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Bagga B, Das S, Tawde Y, Singh S, Shaw T, Sharma S, Ghosh A. Fusarium Keratitis From a Comprehensive Eye Health Care Facility in South India: Molecular Characterization by MALDI-TOF Versus PCR Sequencing, Species Complex Distribution, and Clinical Correlation. Cornea 2023; Publish Ahead of Print:00003226-990000000-00304. [PMID: 37267470 DOI: 10.1097/ico.0000000000003315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 04/20/2023] [Indexed: 06/04/2023]
Abstract
PURPOSE Fusarium keratitis possesses significant diagnostic and therapeutic challenges. Medically relevant Fusaria belong to various species complexes and show prominent differences in their antifungal susceptibility profile which may influence the clinical outcome. Rapid diagnostic methods are warranted for precise identification of species complexes for prompt initiation of correct antifungals. The aim of the study was to compare between matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) and PCR sequencing for correct species-level identification and to analyze the clinical outcome among different Fusarium species complexes. METHODS Twenty-nine culture-proven Fusarium keratitis cases were included in this study. A phylogenetic tree was constructed after TEF1α gene sequencing and isolates were subjected to MALDI-TOF MS, followed by database expansion and identification. Clinical outcome and risk association among species complexes were analyzed retrospectively. RESULTS Maximum likelihood phylogeny categorized 68.9% isolates as Fusarium solani species complex (FSSC), 17.2% as Fusarium dimerum species complex (FDSC), followed by 13.7% as Fusarium fujikuroi species complex (FFSC). With extended database, MALDI-TOF MS could correctly speciate 96.5% (28/29) isolates. Previous antibiotic usage (P = 0.034) and preoperative antifungal treatment with natamycin, voriconazole, or ketoconazole (P = 0.025) were significantly higher in the FSSC group. The patients in the FFSC group had a significantly longer duration of symptoms at the time of clinical presentation to the clinic (15 days vs. 5 days, P = 0.030). Among 11 patients with a clinically poor outcome, 9 (31%) had FSSC infection. CONCLUSIONS Patients infected with the FSSC had more aggressive infection with poor prognosis. MALDI-TOF MS can serve as the best alternative method to conventional molecular identification with reduced turnaround time, which may help the ophthalmologists to consider the appropriate antifungals or early surgical intervention for improved outcome.
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Affiliation(s)
- Bhupesh Bagga
- Department of Cornea and Anterior Segment, L. V. Prasad Eye Institute, Hyderabad, Telangana, India
| | - Sourav Das
- Department of Medical Microbiology (Mycology Division), Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Yamini Tawde
- Department of Medical Microbiology (Mycology Division), Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Shreya Singh
- Department of Microbiology, Dr B. R. Ambedkar Institute of Medical Sciences (AIMS Mohali), Chandigarh, India
| | - Tushar Shaw
- Department of Life and Allied Health Sciences, Ramaiah University of Applied Sciences, Bangalore, Karnataka, India; and
| | - Savitri Sharma
- Jhaveri Microbiology Centre, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Anup Ghosh
- Department of Medical Microbiology (Mycology Division), Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Balmas V, Fancellu F, Sanna S, Scherm B, Migheli Q, Malbrán I. Water distribution systems in Sardinian hospitals host invasive clonal lineages of the Fusarium oxysporum and Fusarium solani species complexes. Mycologia 2021; 113:725-733. [PMID: 33989126 DOI: 10.1080/00275514.2021.1905497] [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: 10/21/2022]
Abstract
Several Fusarium species cause disease on human hosts, including commonly fatal infections in immunocompromised individuals. Recently, cases of hospitalized patients affected by fusaria were reported in the Tyrrhenian Island of Sardinia, Italy. To precisely characterize the Fusarium species and haplotypes present in hospitals of the region, a multilocus DNA sequence typing (MLST) approach was applied. Water distribution systems in four departments belonging to four Sardinian hospitals were sampled. Fusarium species and sequence types (STs) were identified using MLST based on sequences of the elongation factor 1-alpha (EF-1α) gene, the nuclear ribosomal DNA intergenic spacer region (IGS rDNA), and/or a portion of the second-largest subunit of RNA polymerase (RPB2) gene. The majority of isolates obtained from Sardinian hospitals (90.7%) were identified as representatives of the Fusarium oxysporum species complex (FOSC), followed by those of the F. solani species complex (FSSC) (8.2%), and F. dimerum (1.1% of all isolates). Ten STs were found among the FOSC and FSSC, with more than 60% of the isolates identified as either FOSC ST 33 or FSSC 1 (F. petroliphilum). More than half of the FOSC isolates obtained from the water systems in all four hospitals belonged to the worldwide distributed clonal lineage ST 33. This haplotype is the most prevalent among the FOSC in different countries, being responsible for the vast majority of cases of human fusariosis.
