboratory, College of Medicine, Federal University of Rio Grande, Rio Grande, RS, Brazil
| | - Cristina Wayne Nogueira
- Biological Sciences Post-graduation program, Department of Biochemistry and Molecular Biology, Center for Natural and Exact Sciences, Federal University of Santa Maria. RS, Brazil
| | - Gilson Zeni
- Biological Sciences Post-graduation program, Department of Biochemistry and Molecular Biology, Center for Natural and Exact Sciences, Federal University of Santa Maria. RS, Brazil
| | - Marife Martinez
- California Institute for Medical Research, San Jose, California, USA
| | - Gabriele Sass
- California Institute for Medical Research, San Jose, California, USA
| | - David A Stevens
- California Institute for Medical Research, San Jose, California, USA
- Division of Infectious Diseases and Geographic Medicine, Stanford University Medical School, Stanford, California, USA
| | - Melissa Orzechowski Xavier
- Microbiology and Parasitology Post-graduation program, Institute of Biology, Federal University of Pelotas, Pelotas, RS, Brazil
- Mycology Laboratory, College of Medicine, Federal University of Rio Grande, Rio Grande, RS, Brazil
- Health Science Post-graduation program, College of Medicine, Federal University of Rio Grande, Rio Grande, RS, Brazil
- California Institute for Medical Research, San Jose, California, USA
| |
Collapse
|
30
|
Species Distribution and Comparison between EUCAST and Gradient Concentration Strips Methods for Antifungal Susceptibility Testing of 112 Aspergillus Section Nigri Isolates. Antimicrob Agents Chemother 2020; 64:AAC.02510-19. [PMID: 32312779 DOI: 10.1128/aac.02510-19] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 04/15/2020] [Indexed: 11/20/2022] Open
Abstract
Aspergillus niger, the third species responsible for invasive aspergillosis, has been considered as a homogeneous species until DNA-based identification uncovered many cryptic species. These species have been recently reclassified into the Aspergillus section Nigri However, little is yet known among the section Nigri about the species distribution and the antifungal susceptibility pattern of each cryptic species. A total of 112 clinical isolates collected from 5 teaching hospitals in France and phenotypically identified as A. niger were analyzed. Identification to the species level was carried out by nucleotide sequence analysis. The MICs of itraconazole, voriconazole, posaconazole, isavuconazole, and amphotericin B were determined by both the EUCAST and gradient concentration strip methods. Aspergillus tubingensis (n = 51, 45.5%) and Aspergillus welwitschiae (n = 50, 44.6%) were the most common species while A. niger accounted for only 6.3% (n = 7). The MICs of azole drugs were higher for A. tubingensis than for A. welwitschiae The MIC of amphotericin B was 2 mg/liter or less for all isolates. Importantly, MICs determined by EUCAST showed no correlation with those determined by the gradient concentration strip method, with the latter being lower than the former (Spearman's rank correlation tests ranging from 0.01 to 0.25 depending on the antifungal agent; P > 0.4). In conclusion, A. niger should be considered as a minority species in the section Nigri The differences in MICs between species for different azoles underline the importance of accurate identification. Significant divergences in the determination of MIC between EUCAST and the gradient concentration strip methods require further investigation.
Collapse
|
31
|
D'hooge E, Becker P, Stubbe D, Normand AC, Piarroux R, Hendrickx M. Black aspergilli: A remaining challenge in fungal taxonomy? Med Mycol 2020; 57:773-780. [PMID: 30535052 DOI: 10.1093/mmy/myy124] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 10/18/2018] [Accepted: 10/24/2018] [Indexed: 12/14/2022] Open
Abstract
Aspergillus section Nigri is a taxonomically difficult but medically and economically important group. In this study, an update of the taxonomy of A. section Nigri strains within the BCCM/IHEM collection has been conducted. The identification accuracy of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) was tested and the antifungal susceptibilities of clinical isolates were evaluated. A total of 175 strains were molecularly analyzed. Three regions were amplified (ITS, benA, and caM) and a multi-locus phylogeny of the combined loci was created by using maximum likelihood analysis. The in-house MALDI-TOF MS reference database was extended and an identification data set of 135 strains was run against a reference data set. Antifungal susceptibility was tested for voriconazole, itraconazole, and amphotericin B, using the EUCAST method. Phylogenetic analysis revealed 18 species in our data set. MALDI-TOF MS was able to distinguish between A. brasiliensis, A. brunneoviolaceus, A. neoniger, A. niger, A. tubingensis, and A. welwitschiae of A. sect. Nigri. In the routine clinical lab, isolates of A. sect. Nigri are often identified as A. niger. However, in the clinical isolates of our data set, A. tubingensis (n = 35) and A. welwitschiae (n = 34) are more common than A. niger (n = 9). Decreased antifungal susceptibility to azoles was observed in clinical isolates of the /tubingensis clade. This emphasizes the importance of identification up to species level or at least up to clade level in the clinical lab. Our results indicate that MALDI-TOF MS can be a powerful tool to replace classical morphology.