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Affiliation(s)
- Virgilio Balmas
- Dipartimento di Agraria and Centro Interdipartimentale per la Conservazione e Valorizzazione della Biodiversità Vegetale, Università degli Studi di Sassari, Viale Italia 39, I-07100 Sassari, Italy
| | - Francesca Fancellu
- Dipartimento di Agraria and Centro Interdipartimentale per la Conservazione e Valorizzazione della Biodiversità Vegetale, Università degli Studi di Sassari, Viale Italia 39, I-07100 Sassari, Italy
| | - Silvana Sanna
- Dipartimento di Scienze Biomediche, Università degli Studi di Sassari, Sassari, Italy
| | - Barbara Scherm
- Dipartimento di Agraria and Centro Interdipartimentale per la Conservazione e Valorizzazione della Biodiversità Vegetale, Università degli Studi di Sassari, Viale Italia 39, I-07100 Sassari, Italy
| | - Quirico Migheli
- Dipartimento di Agraria and Centro Interdipartimentale per la Conservazione e Valorizzazione della Biodiversità Vegetale, Università degli Studi di Sassari, Viale Italia 39, I-07100 Sassari, Italy.,Nucleo di Ricerca sulla Desertificazione (NRD), Università degli Studi di Sassari, Sassari, Italy
| | - Ismael Malbrán
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET)-Centro de Investigaciones de Fitopatologia (CIDEFI-CIC-UNLP), Facultad de Ciencias Agrarias y Forestales, Universidad Nacional de La Plata, Avenida 60 y calle 119 S/N, (1900) La Plata, Buenos Aires, Argentina
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3
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Oufensou S, Casalini S, Balmas V, Carta P, Chtioui W, Dettori MA, Fabbri D, Migheli Q, Delogu G. Prenylated Trans-Cinnamic Esters and Ethers against Clinical Fusarium spp.: Repositioning of Natural Compounds in Antimicrobial Discovery. Molecules 2021; 26:molecules26030658. [PMID: 33513915 PMCID: PMC7865625 DOI: 10.3390/molecules26030658] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/15/2021] [Accepted: 01/24/2021] [Indexed: 12/14/2022] Open
Abstract
Onychomycosis is a common nail infection mainly caused by species belonging to the F. oxysporum, F. solani, and F. fujikuroi species complexes. The aim of this study was to evaluate the in vitro susceptibility of six representative strains of clinically relevant Fusarium spp. toward a set of natural-occurring hydroxycinnamic acids and their derivatives with the purpose to develop naturally occurring products in order to cope with emerging resistance phenomena. By introducing a prenylated chain at one of the hydroxy groups of trans-cinnamic acids 1–3, ten prenylated derivatives (coded 4–13) were preliminarily investigated in solid Fusarium minimal medium (FMM). Minimal inhibitory concentration (MIC) and lethal dose 50 (LD50) values were then determined in liquid FMM for the most active selected antifungal p-coumaric acid 3,3′-dimethyl allyl ester 13, in comparison with the conventional fungicides terbinafine (TRB) and amphotericin B (AmB), through the quantification of the fungal growth. Significant growth inhibition was observed for prenylated derivatives 4–13, evidencing ester 13 as the most active. This compound presented MIC and LD50 values (62–250 µM and 7.8–125 µM, respectively) comparable to those determined for TRB and AmB in the majority of the tested pathogenic strains. The position and size of the prenylated chain and the presence of a free phenol OH group appear crucial for the antifungal activity. This work represents the first report on the activity of prenylated cinnamic esters and ethers against clinical Fusarium spp. and opens new avenues in the development of alternative antifungal compounds based on a drug repositioning strategy.
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Affiliation(s)
- Safa Oufensou
- Dipartimento di Agraria, Università degli Studi di Sassari, Via E. De Nicola 9, 07100 Sassari, Italy; (S.O.); (S.C.); (V.B.); (W.C.); (Q.M.)
| | - Stefano Casalini
- Dipartimento di Agraria, Università degli Studi di Sassari, Via E. De Nicola 9, 07100 Sassari, Italy; (S.O.); (S.C.); (V.B.); (W.C.); (Q.M.)
| | - Virgilio Balmas
- Dipartimento di Agraria, Università degli Studi di Sassari, Via E. De Nicola 9, 07100 Sassari, Italy; (S.O.); (S.C.); (V.B.); (W.C.); (Q.M.)
| | - Paola Carta
- Istituto CNR di Chimica Biomolecolare, Traversa La Crucca 3, 07100 Sassari, Italy; (P.C.); (D.F.); (G.D.)
| | - Wiem Chtioui
- Dipartimento di Agraria, Università degli Studi di Sassari, Via E. De Nicola 9, 07100 Sassari, Italy; (S.O.); (S.C.); (V.B.); (W.C.); (Q.M.)
| | - Maria A. Dettori
- Istituto CNR di Chimica Biomolecolare, Traversa La Crucca 3, 07100 Sassari, Italy; (P.C.); (D.F.); (G.D.)
- Correspondence: ; Tel.: +39-079-284-1224
| | - Davide Fabbri
- Istituto CNR di Chimica Biomolecolare, Traversa La Crucca 3, 07100 Sassari, Italy; (P.C.); (D.F.); (G.D.)
| | - Quirico Migheli
- Dipartimento di Agraria, Università degli Studi di Sassari, Via E. De Nicola 9, 07100 Sassari, Italy; (S.O.); (S.C.); (V.B.); (W.C.); (Q.M.)
- Nucleo di Ricerca sulla Desertificazione, Università degli Studi di Sassari, Via E. De Nicola 9, 07100 Sassari, Italy
| | - Giovanna Delogu
- Istituto CNR di Chimica Biomolecolare, Traversa La Crucca 3, 07100 Sassari, Italy; (P.C.); (D.F.); (G.D.)
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Rai M, Ingle AP, Ingle P, Gupta I, Mobin M, Bonifaz A, Alves M. Recent advances on mycotic keratitis caused by dematiaceous hyphomycetes. J Appl Microbiol 2021; 131:1652-1667. [PMID: 33462841 DOI: 10.1111/jam.15008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 12/31/2020] [Accepted: 01/14/2021] [Indexed: 02/06/2023]
Abstract
Dematiaceous hyphomycetes (DH) are darkly pigmented fungi ubiquitously found all over the world as plant pathogens and saprophytes, and many of the members of this group have emerged as opportunistic pathogens. These fungi are responsible for a wide variety of infections including mycotic keratitis, which is considered as one of the major causes of corneal blindness, particularly in tropical and subtropical countries with an annual global burden of about 1 000 000 patients. The infection is more common in workers working in an outdoor environment. Moreover, trauma is found to be the most important predisposing cause of mycotic keratitis. Considerable delay in diagnosis and scarcity of effective pharmacological drugs are the major factors responsible for increased morbidity and visual impairment. Considering the crucial role of DH in mycotic keratitis, in the present review, we have focused on major DH with special emphasis on their pathogenicity, diagnosis and treatment strategies.