Collapse
Affiliation(s)
- Elizabet D'hooge
- BCCM/IHEM collection, Mycology and Aerobiology, Sciensano, J. Wytsmanstraat 14, 1050 Brussels, Belgium
| | - Pierre Becker
- BCCM/IHEM collection, Mycology and Aerobiology, Sciensano, J. Wytsmanstraat 14, 1050 Brussels, Belgium
| | - Dirk Stubbe
- BCCM/IHEM collection, Mycology and Aerobiology, Sciensano, J. Wytsmanstraat 14, 1050 Brussels, Belgium
| | - Anne-Cécile Normand
- Laboratoire de Parasitologie-Mycologie, Hôpital Pitié-Salpêtrière et Sorbonne Université, Paris, France
| | - Renaud Piarroux
- Laboratoire de Parasitologie-Mycologie, Hôpital Pitié-Salpêtrière et Sorbonne Université, Paris, France
| | - Marijke Hendrickx
- BCCM/IHEM collection, Mycology and Aerobiology, Sciensano, J. Wytsmanstraat 14, 1050 Brussels, Belgium
| |
Collapse
|
32
|
Zhang L, Wang X, Houbraken J, Mei H, Liao W, Hasimu H, Liu W, Deng S. Molecular Identification and In Vitro Antifungal Susceptibility of Aspergillus Isolates Recovered from Otomycosis Patients in Western China. Mycopathologia 2020; 185:527-535. [DOI: 10.1007/s11046-020-00448-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 04/10/2020] [Indexed: 11/30/2022]
|
33
|
The Brief Case: Mold Infection of an Indwelling Cranial Device-a Perplexing Combination of "Classic" Laboratory Findings. J Clin Microbiol 2020; 58:58/5/e01116-19. [PMID: 32327542 DOI: 10.1128/jcm.01116-19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
34
|
Azole resistance mechanisms in Aspergillus: update and recent advances. Int J Antimicrob Agents 2020; 55:105807. [DOI: 10.1016/j.ijantimicag.2019.09.011] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 09/05/2019] [Accepted: 09/15/2019] [Indexed: 12/11/2022]
|
35
|
Harada S, Ohkushi D, Nakano K, Mitani H, Yamamoto Y, Kamei K, Hayama B. Fatal invasive pulmonary aspergillosis caused by voriconazole-resistant Aspergillus tubingensis in a patient with solid tumor. J Infect Chemother 2019; 26:301-304. [PMID: 31787529 DOI: 10.1016/j.jiac.2019.10.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 10/15/2019] [Accepted: 10/25/2019] [Indexed: 10/25/2022]
Abstract
We report a fatal case of invasive pulmonary aspergillosis caused by voriconazole-resistant Aspergillus tubingensis in a patient with solid tumor but without severe immunosuppression. A high index of suspicion for invasive pulmonary aspergillosis, coupled with molecular identification of species and resistance genes, may facilitate early initiation of appropriate treatment.
Collapse
Affiliation(s)
- Sohei Harada
- Department of Infectious Diseases, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan; Department of Infectious Diseases, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
| | - Daisuke Ohkushi
- Department of Infectious Diseases, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Kenji Nakano
- Department of Medical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Hiroki Mitani
- Department of Head and Neck Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Yutaka Yamamoto
- Department of Intensive Care, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Katsuhiko Kamei
- Division of Infectious Diseases, Medical Mycology Research Center, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-city, Chiba, 260-8670, Japan
| | - Brian Hayama
- Department of Infectious Diseases, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| |
Collapse
|
36
|
Dannaoui E, Espinel-Ingroff A. Antifungal Susceptibly Testing by Concentration Gradient Strip Etest Method for Fungal Isolates: A Review. J Fungi (Basel) 2019; 5:jof5040108. [PMID: 31766762 PMCID: PMC6958406 DOI: 10.3390/jof5040108] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 11/13/2019] [Accepted: 11/16/2019] [Indexed: 12/23/2022] Open
Abstract
Antifungal susceptibility testing is an important tool for managing patients with invasive fungal infections, as well as for epidemiological surveillance of emerging resistance. For routine testing in clinical microbiology laboratories, ready-to-use commercial methods are more practical than homemade reference techniques. Among commercially available methods, the concentration gradient Etest strip technique is widely used. It combines an agar-based diffusion method with a dilution method that determinates a minimal inhibitory concentration (MIC) in µg/mL. Many studies have evaluated the agreement between the gradient strip method and the reference methods for both yeasts and filamentous fungi. This agreement has been variable depending on the antifungal, the species, and the incubation time. It has also been shown that the gradient strip method could be a valuable alternative for detection of emerging resistance (non-wild-type isolates) as Etest epidemiological cutoff values have been recently defined for several drug-species combinations. Furthermore, the Etest could be useful for direct antifungal susceptibility testing on blood samples and basic research studies (e.g., the evaluation of the in vitro activity of antifungal combinations). This review summarizes the available data on the performance and potential use of the gradient strip method.
Collapse
Affiliation(s)
- Eric Dannaoui
- Paris-Descartes University, Faculty of Medicine, 75006 Paris, France
- APHP, European Georges Pompidou Hospital, Parasitology-Mycology Unit, Microbiology Department, 75015 Paris, France
- Correspondence: ; Tel.: +33-15-6093-948; Fax: +33-15-6092-446
| | - Ana Espinel-Ingroff
- Virginia Commonwealth University (VCU) Medical Center, Richmond, VA 23219, USA;
| |
Collapse
|
37
|
Ohno Y, Akune Y, Inoshima Y, Kano R. First isolation of voriconazole-resistant Candida albicans, C. tropicalis, and Aspergillus niger from the blowholes of bottlenose dolphins (Tursiops truncatus). J Vet Med Sci 2019; 81:1628-1631. [PMID: 31611481 PMCID: PMC6895615 DOI: 10.1292/jvms.18-0749] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Pulmonary mycosis is a fungal disease that commonly affects bottlenose dolphins (Tursiops truncatus) and is generally treated by the oral administration of azoles, such as itraconazole (ITZ) and voriconazole (VRZ). However, antifungal susceptibility testing of clinical isolates has not been well performed as a routine clinical examination in aquaria. In this study, we collected fungal species from the blowholes of 14 bottlenose dolphins, of which 12 were treated with ITZ or VRZ. All dolphins were housed in the Port of Nagoya Public Aquarium. The fungal species Candida albicans, C. tropicalis, C. glabrata, Aspergillus fumigatus, and A. niger were isolated. E-tests were performed to determine the minimum inhibitory concentrations (MICs) of ITZ and VRZ on these isolates. VRZ-resistant C. tropicalis (MIC: >32 µg/ml) and A. niger (MIC: >32 µg/ml) were isolated from three dolphins treated with ITZ or VRZ. Additionally, azole-resistant isolates of C. albicans and C. glabrata were collected from two dolphins that had never received azole therapy. To the best of our knowledge, our study is the first to report the isolation of VRZ-resistant C. albicans, C. tropicalis, and A. niger from the blowholes of bottlenose dolphins. Thus, antifungal susceptibility testing is a crucial strategy for selecting antifungal agents to treat respiratory fungal infections in bottlenose dolphins in aquaria.
Collapse
Affiliation(s)
- Yoshito Ohno
- Port of Nagoya Public Aquarium, 1-3 Minato-machi, Minato-ku, Nagoya, Aichi 455-0033, Japan
| | - Yuichiro Akune
- Port of Nagoya Public Aquarium, 1-3 Minato-machi, Minato-ku, Nagoya, Aichi 455-0033, Japan
| | - Yasuo Inoshima
- Cooperative Department of Veterinary Medicine, Gifu University, 1-1 Yanagido, Gifu, Gifu 501-1193, Japan
| | - Rui Kano
- Department of Veterinary Pathobiology, Nihon University College of Bioresource Sciences, 1866 Kameino, Fujisawa, Kanagawa 252-0880, Japan
| |
Collapse
|
38
|
Toyotome T, Saito S, Koshizaki Y, Komatsu R, Matsuzawa T, Yaguchi T. Prospective survey of Aspergillus species isolated from clinical specimens and their antifungal susceptibility: A five-year single-center study in Japan. J Infect Chemother 2019; 26:321-323. [PMID: 31564504 DOI: 10.1016/j.jiac.2019.09.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 08/09/2019] [Accepted: 09/02/2019] [Indexed: 10/25/2022]
Abstract
Aspergillus fumigatus is the most prevalent species that causes aspergillosis. A. fumigatus strains with tandem repeats in the cyp51A promoter have emerged in the environment. Aspergillus species other than A. fumigatus have also been recognized as causative agents of aspergillosis; however, they show lower susceptibility to antifungals compared with A. fumigatus. Therefore, it is important to precisely identify Aspergillus species and determine their antifungal susceptibility. Herein, we collected 119 mold strains isolated from clinical specimens collected at a hospital between November 2013 and December 2018. The collected strains were identified by sequencing several regions, including internal transcribed spacers, and determined their susceptibility to the antifungals itraconazole, voriconazole, and amphotericin B. Of 119 strains, 107 were Aspergillus species, which were identified as A. fumigatus (67), Aspergillus section Nigri (21), A. flavus (7), A. terreus (6), and A. nidulans (6). In Aspergillus section Nigri, the number of A. niger was less than the number of A. welwitschiae and A. tubingensis. Two azole-resistant A. fumigatus samples were included among the isolates. Four of the eight A. tubingensis isolates showed less susceptibility to voriconazole; however, all isolates of A. niger and A. welwitschiae were susceptible to itraconazole and voriconazole. Because of lack of susceptibility data for non-fumigatus Aspergillus and an increasing frequency of antifungal resistance among A. fumigatus, our data along with further surveillance may contribute to determining the frequency and susceptibility of Aspergillus spp. clinical isolates in Japan.
Collapse
Affiliation(s)
- Takahito Toyotome
- Department of Veterinary Medicine, Obihiro University of Agriculture and Veterinary Medicine, Nishi 2-11, Inada-cho, Obihiro, Hokkaido, 080-8555, Japan; Diagnostic Center for Animal Health and Food Safety, Obihiro University of Agriculture and Veterinary Medicine, Nishi 2-11, Inada-cho, Obihiro, Hokkaido, 080-8555, Japan; Division of Clinical Research, Medical Mycology Research Center, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba, 260-8673, Japan.
| | - Shunpei Saito
- Department of Medical Technologist, Obihiro-Kosei General Hospital, West 14 South 10-1, Obihiro, Hokkaido, 080-0016, Japan
| | - Yusuke Koshizaki
- Department of Medical Technologist, Obihiro-Kosei General Hospital, West 14 South 10-1, Obihiro, Hokkaido, 080-0016, Japan
| | - Ryoichi Komatsu
- Department of Medical Technologist, Obihiro-Kosei General Hospital, West 14 South 10-1, Obihiro, Hokkaido, 080-0016, Japan
| | | | - Takashi Yaguchi
- Division of Bio-resources, Medical Mycology Research Center, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba, 260-8673, Japan
| |
Collapse
|
39
|
Organic dust exposure in veterinary clinics: a case study of a small-animal practice in Portugal. Arh Hig Rada Toksikol 2019; 69:309-316. [PMID: 30864379 DOI: 10.2478/aiht-2018-69-3171] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Accepted: 12/01/2018] [Indexed: 01/10/2023] Open
Abstract
Literature about occupational health in small-animal veterinary practices is scarce, but most of it has recognised a number of risks to be considered, including organic dust exposure. The aim of this pilot study was to assess organic dust, bacterial, and fungal contamination in the indoor environment of a typical Portuguese veterinary clinic but also to screen for azoleresistant fungi. To complement these findings we also analysed workers' nasal exudates for resistant bacteriota. Particles measurements included mass concentrations (PMC) of five particle sizes (PM0.5, PM1, PM2.5, PM5, PM10) and their counts (PNC). Indoor air samples were obtained from six locations as well as before and during cat dental cleaning and cultured on four media for bacterial and fungal assessment. An outdoor sample was also collected for reference Surface samples were taken from the same indoor locations using swabs and we also use electrostatic dust cloths as passive methods. PM10 showed the highest concentrations across the locations. Indoor air fungal loads ranged from 88 to 504 CFU m-3. The azole-resistant Aspergillus section Nigri was identified in one sample. Indoor air bacterial loads ranged from 84 to 328 CFU m-3. Nasopharyngeal findings in the 14 veterinary clinic workers showed a remarkably low prevalence of Staphylococcus aureus (7.1 %). Our results point to contamination with organic dusts above the WHO limits and to the need for better ventilation. Future studies should combine the same sampling protocol (active and passive methods) with molecular tools to obtain more accurate risk characterisation. In terms of prevention, animals should be caged in rooms separate from where procedures take place, and worker protection should be observed at all times.