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Affiliation(s)
- M Rai
- Department of Biotechnology, Sant Gadge Baba Amravati University, Amravati, Maharashtra, India
| | - A P Ingle
- Department of Biotechnology, Engineering School of Lorena, University of Sao Paulo, Lorena, SP, Brazil
| | - P Ingle
- Department of Biotechnology, Sant Gadge Baba Amravati University, Amravati, Maharashtra, India
| | - I Gupta
- Department of Biotechnology, Sant Gadge Baba Amravati University, Amravati, Maharashtra, India
| | - M Mobin
- Research Laboratory, University Center UNINOVAFAPI, Teresina, Brazil
| | - A Bonifaz
- Department of Mycology & Dermatology Service, General Hospital of Mexico, Mexico City, Mexico
| | - M Alves
- Department of Ophthalmology, University of Campinas, Campinas, SP, Brazil
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5
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Shariati A, Moradabadi A, Chegini Z, Khoshbayan A, Didehdar M. An Overview of the Management of the Most Important Invasive Fungal Infections in Patients with Blood Malignancies. Infect Drug Resist 2020; 13:2329-2354. [PMID: 32765009 PMCID: PMC7369308 DOI: 10.2147/idr.s254478] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 06/26/2020] [Indexed: 12/12/2022] Open
Abstract
In patients with hematologic malignancies due to immune system disorders, especially persistent febrile neutropenia, invasive fungal infections (IFI) occur with high mortality. Aspergillosis, candidiasis, fusariosis, mucormycosis, cryptococcosis and trichosporonosis are the most important infections reported in patients with hematologic malignancies that undergo hematopoietic stem cell transplantation. These infections are caused by opportunistic fungal pathogens that do not cause severe issues in healthy individuals, but in patients with hematologic malignancies lead to disseminated infection with different clinical manifestations. Prophylaxis and creating a safe environment with proper filters and air pressure for patients to avoid contact with the pathogens in the surrounding environment can prevent IFI. Furthermore, due to the absence of specific symptoms in IFI, rapid and accurate diagnosis reduces the mortality rate of these infections and using molecular techniques along with standard mycological methods will improve the diagnosis of disseminated fungal infection in patients with hematologic disorders. Amphotericin B products, extended-spectrum azoles, and echinocandins are the essential drugs to control invasive fungal infections in patients with hematologic malignancies, and according to various conditions of patients, different results of treatment with these drugs have been reported in different studies. On the other hand, drug resistance in recent years has led to therapeutic failures and deaths in patients with blood malignancies, which indicates the need for antifungal susceptibility tests to use appropriate therapies. Life-threatening fungal infections have become more prevalent in patients with hematologic malignancies in recent years due to the emergence of new risk factors, new species, and increased drug resistance. Therefore, in this review, we discuss the different dimensions of the most critical invasive fungal infections in patients with hematologic malignancies and present a list of these infections with different clinical manifestations, treatment, and outcomes.
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Affiliation(s)
- Aref Shariati
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Moradabadi
- Department of Medical Parasitology and Mycology, Arak University of Medical Sciences, Arak, Iran
| | - Zahra Chegini
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Amin Khoshbayan
- Student Research Committee, Iran University of Medical Sciences, Tehran, Iran
| | - Mojtaba Didehdar
- Department of Medical Parasitology and Mycology, Arak University of Medical Sciences, Arak, Iran
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6
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Hino Y, Muraosa Y, Oguchi M, Yahiro M, Yarita K, Watanabe A, Sakaida E, Yokote K, Kamei K. Drain outlets in patient rooms as sources for invasive fusariosis: an analysis of patients with haematological disorders. J Hosp Infect 2020; 105:S0195-6701(20)30204-8. [PMID: 32360338 DOI: 10.1016/j.jhin.2020.04.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 04/21/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND Invasive fusariosis (IF) is a frequently fatal disease as there are few antifungals to treat it, making the prevention of IF crucial. However, fusarium infections have not been as thoroughly studied as other common pathogenic fungi such as Aspergillus or Candida. AIM To investigate the epidemiology of IF in patients with haematological diseases in Japan and to elucidate the infectious route of fusarium infection. METHODS We retrospectively analysed 29 IF cases in patients with haematological diseases from 2009 to 2019 in Japan. To discover the infectious source of IF, we performed an indoor environment survey targeted at indoor air and drain outlets in medical institutions and residences using culture-based and metagenomic methods. Finally, we performed aerosol- and droplet-mediated dispersion studies. FINDINGS The epidemiological study showed that the primary pathogen of IF was Fusarium solani species complex (FSSC), and the most common species was Fusarium petroliphilum. Most patients were likely to develop IF during hospitalization. A fusarium culture was positive in 26 of 72 drain samples. Few fusarium were detected from air samples; by contrast, 29 of 108 isolates from the drain outlets were identified as fusarium. Furthermore, similar results were obtained in the metagenomic analysis. Interestingly, species belonging to FSSC were isolated from indoor drain outlets, which was similar to those of the IF patients. In the droplet-mediated dispersion study, eight to 17 colonies of fusarium were isolated. CONCLUSION Our study indicates that causative Fusarium spp. could inhabit drain outlets in hospitals or residences, and droplet-mediated fusarium dispersion is a potential cause of IF.
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Affiliation(s)
- Y Hino
- Medical Mycology Research Center, Chiba University, Chiba, Japan; Department of Haematology, Chiba University Hospital, Chiba, Japan; Department of Endocrinology, Haematology and Gerontology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Y Muraosa
- Medical Mycology Research Center, Chiba University, Chiba, Japan.
| | - M Oguchi
- Medical Mycology Research Center, Chiba University, Chiba, Japan
| | - M Yahiro
- Medical Mycology Research Center, Chiba University, Chiba, Japan
| | - K Yarita
- Medical Mycology Research Center, Chiba University, Chiba, Japan
| | - A Watanabe
- Medical Mycology Research Center, Chiba University, Chiba, Japan
| | - E Sakaida
- Department of Haematology, Chiba University Hospital, Chiba, Japan; Department of Endocrinology, Haematology and Gerontology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - K Yokote
- Department of Endocrinology, Haematology and Gerontology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - K Kamei
- Medical Mycology Research Center, Chiba University, Chiba, Japan
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7
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Rosa PDD, Ramirez-Castrillon M, Borges R, Aquino V, Meneghello Fuentefria A, Zubaran Goldani L. Epidemiological aspects and characterization of the resistance profile of Fusarium spp. in patients with invasive fusariosis. J Med Microbiol 2019; 68:1489-1496. [PMID: 31419209 DOI: 10.1099/jmm.0.001059] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Introduction. The remarkable intrinsic resistance of Fusarium species to most antifungal agents results in high mortality rates in the immunocompromised population.Aims. This study aimed to investigate the epidemiology, clinical features and antifungal susceptibility of Fusarium isolates in patients with invasive fusariosis.Methodology. A total of 27 patients admitted to a referral hospital from January 2008 to June 2017 were evaluated. Antifungal susceptibility testing of isolates was performed by broth microdilution according to the Clinical and Laboratory Standards Institute guidelines.Results. Haematological malignancy was the predominant underlying condition, with an incidence of invasive fusariosis of 14.8 cases per 1000 patients with acute lymphoid leukaemia and 13.1 cases per 1000 patients with acute myeloid leukaemia. The Fusarium solani species complex (FSSC) was the most frequent agent group, followed by the Fusarium oxysporum species complex (FOSC). Voriconazole showed the best activity against Fusarium, followed by amphotericin B. Itraconazole showed high minimum inhibitory concentration values, indicating in vitro resistance. Clinical FSSC isolates were significantly (P<0.05) more resistant to amphotericin B and voriconazole than FOSC isolates.Conclusion. The present antifungal susceptibility profiles indicate a high incidence of fusariosis in patients with haematological malignancy. Species- and strain-specific differences in antifungal susceptibility exist within Fusarium in this setting.