Collapse
|
40
|
Epidemiology and Antifungal Susceptibility Profile of Aspergillus Species: Comparison between Environmental and Clinical Isolates from Patients with Hematologic Malignancies. J Clin Microbiol 2019; 57:JCM.02023-18. [PMID: 31018982 PMCID: PMC6595445 DOI: 10.1128/jcm.02023-18] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 04/16/2019] [Indexed: 02/03/2023] Open
Abstract
Global data on the epidemiology and susceptibility of Aspergillus are crucial in the management of invasive aspergillosis. Here, we aimed to determine the characteristics of clinical and environmental Aspergillus isolates, focusing mainly on hematologic malignancy patients. Global data on the epidemiology and susceptibility of Aspergillus are crucial in the management of invasive aspergillosis. Here, we aimed to determine the characteristics of clinical and environmental Aspergillus isolates, focusing mainly on hematologic malignancy patients. We prospectively collected all consecutive cases and clinical isolates of culture-positive proven/probable invasive aspergillosis patients from January 2016 to April 2018 and sampled the air inside and outside the hospital. Cryptic species-level identification of Aspergillus, antifungal susceptibilities, and cyp51 gene sequencing were performed, and clinical data were analyzed. This study was conducted as part of the Catholic Hematology Hospital Fungi Epidemiology (CAFÉ) study. A total of 207 proven/probable invasive aspergillosis and 102 clinical and 129 environmental Aspergillus isolates were included in this analysis. The incidence of proven/probable invasive aspergillosis was 1.3 cases/1,000 patient-days during the study period. Cryptic Aspergillus species accounted for 33.8%, with no differences in proportions between the clinical and environmental isolates. Section Nigri presented a high proportion (70.5%) of cryptic species, mainly from A. tubingensis and A. awamori: the former being dominant in environmental samples, and the latter being more common in clinical isolates (P < 0.001). Of 91 A. fumigatus isolates, azole-resistant A. fumigatus was found in 5.3% of all A. fumigatus isolates. Three isolates presented the TR34/L98H mutation of the cyp51A gene. Patients with invasive aspergillosis caused by azole-resistant A. fumigatus showed 100% all-cause mortality at 100 days. This study demonstrates the significant portion of cryptic Aspergillus species and clinical implications of azole resistance and underscores the comparison between clinical and environmental isolates.
Collapse
|
41
|
New Insights into the Cyp51 Contribution to Azole Resistance in Aspergillus Section Nigri. Antimicrob Agents Chemother 2019; 63:AAC.00543-19. [PMID: 31061160 DOI: 10.1128/aac.00543-19] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 05/02/2019] [Indexed: 11/20/2022] Open
Abstract
Invasive aspergillosis (IA) is a severe condition mainly caused by Aspergillus fumigatus, although other species of the genus, such as section Nigri members, can also be involved. Voriconazole (VRC) is the recommended treatment for IA; however, the prevalence of azole-resistant Aspergillus isolates has alarmingly increased in recent years, and the underlying resistance mechanisms in non-fumigatus species remain unclear. We have determined the in vitro susceptibility of 36 strains from section Nigri to VRC, posaconazole (POS), and itraconazole (ITC), and we have explored the role of Cyp51A and Cyp51B, both targets of azoles, in azole resistance. The three drugs were highly active; POS displayed the best in vitro activity, while ITC and VRC showed MICs above the established epidemiological cutoff values in 9 and 16% of the strains, respectively. Furthermore, expression studies of cyp51A and cyp51B in control condition and after VRC exposure were performed in 14 strains with different VRC susceptibility. We found higher transcription of cyp51A, which was upregulated upon VRC exposure, but no correlation between MICs and cyp51 transcription levels was observed. In addition, cyp51A sequence analyses revealed nonsynonymous mutations present in both, wild-type and non-wild-type strains of A. niger and A. tubingensis Nevertheless, a few mutations were exclusively present in non-wild-type A. tubingensis strains. Altogether, our results suggest that azole resistance in section Nigri is not clearly explained by Cyp51A protein alteration or by cyp51 gene upregulation, which indicates that other mechanisms might be involved.
Collapse
|
42
|
Castro C, Galán-Sanchez F, Linares MJ, Tejero R, Ruiz M, Serrano ML, Rodríguez-Iglesias M, Martín-Mazuelos E. A prospective survey of Aspergillus spp. in respiratory tract samples: Species identification and susceptibility patterns. Med Mycol 2019; 57:412-420. [PMID: 30289467 DOI: 10.1093/mmy/myy080] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 07/31/2018] [Accepted: 09/25/2018] [Indexed: 02/03/2023] Open
Abstract
We analyzed the species distribution and susceptibility patterns of 433 strains of Aspergillus spp. isolated from respiratory samples of 419 in-patients included in multicenter prospective study (FUNGAE-IFI) between July 2014 and October 2015. Identification was carried out by conventional methods at each participating center and by molecular sequencing of a portion of the β-tubulin gene at one of the centers. In vitro susceptibility was evaluated by broth microdilution methods and using the E-test (for cryptic species). Species identified included 249 A. fumigatus sensu stricto, 60 A. terreus sensu stricto, 47 A. flavus sensu stricto, 44 A. tubingensis, 18 A. niger sensu stricto , five A. nidulans sensu stricto, three A. tamarii, two A. calidoustus, two A. carneus, one A. acuelatus, one A. carbonarius, and one A. sydowii. Cryptic species were found in 12.5% of isolates (n = 54). The frequency of non-wild-type isolates for amphotericin B was 3.4% (n = 15) of the isolates tested and for azoles 3% (n = 10). None of the Aspergillus spp. were non-wild type to echinocandins. Of the 54 cryptic species only two strains were non-wild-type strains by microdilution method (3.7%) (two A. tubingensis, one to amphotericin B and another one to voriconazole) and by E-test method five strains of A. tubingensis showed high minimal inhibitory concentration (MIC) to amphotericin B (11.4%) and five to azoles (12.1%), one A. calidoustus strain showed high MICs for three azoles (50%), A. carneus to itraconazole (100%) and A. sydowii to amphotericin B and itraconazole (100%). These results provide relevant information on susceptibility patterns, frequency, and epidemiology of species involved in respiratory tract samples and of the incidence of recently described cryptic species.