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Affiliation(s)
- Priscila Dallé da Rosa
- Experimental Research Center, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.,Graduate Program in Medicine: Medical Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | - Rafael Borges
- Experimental Research Center, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Valério Aquino
- Department of Microbiology, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | | | - Luciano Zubaran Goldani
- Experimental Research Center, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.,Graduate Program in Medicine: Medical Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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8
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Sun L, Wan Z, Li R, Yu J. In vitro activities of nine antifungal agents against rare pathogenic fungi. J Med Microbiol 2019; 68:1664-1670. [PMID: 31553302 DOI: 10.1099/jmm.0.001083] [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] [Indexed: 01/09/2023] Open
Abstract
Purpose. To assess in vitro activities of nine antifungal agents (amphotericin B, fluconazole, voriconazole, itraconazole, posaconazole, caspofungin, micafungin, terbinafine and 5-flucytosine) against 93 strains of rare pathogenic fungi and the combined effects of drug combinations against several multidrug-resistant fungi.Methodology. The broth microdilution method M38-A3 and M27-A4 from the Clinical and Laboratory Standards Institute and the checkerboard method were performed in this study.Results. Low MICs for fluconazole were observed in moulds including Tritirachium oryzae, Exophiala attenuata and yeasts. MICs for amphotericin B>2 µg ml-1 were found among Aspergillus nidulans, Fusarium napiforme, Trichoderma longibrachiatum, Tritirachium oryzae, Cunninghamella bertholletiae, Cunninghamella phaeospora, Conidiobolus coronatus, Exophiala attenuata, Ochroconis mirabilis and Rhinocladiella basitona. Multidrug resistance was observed in Microascus spp., Lomentospora prolificans and Pythium insidiosum.Conclusion. Our study illustrated in vitro drug susceptibilities of some rare pathogenic fungi, which provide data to guide clinical treatment of fungal infections.
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Affiliation(s)
- Lingyue Sun
- Department of Dermatology and Venereology, Peking University First Hospital, Research Center for Medical Mycology, Peking University, National Clinical Research Center for Skin and Immune Diseases, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, PR China
| | - Zhe Wan
- Department of Dermatology and Venereology, Peking University First Hospital, Research Center for Medical Mycology, Peking University, National Clinical Research Center for Skin and Immune Diseases, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, PR China
| | - Ruoyu Li
- Department of Dermatology and Venereology, Peking University First Hospital, Research Center for Medical Mycology, Peking University, National Clinical Research Center for Skin and Immune Diseases, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, PR China
| | - Jin Yu
- Department of Dermatology and Venereology, Peking University First Hospital, Research Center for Medical Mycology, Peking University, National Clinical Research Center for Skin and Immune Diseases, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, PR China
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9
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Lombard L, van Doorn R, Crous PW. Neotypification of Fusarium chlamydosporum - a reappraisal of a clinically important species complex. Fungal Syst Evol 2019; 4:183-200. [PMID: 32467911 PMCID: PMC7241675 DOI: 10.3114/fuse.2019.04.10] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Fusarium chlamydosporum represents a well-defined morpho-species of both phytopathological and clinical importance. Presently, five phylo-species lacking Latin binomials have been resolved in the F. chlamydosporum species complex (FCSC). Naming these phylo-species is complicated due to the lack of type material for F. chlamydosporum. Over the years a number of F. chlamydosporum isolates (which were formerly identified based on morphology only) have been accessioned in the culture collection of the Westerdijk Fungal Biodiversity Institute. The present study was undertaken to correctly identify these 'F. chlamydosporum' isolates based on multilocus phylogenetic inference supported by morphological characteristics. Closer scrutiny of the metadata associated with one of these isolates allowed us to propose a neotype for F. chlamydosporum. Phylogenetic inference revealed the presence of nine phylo-species within the FCSC in this study. Of these, eight could be provided with names supported by subtle morphological characters. In addition, a new species, as F. nodosum, is introduced in the F. sambucinum species complex and F. chlamydosporum var. fuscum is raised to species level, as F. coffeatum, in the F. incarnatum-equiseti species complex (FIESC).
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Affiliation(s)
- L Lombard
- Westerdijk Fungal Biodiversity Institute, P.O. Box 85176, 3508 AD Utrecht, The Netherlands
| | - R van Doorn
- Westerdijk Fungal Biodiversity Institute, P.O. Box 85176, 3508 AD Utrecht, The Netherlands
| | - P W Crous
- Westerdijk Fungal Biodiversity Institute, P.O. Box 85176, 3508 AD Utrecht, The Netherlands.,Department of Genetics, Biochemistry and Microbiology, Forestry and Agricultural Biotechnology Institute (FABI), University of Pretoria, Pretoria, 0002, South Africa.,Wageningen University and Research Centre (WUR), Laboratory of Phytopathology, Droevendaalsesteeg 1, 6708 PB Wageningen, The Netherlands
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10
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Stępień Ł, Gromadzka K, Chełkowski J, Basińska-Barczak A, Lalak-Kańczugowska J. Diversity and mycotoxin production by Fusarium temperatum and Fusarium subglutinans as causal agents of pre-harvest Fusarium maize ear rot in Poland. J Appl Genet 2018; 60:113-121. [PMID: 30430379 PMCID: PMC6373406 DOI: 10.1007/s13353-018-0478-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 10/04/2018] [Accepted: 11/01/2018] [Indexed: 11/13/2022]
Abstract
Maize ear rot is a common disease found worldwide, caused by several toxigenic Fusarium species. Maize ears and kernels infected by Fusarium subglutinans contained significant amounts of beauvericin, fusaproliferin, moniliformin, and enniatins. In 2011, F. subglutinans sensu lato has been divided into two species: Fusarium temperatum sp. nov. and F. subglutinans sensu stricto, showing different phylogeny and beauvericin production within the populations of maize pathogens in Belgium. Isolates of the new species—F. temperatum—were also identified and characterized in Spain, Argentina, Poland, France, and China as one of the most important pathogens of maize. Moreover, F. temperatum was proved to be pathogenic to maize seedlings and stalks. We identified Fusarium isolates obtained from diseased maize ears collected between 2013 and 2016 in Poland (321 isolates). Based on morphological analyses, six Fusarium species were identified. Molecular identification performed on the set of selected isolates (42 isolates) revealed 34 isolates to be F. temperatum and only five to be F. subglutinans. Interestingly, the phylogenetic analysis showed that the population of F. temperatum infecting maize in Poland remained quite uniform for over 30 years with only a few exceptions. For the first time, a single isolate of Fusarium ramigenum was detected from the area of Poland. Significant amounts of BEA were found in Fusarium-damaged kernels. The same kernel samples contained also enniatins A1, A, B1, and B. The results clearly demonstrate the occurrence of F. temperatum as maize pathogen in Poland for over the last three decades.
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Affiliation(s)
- Ł Stępień
- Institute of Plant Genetics, Polish Academy of Sciences, Poznań, ul. Strzeszyńska 34, 60-479, Poznań, Poland
| | - K Gromadzka
- Department of Chemistry, Poznan University of Life Sciences, ul. Wojska Polskiego 75, 60-625, Poznań, Poland.
| | - J Chełkowski
- Institute of Plant Genetics, Polish Academy of Sciences, Poznań, ul. Strzeszyńska 34, 60-479, Poznań, Poland
| | - A Basińska-Barczak
- Institute of Plant Genetics, Polish Academy of Sciences, Poznań, ul. Strzeszyńska 34, 60-479, Poznań, Poland
| | - J Lalak-Kańczugowska
- Institute of Plant Genetics, Polish Academy of Sciences, Poznań, ul. Strzeszyńska 34, 60-479, Poznań, Poland
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11
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Abstract
Fusarium is an emerging human opportunistic pathogen of growing importance, especially among immunosuppressed haematology patients due to an increased incidence of disseminated infections over the past two decades. This trend is expected only to continue due to the advances in medical and surgical technologies that will prolong the lives of the severely ill, making these patients susceptible to rare opportunistic infections. Production of mycotoxins, enzymes such as proteases, angio-invasive property and an intrinsically resistant nature, makes this genus very difficult to treat. Fusarium is frequently isolated from the cornea and less commonly from nail, skin, blood, tissue, Continuous Ambulatory Peritoneal Dialysis (CAPD) fluid, urine and pleural fluid. Conventional microscopy establishes the genus, but accurate speciation requires multilocus sequence typing with housekeeping genes such as internal transcribed spacer, translation elongation factor-1α and RPB1 and 2 (largest and second largest subunits of RNA polymerase), for which expansive internet databases exist. Identifying pathogenic species is of epidemiological significance, and the treatment includes immune reconstitution by granulocyte-colony-stimulating factor, granulocyte macrophage-colony-stimulating factor and a combination of the most active species - specific antifungals, typically liposomal amphotericin-B and voriconazole. However, patient outcome is difficult to predict even with in vitro susceptibility with these drugs. Therefore, prevention methods and antifungal prophylaxis have to be taken seriously for these vulnerable patients by vigilant healthcare workers. The current available literature on PubMed and Google Scholar using search terms 'Fusarium', 'opportunistic invasive fungi' and 'invasive fusariosis' was summarised for this review.
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Affiliation(s)
- Ananya Tupaki-Sreepurna
- Department of Microbiology, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra University, Porur, Chennai, Tamil Nadu, India
| | - Anupma Jyoti Kindo
- Department of Microbiology, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra University, Porur, Chennai, Tamil Nadu, India
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Identification and Characterization of Fusarium proliferatum, a New Species of Fungi that Cause Fungal Keratitis. Sci Rep 2018; 8:4859. [PMID: 29559666 PMCID: PMC5861105 DOI: 10.1038/s41598-018-23255-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 03/07/2018] [Indexed: 11/08/2022] Open
Abstract
Fusarium proliferatum (F. proliferatum) is known as a pathogen of corn and other crops, but its role in fungal keratitis has not been well investigated. Among 877 Fusarium isolates, we identified 155 (17.7%) stains as F. proliferatum according to their morphological features and partial DNA sequencing of translation elongation factor-\documentclass[12pt]{minimal}
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\begin{document}$$1\alpha $$\end{document}1α) in this study. In vitro antifungal susceptibility tests showed that the F. proliferatum strains were sensitive to natamycin and vorionazole but resistant to amphotericin B, fluconazol, ketoconazole and itaconazole. Most of the F. proliferatum-positive keratitis patients (44/155,28.4%) were aged 51–60 years old. The main cause of infection was injury by a plant (51/155, 32.9%). A combination of 1% amphotericin B and 3% ketoconazole cured 45.2% (14/31) and a combination of 0.5% natamycin and 0.5% voriconazole cured 59.1% (13/22) of F. proliferatum-positive patients. The date suggests that F. proliferatum identified through EF-1ɑ DNA sequencing is an important new species that causes fungal keratitis. Based on antifungal susceptibility, treatment with a combination of 0.5% natamycin and 0.5% voriconazole improves the therapeutic efficacy in F. prolifertum-positive patients.
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13
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Carlesse F, Amaral APC, Gonçalves SS, Xafranski H, Lee MLM, Zecchin V, Petrilli AS, Al-Hatmi AM, Hagen F, Meis JF, Colombo AL. Outbreak of Fusarium oxysporum infections in children with cancer: an experience with 7 episodes of catheter-related fungemia. Antimicrob Resist Infect Control 2017; 6:93. [PMID: 28912948 PMCID: PMC5588724 DOI: 10.1186/s13756-017-0247-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 08/24/2017] [Indexed: 11/28/2022] Open
Abstract
Background Fusarium species are widely spread in nature as plant pathogens but are also able to cause opportunistic fungal infections in humans. We report a cluster of Fusarium oxysporum bloodstream infections in a single pediatric cancer center. Methods All clinical and epidemiological data related to an outbreak involving seven cases of fungemia by Fusarium oxysporum during October 2013 and February 2014 were analysed. All cultured isolates (n = 14) were identified to species level by sequencing of the TEF1 and RPB2 genes. Genotyping of the outbreak isolates was performed by amplified fragment length polymorphism fingerprinting. Results In a 5-month period 7 febrile pediatric cancer patients were diagnosed with catheter-related Fusarium oxysporum bloodstream infections. In a time span of 11 years, only 6 other infections due to Fusarium were documented and all were caused by a different species, Fusarium solani. None of the pediatric cancer patients had neutropenia at the time of diagnosis and all became febrile within two days after catheter manipulation in a specially designed room. Extensive environmental sampling in this room and the hospital did not gave a clue to the source. The outbreak was terminated after implementation of a multidisciplinary central line insertion care bundle. All Fusarium strains from blood and catheter tips were genetically related by amplified fragment length polymorphism fingerprinting. All patients survived the infection after prompt catheter removal and antifungal therapy. Conclusion A cluster with, genotypical identical, Fusarium oxysporum strains infecting 7 children with cancer, was most probably catheter-related. The environmental source was not discovered but strict infection control measures and catheter care terminated the outbreak. Electronic supplementary material The online version of this article (10.1186/s13756-017-0247-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Fabianne Carlesse