Collapse
Affiliation(s)
- Carmen Castro
- Unit of Infectious Diseases and Clinical Microbiology (UCEIM), Hospital Universitario de Valme, Seville, Spain
| | - Fátima Galán-Sanchez
- Service of Clinical Microbiology, Hospital Universitario Puerta del Mar, Cádiz, Spain
| | - María José Linares
- Service of Clinical Microbiology, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Rocío Tejero
- Service of Clinical Microbiology, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Maite Ruiz
- Service of Clinical Microbiology, Hospital Universitario Virgen del Rocío, Seville, Spain
| | - María Luisa Serrano
- Service of Clinical Microbiology, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | | | - Estrella Martín-Mazuelos
- Unit of Infectious Diseases and Clinical Microbiology (UCEIM), Hospital Universitario de Valme, Seville, Spain
| | | |
Collapse
|
43
|
Won EJ, Shin JH, Kim SH, Choi MJ, Byun SA, Kim MN, Lee WG, Lee K, Uh Y, Shin MG, Suh SP. Antifungal susceptibilities to amphotericin B, triazoles and echinocandins of 77 clinical isolates of cryptic Aspergillus species in multicenter surveillance in Korea. Med Mycol 2019; 56:501-505. [PMID: 28992138 DOI: 10.1093/mmy/myx067] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 08/31/2017] [Indexed: 11/13/2022] Open
Abstract
We investigated the in vitro antifungal susceptibilities of cryptic Aspergillus species from nine Korean hospitals. Based on the CLSI epidemiological cutoff values, resistance rates to amphotericin B, itraconazole, voriconazole, posaconazole and caspofungin were as follows: A. awamori (34 isolates; all 0%), A. tubingensis (22; 0%, 4.5%, 0%, 0%, and 0%, respectively), A. sydowii (16; 0%, 6.3%, 0%, 0%, and 6.3%), A. lentulus (2; 50%, 0%, 100%, 50%, and 0%), and A. tamarii (2; all 0%). A. calidoustus (one isolate) showed resistance to multiple drugs. Thus, cryptic species identification can be mandatory for clinically important Aspergillus isolates, with their susceptibility data.
Collapse
Affiliation(s)
- Eun Jeong Won
- Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Jong Hee Shin
- Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Soo Hyun Kim
- Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Min Ji Choi
- Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Seung A Byun
- Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Mi-Na Kim
- Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Republic of Korea
| | - Wee-Gyo Lee
- Department of Laboratory Medicine, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Kyungwon Lee
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young Uh
- Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Myung Geun Shin
- Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Soon Pal Suh
- Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| |
Collapse
|
44
|
Becker P, Normand AC, Vanantwerpen G, Vanrobaeys M, Haesendonck R, Vercammen F, Stubbe D, Piarroux R, Hendrickx M. Identification of fungal isolates by MALDI-TOF mass spectrometry in veterinary practice: validation of a web application. J Vet Diagn Invest 2019; 31:471-474. [PMID: 30943879 DOI: 10.1177/1040638719835577] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) has emerged as a reliable method to identify fungal isolates. The success of this approach relies on the availability of exhaustive databases, but the latter were built with a focus on human pathogens. We assessed a large in-house database of reference spectra and a dedicated web application for their suitability for use in veterinary laboratories. A panel of 290 mold and yeast isolates representing 69 different fungal species was isolated from various animals (including pets, cattle, and zoo animals) and identified using both MALDI-TOF MS and conventional techniques. The performance of the 2 methods was compared, and identifications were confirmed by DNA sequencing. MALDI-TOF MS allowed distinction between some closely related species and achieved 89% correct identification at the species level. In comparison, only 60% of the isolates were correctly identified with conventional approaches. Using this online application, MALDI-TOF MS thus appears to be a relevant alternative for the identification of fungal isolates encountered by animal health professionals.
Collapse
Affiliation(s)
- Pierre Becker
- Belgian Coordinated Collections of Microorganisms (BCCM/IHEM) Fungal Collection, Mycology and Aerobiology, Sciensano, Brussels, Belgium (Becker, Stubbe, Hendrickx).,Animal Health Care Flanders, Torhout, Belgium (Vanantwerpen, Vanrobaeys).,Zoolyx, Aalst, Belgium (Haesendonck).,Centre for Research and Conservation, Royal Zoological Society of Antwerp, Antwerp, Belgium (Vercammen).,Sorbonne University, National Institute for Health and Medical Research, Pierre-Louis Institute of Epidemiology and Public Health (Piarroux).,Public Assistance-Hospitals of Paris, University Hospital Pitie-Salpetriere (Normand, Piarroux), Paris, France
| | - Anne-Cécile Normand
- Belgian Coordinated Collections of Microorganisms (BCCM/IHEM) Fungal Collection, Mycology and Aerobiology, Sciensano, Brussels, Belgium (Becker, Stubbe, Hendrickx).,Animal Health Care Flanders, Torhout, Belgium (Vanantwerpen, Vanrobaeys).,Zoolyx, Aalst, Belgium (Haesendonck).,Centre for Research and Conservation, Royal Zoological Society of Antwerp, Antwerp, Belgium (Vercammen).,Sorbonne University, National Institute for Health and Medical Research, Pierre-Louis Institute of Epidemiology and Public Health (Piarroux).,Public Assistance-Hospitals of Paris, University Hospital Pitie-Salpetriere (Normand, Piarroux), Paris, France
| | - Gerty Vanantwerpen
- Belgian Coordinated Collections of Microorganisms (BCCM/IHEM) Fungal Collection, Mycology and Aerobiology, Sciensano, Brussels, Belgium (Becker, Stubbe, Hendrickx).,Animal Health Care Flanders, Torhout, Belgium (Vanantwerpen, Vanrobaeys).,Zoolyx, Aalst, Belgium (Haesendonck).,Centre for Research and Conservation, Royal Zoological Society of Antwerp, Antwerp, Belgium (Vercammen).,Sorbonne University, National Institute for Health and Medical Research, Pierre-Louis Institute of Epidemiology and Public Health (Piarroux).,Public Assistance-Hospitals of Paris, University Hospital Pitie-Salpetriere (Normand, Piarroux), Paris, France
| | - Mia Vanrobaeys
- Belgian Coordinated Collections of Microorganisms (BCCM/IHEM) Fungal Collection, Mycology and Aerobiology, Sciensano, Brussels, Belgium (Becker, Stubbe, Hendrickx).,Animal Health Care Flanders, Torhout, Belgium (Vanantwerpen, Vanrobaeys).,Zoolyx, Aalst, Belgium (Haesendonck).,Centre for Research and Conservation, Royal Zoological Society of Antwerp, Antwerp, Belgium (Vercammen).,Sorbonne University, National Institute for Health and Medical Research, Pierre-Louis Institute of Epidemiology and Public Health (Piarroux).,Public Assistance-Hospitals of Paris, University Hospital Pitie-Salpetriere (Normand, Piarroux), Paris, France
| | - Roel Haesendonck
- Belgian Coordinated Collections of Microorganisms (BCCM/IHEM) Fungal Collection, Mycology and Aerobiology, Sciensano, Brussels, Belgium (Becker, Stubbe, Hendrickx).,Animal Health Care Flanders, Torhout, Belgium (Vanantwerpen, Vanrobaeys).,Zoolyx, Aalst, Belgium (Haesendonck).,Centre for Research and Conservation, Royal Zoological Society of Antwerp, Antwerp, Belgium (Vercammen).,Sorbonne University, National Institute for Health and Medical Research, Pierre-Louis Institute of Epidemiology and Public Health (Piarroux).,Public Assistance-Hospitals of Paris, University Hospital Pitie-Salpetriere (Normand, Piarroux), Paris, France
| | - Francis Vercammen
- Belgian Coordinated Collections of Microorganisms (BCCM/IHEM) Fungal Collection, Mycology and Aerobiology, Sciensano, Brussels, Belgium (Becker, Stubbe, Hendrickx).,Animal Health Care Flanders, Torhout, Belgium (Vanantwerpen, Vanrobaeys).,Zoolyx, Aalst, Belgium (Haesendonck).,Centre for Research and Conservation, Royal Zoological Society of Antwerp, Antwerp, Belgium (Vercammen).,Sorbonne University, National Institute for Health and Medical Research, Pierre-Louis Institute of Epidemiology and Public Health (Piarroux).,Public Assistance-Hospitals of Paris, University Hospital Pitie-Salpetriere (Normand, Piarroux), Paris, France
| | - Dirk Stubbe
- Belgian Coordinated Collections of Microorganisms (BCCM/IHEM) Fungal Collection, Mycology and Aerobiology, Sciensano, Brussels, Belgium (Becker, Stubbe, Hendrickx).,Animal Health Care Flanders, Torhout, Belgium (Vanantwerpen, Vanrobaeys).,Zoolyx, Aalst, Belgium (Haesendonck).,Centre for Research and Conservation, Royal Zoological Society of Antwerp, Antwerp, Belgium (Vercammen).,Sorbonne University, National Institute for Health and Medical Research, Pierre-Louis Institute of Epidemiology and Public Health (Piarroux).,Public Assistance-Hospitals of Paris, University Hospital Pitie-Salpetriere (Normand, Piarroux), Paris, France
| | - Renaud Piarroux
- Belgian Coordinated Collections of Microorganisms (BCCM/IHEM) Fungal Collection, Mycology and Aerobiology, Sciensano, Brussels, Belgium (Becker, Stubbe, Hendrickx).,Animal Health Care Flanders, Torhout, Belgium (Vanantwerpen, Vanrobaeys).,Zoolyx, Aalst, Belgium (Haesendonck).,Centre for Research and Conservation, Royal Zoological Society of Antwerp, Antwerp, Belgium (Vercammen).,Sorbonne University, National Institute for Health and Medical Research, Pierre-Louis Institute of Epidemiology and Public Health (Piarroux).,Public Assistance-Hospitals of Paris, University Hospital Pitie-Salpetriere (Normand, Piarroux), Paris, France
| | - Marijke Hendrickx
- Belgian Coordinated Collections of Microorganisms (BCCM/IHEM) Fungal Collection, Mycology and Aerobiology, Sciensano, Brussels, Belgium (Becker, Stubbe, Hendrickx).,Animal Health Care Flanders, Torhout, Belgium (Vanantwerpen, Vanrobaeys).,Zoolyx, Aalst, Belgium (Haesendonck).,Centre for Research and Conservation, Royal Zoological Society of Antwerp, Antwerp, Belgium (Vercammen).,Sorbonne University, National Institute for Health and Medical Research, Pierre-Louis Institute of Epidemiology and Public Health (Piarroux).,Public Assistance-Hospitals of Paris, University Hospital Pitie-Salpetriere (Normand, Piarroux), Paris, France
| |
Collapse
|
45
|
Sabz G, Gharaghani M, Mirhendi H, Ahmadi B, Gatee MA, Sisakht MT, Hemati A, Mohammadi R, Taghavi J, Nouripour-Sisakht S. Clinical and microbial epidemiology of otomycosis in the city of Yasuj, southwest Iran, revealing Aspergillus tubingensis as the dominant causative agent. J Med Microbiol 2019; 68:585-590. [PMID: 30801244 DOI: 10.1099/jmm.0.000948] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
PURPOSE Otomycosis is a mycotic infection of the external auditory canal and can be caused by a wide range of fungal species. In this study, we aimed to identify fungal isolates from patients suspected of otomycosis. METHODOLOGY External ear canal samples were taken from patients referred to the outpatient department of Shahid-Mofatteh Clinic in the city of Yasuj, Iran, and examined by direct microscopy and culture. DNA of the isolated fungi was tested by internal transcribed spacer PCR restriction fragment length polymorphism analysis for identification of yeasts and β-tubulin sequencing for identification of Aspergillus species. RESULTS Among 275 patients suspected of otomycosis, 144 cases (83 female and 61 male) were confirmed with otomycosis. For 89% (n=128) of positive cultures, microscopy was also positive, while there were no cases with a microscopy-positive and culture-negative result. The predominant predisposing factor was self-cleaning of the external ear using unhygienic tools, and the main risk occupation was 'housewife'. The most common isolated fungi were typically Aspergillus (n=120), including 73 isolates of Aspergillus section Nigri, 43 of section Flavi, 3 of section Terrei and 1 of section Fumigati. After sequencing, 44 out of 73 strains primarily identified as Aspergillus niger turned out to be Aspergillus tubingensis. Thirty-five isolates were identified as Candida, including Candida parapsilosis (n=22), Candida albicans (n=12) and Candida tropicalis (n=1). CONCLUSION Aspergillus tubingensis was the most common species involved in otomycosis. This work corroborates the difficulty of precise identification of species within the black Aspergilli by morphological characteristics.