- Oncology Pediatric Institute (IOP-GRAACC), Escola Paulista de Medicina, Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil.,Department of Pediatrics, Escola Paulista de Medicina, Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | - Anna-Paula C Amaral
- Department of Pediatrics, Escola Paulista de Medicina, Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | - Sarah S Gonçalves
- Division of Infectious Diseases, Escola Paulista de Medicina, Federal University of Sao Paulo (UNIFESP), Rua Pedro de Toledo, 669 e 5° -andar, Sao Paulo, CEP 04039-032 Brazil
| | - Hemilio Xafranski
- Division of Infectious Diseases, Escola Paulista de Medicina, Federal University of Sao Paulo (UNIFESP), Rua Pedro de Toledo, 669 e 5° -andar, Sao Paulo, CEP 04039-032 Brazil
| | - Maria-Lucia M Lee
- Oncology Pediatric Institute (IOP-GRAACC), Escola Paulista de Medicina, Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | - Victor Zecchin
- Oncology Pediatric Institute (IOP-GRAACC), Escola Paulista de Medicina, Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | - Antonio S Petrilli
- Oncology Pediatric Institute (IOP-GRAACC), Escola Paulista de Medicina, Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | - Abdullah M Al-Hatmi
- Westerdijk Fungal Biodiversity Centre, Utrecht, The Netherlands.,Center of Expertise in Mycology Radboudumc/CWZ, Nijmegen, The Netherlands
| | - Ferry Hagen
- Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital (CWZ), Nijmegen, The Netherlands
| | - Jacques F Meis
- Center of Expertise in Mycology Radboudumc/CWZ, Nijmegen, The Netherlands.,Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital (CWZ), Nijmegen, The Netherlands
| | - Arnaldo L Colombo
- Division of Infectious Diseases, Escola Paulista de Medicina, Federal University of Sao Paulo (UNIFESP), Rua Pedro de Toledo, 669 e 5° -andar, Sao Paulo, CEP 04039-032 Brazil
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14
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Maharana PK, Sharma N, Nagpal R, Jhanji V, Das S, Vajpayee RB. Recent advances in diagnosis and management of Mycotic Keratitis. Indian J Ophthalmol 2017; 64:346-57. [PMID: 27380973 PMCID: PMC4966371 DOI: 10.4103/0301-4738.185592] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Mycotic keratitis is a major cause of corneal blindness, especially in tropical and subtropical countries. The prognosis is markedly worse compared to bacterial keratitis. Delayed diagnosis and scarcity of effective antifungal agents are the major factors for poor outcome. Over the last decade, considerable progress has been made to rapidly diagnose cases with mycotic keratitis and increase the efficacy of treatment. This review article discusses the recent advances in diagnosis and management of mycotic keratitis with a brief discussion on rare and emerging organisms. A MEDLINE search was carried out for articles in English language, with the keywords, mycotic keratitis, fungal keratitis, emerging or atypical fungal pathogens in mycotic keratitis, investigations in mycotic keratitis, polymerase chain reaction in mycotic keratitis, confocal microscopy, treatment of mycotic keratitis, newer therapy for mycotic keratitis. All relevant articles were included in this review. Considering the limited studies available on newer diagnostic and therapeutic modalities in mycotic keratitis, case series as well as case reports were also included if felt important.
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Affiliation(s)
- Prafulla K Maharana
- Department of Ophthalmology, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Namrata Sharma
- Cornea and Refractive Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Ritu Nagpal
- Department of Ophthalmology, L.V. Prasad Eye Institute, Hyderabad, India
| | - Vishal Jhanji
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Sujata Das
- Department of Ophthalmology, L.V. Prasad Eye Institute, Bhubaneswar, India
| | - Rasik B Vajpayee
- Department of Ophthalmology, Vision Eye Institute, Royal Victorian Eye and Ear Hospital, North West Academic Centre, University of Melbourne, Australia
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15
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Al-Hatmi AMS, Curfs-Breuker I, de Hoog GS, Meis JF, Verweij PE. Antifungal Susceptibility Testing of Fusarium: A Practical Approach. J Fungi (Basel) 2017; 3:jof3020019. [PMID: 29371537 PMCID: PMC5715922 DOI: 10.3390/jof3020019] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Revised: 04/14/2017] [Accepted: 04/19/2017] [Indexed: 12/12/2022] Open
Abstract
In vitro susceptibility testing of Fusarium is becoming increasingly important because of frequency and diversity of infections and because resistance profiles are species-specific. Reference methods for antifungal susceptibility testing (AFST) are those of Clinical and Laboratory Standards Institute (CLSI) and European Committee on Antimicrobial Susceptibility (EUCAST), but breakpoints (BPs) have not yet been established. One of the problems is that phylogenetic distances between Fusarium species are much smaller than between species of, e.g., Candida. Epidemiological cutoff values (ECVs) for some Fusarium species have been determined in order to differentiate wild-type from non-wild-type isolates. In clinical routine, commercially available assays such as Etest, Sensititre or others provide essential agreement with reference methods. Our objective is to summarize antifungal susceptibility testing of Fusarium genus in the clinical laboratory: how to do it, when to do it, and how to interpret it.
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Affiliation(s)
- Abdullah M S Al-Hatmi
- Westerdijk Fungal Biodiversity Institute, PO Box 85167, 3508 AD Utrecht, The Netherlands.
- Centre of Expertise in Mycology Radboud University Medical Centre, Canisius Wilhelmina Hospital, 6500HB Nijmegen, The Netherlands.
- Ministry of Health, Directorate General of Health Services, PO Box 393, 100 Muscat, Oman.
| | - Ilse Curfs-Breuker
- Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital, 6500HB Nijmegen, The Netherlands.
| | - G Sybren de Hoog
- Westerdijk Fungal Biodiversity Institute, PO Box 85167, 3508 AD Utrecht, The Netherlands.
- Basic Pathology Department, Federal University of Paraná State, Curitiba, 81540-970 Paraná, Brazil.
- Biological Sciences Department, Faculty of Science, King Abdulaziz University, PO Box 80203 Jeddah, Saudi Arabia.
| | - Jacques F Meis
- Centre of Expertise in Mycology Radboud University Medical Centre, Canisius Wilhelmina Hospital, 6500HB Nijmegen, The Netherlands.
- Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital, 6500HB Nijmegen, The Netherlands.
| | - Paul E Verweij
- Centre of Expertise in Mycology Radboud University Medical Centre, Canisius Wilhelmina Hospital, 6500HB Nijmegen, The Netherlands.