Collapse
Affiliation(s)
- Gholamabbas Sabz
- Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Maral Gharaghani
- Department of Medical Mycology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Hossein Mirhendi
- Departments of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Bahram Ahmadi
- Department of Medical Laboratory Sciences, Faculty of Paramedical, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Mohamad Amin Gatee
- Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, Iran.,Student Research Committee, Yasuj University of Medical Sciences, Yasuj, Iran
| | | | - Alireza Hemati
- Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Reza Mohammadi
- Medicinal Plants Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Jabar Taghavi
- Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Sadegh Nouripour-Sisakht
- Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, Iran.,Medicinal Plants Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| |
Collapse
|
46
|
|
47
|
Wiederhold NP, Gibas CFC. From the Clinical Mycology Laboratory: New Species and Changes in Fungal Taxonomy and Nomenclature. J Fungi (Basel) 2018; 4:E138. [PMID: 30558386 PMCID: PMC6308937 DOI: 10.3390/jof4040138] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 12/12/2018] [Accepted: 12/13/2018] [Indexed: 12/14/2022] Open
Abstract
Fungal taxonomy is the branch of mycology by which we classify and group fungi based on similarities or differences. Historically, this was done by morphologic characteristics and other phenotypic traits. However, with the advent of the molecular age in mycology, phylogenetic analysis based on DNA sequences has replaced these classic means for grouping related species. This, along with the abandonment of the dual nomenclature system, has led to a marked increase in the number of new species and reclassification of known species. Although these evaluations and changes are necessary to move the field forward, there is concern among medical mycologists that the rapidity by which fungal nomenclature is changing could cause confusion in the clinical literature. Thus, there is a proposal to allow medical mycologists to adopt changes in taxonomy and nomenclature at a slower pace. In this review, changes in the taxonomy and nomenclature of medically relevant fungi will be discussed along with the impact this may have on clinicians and patient care. Specific examples of changes and current controversies will also be given.
Collapse
Affiliation(s)
- Nathan P Wiederhold
- Fungus Testing Laboratory, Department of Pathology and Laboratory Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA.
| | - Connie F C Gibas
- Fungus Testing Laboratory, Department of Pathology and Laboratory Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA.
| |
Collapse
|
48
|
Aït-Ammar N, Levesque E, Murat JB, Imbert S, Foulet F, Dannaoui E, Botterel F. Aspergillus pseudodeflectus: a new human pathogen in liver transplant patients. BMC Infect Dis 2018; 18:648. [PMID: 30541477 PMCID: PMC6292062 DOI: 10.1186/s12879-018-3527-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 11/19/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Liver transplant recipients are at high risk of developing invasive aspergillosis and in particular by Aspergillus fumigatus which is the most commonly encountered species in this population. Other non-fumigatus Aspergillus species with reduced susceptibility to antifungal drugs can also be involved. Accurate identification associated to antifungal susceptibility testing is essential for therapy adjustment. We report a case of invasive pulmonary aspergillosis due to Aspergillus pseudodeflectus in a liver transplant recipient. To our knowledge, this is the first reported case of invasive aspergillosis due to this species with a reduced susceptibility to azoles. CASE PRESENTATION A 64 year-old woman with drug-induced fulminant hepatitis underwent liver transplantation. Prophylactic treatment with caspofungin was introduced due to aspergillosis risk factors consisting in hemodialysis and fulminant hepatitis. Six weeks after transplantation, CT scan showed a right pulmonary opacity associated with an increase of galactomannan (index 5.4). Culture of BAL grew with several colonies of Aspergillus sp. The diagnosis of invasive aspergillosis was probable according to the EORTC criteria. The antifungal susceptibility tests (Etest®) revealed low MICs to echinocandins and amphotericin B) but high MICs to azoles. After these results, voriconazole was switched to liposomal amphotericin B. The patient died one month after diagnosis from a refractory septic shock with multiple organ failure. A molecular identification of isolate, based on partial β-tubulin and calmodulin genes, was performed and identified A. pseudodeflectus. CONCLUSIONS Our case raises the question of pathogenicity of this species, which belongs to Aspergillus section Usti and is genetically and morphologically very close to Aspergillus calidoustus that was previously reported in human transplant recipients.
Collapse
Affiliation(s)
- Nawel Aït-Ammar
- Unité de Parasitologie–Mycologie, Département de Virologie, Bactériologie–Hygiène, Parasitologie–Mycologie, DHU VIC, CHU Henri Mondor, AP-HP, Créteil, France
- EA Dynamyc UPEC, ENVA, Faculté de Médecine de Créteil, Créteil, France
| | - Eric Levesque
- Réanimation Digestive et Hépato-biliaire, Service d’Anesthésie et des Réanimations Chirurgicales, CHU Henri Mondor, AP-HP, Créteil, France
| | - Jean-Benjamin Murat
- Unité de Parasitologie–Mycologie, Département de Virologie, Bactériologie–Hygiène, Parasitologie–Mycologie, DHU VIC, CHU Henri Mondor, AP-HP, Créteil, France
- EA Dynamyc UPEC, ENVA, Faculté de Médecine de Créteil, Créteil, France
| | - Sébastien Imbert
- Service de Parasitologie-Mycologie, CHU Pitié Salpêtrière, AP-HP, Paris, France
| | - Françoise Foulet
- Unité de Parasitologie–Mycologie, Département de Virologie, Bactériologie–Hygiène, Parasitologie–Mycologie, DHU VIC, CHU Henri Mondor, AP-HP, Créteil, France
| | - Eric Dannaoui
- EA Dynamyc UPEC, ENVA, Faculté de Médecine de Créteil, Créteil, France
- Université Paris–Descartes, Faculté de Médecine, Unité de Parasitologie–Mycologie, Service de Microbiologie, Hôpital Européen Georges Pompidou, AP-HP, Paris, France
| | - Françoise Botterel
- Unité de Parasitologie–Mycologie, Département de Virologie, Bactériologie–Hygiène, Parasitologie–Mycologie, DHU VIC, CHU Henri Mondor, AP-HP, Créteil, France
- EA Dynamyc UPEC, ENVA, Faculté de Médecine de Créteil, Créteil, France
| |
Collapse
|
49
|
Bongomin F, Moore CB, Masania R, Rowbotham E, Alastruey-Izquierdo A, Novak-Frazer L, Richardson MD. Sequence analysis of isolates of Aspergillus from patients with chronic and allergic aspergillosis reveals a spectrum of cryptic species. Future Microbiol 2018; 13:1557-1563. [PMID: 30417667 DOI: 10.2217/fmb-2018-0178] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
AIM To establish the prevalence and antifungal susceptibilities of Aspergillus cryptic species from respiratory samples. Methods: Retrospective susceptibility data on Aspergillus species cultured between 2015 and 2017 by 'high volume culture' (HVC) versus 'conventional' culture techniques. RESULTS Fifty-six (2.5%) isolates were identified as Aspergillus cryptic species by sequencing of ITS, BenA and CalM gene loci. Recovery was higher in HVCs compared to conventional cultures. Common cryptic species were Aspergillus montevidensis (n = 15), A. creber (n = 11), A. sydowii (n = 5) and A. calidoustus (n = 4). Eighteen (32.1%) isolates had minimum inhibitory concentration (MIC) values ≥4 mg/l to amphotericin B, and 19.1-60.1% had MIC values ≥8 mg/l to the triazoles. CONCLUSION HVC increases the likelihood of recovery of cryptic species. MIC values to antifungals were high.
Collapse
Affiliation(s)
- Felix Bongomin
- The National Aspergillosis Centre, ECMM Center of Excellence in Clinical & Laboratory Mycology & Clinical Studies, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK.,Division of Infection, Immunity & Respiratory Medicine, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester, UK
| | - Caroline B Moore
- Division of Infection, Immunity & Respiratory Medicine, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester, UK.,NHS Mycology Reference Centre-Manchester, ECMM Center of Excellence in Clinical & Laboratory Mycology & Clinical Studies, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Rikesh Masania
- NHS Mycology Reference Centre-Manchester, ECMM Center of Excellence in Clinical & Laboratory Mycology & Clinical Studies, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Eleanor Rowbotham
- NHS Mycology Reference Centre-Manchester, ECMM Center of Excellence in Clinical & Laboratory Mycology & Clinical Studies, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Ana Alastruey-Izquierdo
- Mycology Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Lily Novak-Frazer
- Division of Infection, Immunity & Respiratory Medicine, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester, UK.,NHS Mycology Reference Centre-Manchester, ECMM Center of Excellence in Clinical & Laboratory Mycology & Clinical Studies, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Malcolm D Richardson
- Division of Infection, Immunity & Respiratory Medicine, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester, UK.,NHS Mycology Reference Centre-Manchester, ECMM Center of Excellence in Clinical & Laboratory Mycology & Clinical Studies, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| |
Collapse
|
50
|
Molecular Identification and Susceptibility Testing of Molds Isolated in a Prospective Surveillance of Triazole Resistance in Spain (FILPOP2 Study). Antimicrob Agents Chemother 2018; 62:AAC.00358-18. [PMID: 29941643 DOI: 10.1128/aac.00358-18] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 06/15/2018] [Indexed: 11/20/2022] Open
Abstract
Antifungal resistance is increasing by the emergence of intrinsically resistant species and by the development of secondary resistance in susceptible species. A previous study performed in Spain revealed levels of azole resistance in molds of between 10 and 12.7%, but secondary resistance in Aspergillus fumigatus was not detected. We used itraconazole (ITZ)-supplemented medium to select resistant strains. A total of 500 plates supplemented with 2 mg/liter of ITZ were sent to 10 Spanish tertiary hospitals, and molecular identification and antifungal susceptibility testing were performed. In addition, the cyp51A gene in those A. fumigatus strains showing azole resistance was sequenced. A total of 493 isolates were included in the study. Sixteen strains were isolated from patients with an infection classified as proven, 104 were isolated from patients with an infection classified as probable, and 373 were isolated from patients with an infection classified as colonization. Aspergillus was the most frequent genus isolated, at 80.3%, followed by Scedosporium-Lomentospora (7.9%), Penicillium-Talaromyces (4.5%), Fusarium (2.6%), and the order Mucorales (1%). Antifungal resistance was detected in Scedosporium-Lomentospora species, Fusarium, Talaromyces, and Mucorales Three strains of A. fumigatus sensu stricto were resistant to azoles; two of them harbored the TR34+L98H mechanism of resistance, and the other one had no mutations in cyp51A The level of azole resistance in A. fumigatus remains low, but cryptic species represent over 10% of the isolates and have a broader but overall higher range of antifungal resistance.
Collapse
|