- Department of Medical Microbiology, Radboud University, Nijmegen Medical Centre, 6500GS Nijmegen, The Netherlands.
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Comparison of DNA Microarray, Loop-Mediated Isothermal Amplification (LAMP) and Real-Time PCR with DNA Sequencing for Identification of Fusarium spp. Obtained from Patients with Hematologic Malignancies. Mycopathologia 2017; 182:625-632. [PMID: 28324245 DOI: 10.1007/s11046-017-0129-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Accepted: 02/24/2017] [Indexed: 01/17/2023]
Abstract
The performance of three molecular biology techniques, i.e., DNA microarray, loop-mediated isothermal amplification (LAMP), and real-time PCR were compared with DNA sequencing for properly identification of 20 isolates of Fusarium spp. obtained from blood stream as etiologic agent of invasive infections in patients with hematologic malignancies. DNA microarray, LAMP and real-time PCR identified 16 (80%) out of 20 samples as Fusarium solani species complex (FSSC) and four (20%) as Fusarium spp. The agreement among the techniques was 100%. LAMP exhibited 100% specificity, while DNA microarray, LAMP and real-time PCR showed 100% sensitivity. The three techniques had 100% agreement with DNA sequencing. Sixteen isolates were identified as FSSC by sequencing, being five Fusarium keratoplasticum, nine Fusarium petroliphilum and two Fusarium solani. On the other hand, sequencing identified four isolates as Fusarium non-solani species complex (FNSSC), being three isolates as Fusarium napiforme and one isolate as Fusarium oxysporum. Finally, LAMP proved to be faster and more accessible than DNA microarray and real-time PCR, since it does not require a thermocycler. Therefore, LAMP signalizes as emerging and promising methodology to be used in routine identification of Fusarium spp. among cases of invasive fungal infections.
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17
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Fusarium dimerum Species Complex (Fusarium penzigii) Keratitis After Corneal Trauma. Mycopathologia 2016; 181:879-884. [DOI: 10.1007/s11046-016-0060-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 08/27/2016] [Indexed: 11/28/2022]
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18
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Guevara-Suarez M, Cano-Lira JF, de García MCC, Sopo L, De Bedout C, Cano LE, García AM, Motta A, Amézquita A, Cárdenas M, Espinel-Ingroff A, Guarro J, Restrepo S, Celis A. Genotyping of Fusarium Isolates from Onychomycoses in Colombia: Detection of Two New Species Within the Fusarium solani Species Complex and In Vitro Antifungal Susceptibility Testing. Mycopathologia 2016; 181:165-74. [PMID: 26943726 DOI: 10.1007/s11046-016-9983-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 01/12/2016] [Indexed: 02/04/2023]
Abstract
Fusariosis have been increasing in Colombia in recent years, but its epidemiology is poorly known. We have morphologically and molecularly characterized 89 isolates of Fusarium obtained between 2010 and 2012 in the cities of Bogotá and Medellín. Using a multi-locus sequence analysis of rDNA internal transcribed spacer, a fragment of the translation elongation factor 1-alpha (Tef-1α) and of the RNA-dependent polymerase subunit II (Rpb2) genes, we identified the phylogenetic species and circulating haplotypes. Since most of the isolates studied were from onychomycoses (nearly 90 %), we carried out an epidemiological study to determine the risk factors associated with such infections. Five phylogenetic species of the Fusarium solani species complex (FSSC), i.e., F. falciforme, F. keratoplasticum, F. lichenicola, F. petroliphilum, and FSSC 6 as well as two of the Fusarium oxysporum species complex (FOSC), i.e., FOSC 3 and FOSC 4, were identified. The most prevalent species were FOSC 3 (38.2%) followed by F. keratoplasticum (33.7%). In addition, our isolates were distributed into 23 haplotypes (14 into FOSC and nine into FSSC). Two of the FSSC phylogenetic species and two haplotypes of FSSC were not described before. Our results demonstrate that recipients of pedicure treatments have a lower probability of acquiring onychomycosis than those not receiving such treatments. The antifungal susceptibility of all the isolates to five clinically available agents showed that amphotericin B was the most active drug, while the azoles exhibited lower in vitro activity.
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Affiliation(s)
- Marcela Guevara-Suarez
- Laboratorio de Micología y Fitopatología, Departamento de Ciencias Biológicas, Universidad de Los Andes, Carrera 1 No 18A-10, Bogotá, Colombia.,Unitat de Micología, Facultat de Medicina i Ciències de la Salut and IISPV, Universitat Rovira i Virgili, Reus, Tarragona, Spain
| | - José Francisco Cano-Lira
- Unitat de Micología, Facultat de Medicina i Ciències de la Salut and IISPV, Universitat Rovira i Virgili, Reus, Tarragona, Spain
| | - María Caridad Cepero de García
- Laboratorio de Micología y Fitopatología, Departamento de Ciencias Biológicas, Universidad de Los Andes, Carrera 1 No 18A-10, Bogotá, Colombia
| | - Leticia Sopo
- Laboratorio Especializado de Micología Médica (LEMM), Bogotá, Colombia
| | - Catalina De Bedout
- Grupo de Micología Médica y Experimental, Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia
| | - Luz Elena Cano
- Escuela de Microbiología, Universidad de Antioquia (UdeA), Medellín, Colombia
| | - Ana María García
- Unidad de Biología Celular y Molecular, Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia
| | - Adriana Motta
- Facultad de Medicina, Universidad El Bosque, Bogotá, Colombia.,Hospital Simón Bolívar, Bogotá, Colombia
| | - Adolfo Amézquita
- Grupo de Ecofisiología, Comportamiento y Herpetología (GECOH), Departamento de Ciencias Biológicas, Universidad de los Andes, Bogotá, Colombia
| | - Martha Cárdenas
- Laboratorio de Micología y Fitopatología, Departamento de Ciencias Biológicas, Universidad de Los Andes, Carrera 1 No 18A-10, Bogotá, Colombia
| | | | - Josep Guarro
- Unitat de Micología, Facultat de Medicina i Ciències de la Salut and IISPV, Universitat Rovira i Virgili, Reus, Tarragona, Spain
| | - Silvia Restrepo
- Laboratorio de Micología y Fitopatología, Departamento de Ciencias Biológicas, Universidad de Los Andes, Carrera 1 No 18A-10, Bogotá, Colombia
| | - Adriana Celis
- Laboratorio de Micología y Fitopatología, Departamento de Ciencias Biológicas, Universidad de Los Andes, Carrera 1 No 18A-10, Bogotá, Colombia.
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Hassan AS, Al-Hatmi AMS, Shobana CS, van Diepeningen AD, Kredics L, Vágvölgyi C, Homa M, Meis JF, de Hoog GS, Narendran V, Manikandan P. Antifungal Susceptibility and Phylogeny of Opportunistic Members of the Genus Fusarium Causing Human Keratomycosis in South India. Med Mycol 2015; 54:287-94. [PMID: 26705832 DOI: 10.1093/mmy/myv105] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 11/15/2015] [Indexed: 12/29/2022] Open
Abstract
Fusarium species are reported frequently as the most common causative agents of fungal keratitis in tropical countries such as India. Sixty-five fusaria isolated from patients were subjected to multilocus DNA sequencing to characterize the spectrum of the species associated with keratitis infections in India. Susceptibilities of these fusaria to ten antifungals were determined in vitro by the broth microdilution method. An impressive phylogenetic diversity of fusaria was reflected in susceptibilities differing at species level. Typing results revealed that the isolates were distributed among species in the species complexes (SCs) of F. solani (FSSC; n = 54), F. oxysporum (FOSC; n = 1), F. fujikuroi (FFSC; n = 3), and F. dimerum (FDSC; n = 7). Amphotericin B, voriconazole, and clotrimazole proved to be the most effective drugs, followed by econazole.
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Affiliation(s)
| | - Abdullah M S Al-Hatmi
- CBS-KNAW Fungal Biodiversity Centre, Utrecht, the Netherlands Institute of Biodiversity and Ecosystem Dynamics, University of Amsterdam, Amsterdam, the Netherlands Directorate General of Health Services, Ministry of Health, Ibri Hospital, Ibri, Oman
| | | | | | - László Kredics
- Department of Microbiology, Faculty of Science and Informatics, University of Szeged, Szeged, Hungary
| | - Csaba Vágvölgyi
- Department of Microbiology, Faculty of Science and Informatics, University of Szeged, Szeged, Hungary Botany and Microbiology Department, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Mónika Homa
- Department of Microbiology, Faculty of Science and Informatics, University of Szeged, Szeged, Hungary
| | - Jacques F Meis
- Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital, Nijmegen, the Netherlands Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - G Sybren de Hoog
- CBS-KNAW Fungal Biodiversity Centre, Utrecht, the Netherlands Institute of Biodiversity and Ecosystem Dynamics, University of Amsterdam, Amsterdam, the Netherlands Basic Pathology Department, Federal University of Paraná State, Curitiba, Paraná, Brazil
| | | | - Palanisamy Manikandan
- Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Coimbatore, India Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Majmaah University, Kingdom of Saudi Arabia Greenlink Analytical and Research Laboratory India Private Ltd., Coimbatore, India.
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Al-Hatmi AMS, Meletiadis J, Curfs-Breuker I, Bonifaz A, Meis JF, De Hoog GS. In vitro combinations of natamycin with voriconazole, itraconazole and micafungin against clinical Fusarium strains causing keratitis. J Antimicrob Chemother 2015; 71:953-5. [PMID: 26702918 DOI: 10.1093/jac/dkv421] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 11/09/2015] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Fusarium species cause a broad spectrum of infections, from superficial to disseminated disease. Because Fusarium species are intrinsically resistant to most antifungal drugs, new approaches are needed. The aim of the present study was to evaluate the in vitro combination of natamycin with currently used antifungal drugs. METHODS The in vitro interactions of combinations between natamycin and voriconazole, itraconazole and micafungin applied to 20 clinical Fusarium strains (members of Fusarium falciforme, Fusarium napiforme, Fusarium petroliphilum, Fusarium proliferatum, Fusarium pseudensiforme and Fusarium sacchari) were evaluated using a chequerboard microdilution method. The MICs of all drugs alone and in combination were determined visually after 48 h and interactions were assessed using fractional inhibitory concentration index (FICI) analysis. RESULTS MICs of voriconazole and natamycin alone were 4 to >16 and 4-8 mg/L, respectively. Values were reduced 3.5-10-fold to 0.02-0.5 mg/L and 0.5-5-fold to 0.13-2 mg/L in combination, for the currently used antifungals and natamycin, respectively, demonstrating additive to synergistic interactions. The combinations natamycin/voriconazole, natamycin/itraconazole and natamycin/micafungin were synergistic (FICI ≤0.5) for 70%, 15% and 5% of the strains, respectively. No antagonism was found. CONCLUSIONS The combination of natamycin with voriconazole was strongly synergistic at clinically achievable serum concentrations.
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Affiliation(s)
- Abdullah M S Al-Hatmi
- CBS-KNAW Fungal Biodiversity Centre, PO Box 85167, 3508 AD Utrecht, The Netherlands Institutes of Biodiversity and Ecosystem Dynamics, University of Amsterdam, Amsterdam, The Netherlands Directorate General of Health Services, Ibri Hospital, Ministry of Health, Muscat, Oman
| | - Joseph Meletiadis
- Clinical Microbiology Laboratory, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Ilse Curfs-Breuker
- Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
| | | | - Jacques F Meis
- Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands Department of Medical Microbiology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - G Sybren De Hoog
- CBS-KNAW Fungal Biodiversity Centre, PO Box 85167, 3508 AD Utrecht, The Netherlands Institutes of Biodiversity and Ecosystem Dynamics, University of Amsterdam, Amsterdam, The Netherlands Basic Pathology Department, Federal University of Paraná State, Curitiba, Paraná, Brazil Biology Department, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
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van Diepeningen AD, Brankovics B, Iltes J, van der Lee TAJ, Waalwijk C. Diagnosis of Fusarium Infections: Approaches to Identification by the Clinical Mycology Laboratory. CURRENT FUNGAL INFECTION REPORTS 2015; 9:135-143. [PMID: 26301000 PMCID: PMC4537702 DOI: 10.1007/s12281-015-0225-2] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Infections caused by the genus Fusarium have emerged over the past decades and range from onychomycosis and keratitis in healthy individuals to deep and disseminated infections with high mortality rates in immune-compromised patients. As antifungal susceptibility can differ between the different Fusarium species, identification at species level is recommended. Several clinical observations as hyaline hyphae in tissue, necrotic lesions in the skin and positive blood tests with fungal growth or presence of fungal cell wall components may be the first hints for fusariosis. Many laboratories rely on morphological identification, but especially multi-locus sequencing proves better to discriminate among members of the species complexes involved in human infection. DNA-based diagnostic tools have best discriminatory power when based on translation elongation factor 1-α or the RNA polymerase II second largest subunit. However, assays based on the detection of other fusarial cell compounds such as peptides and cell wall components may also be used for identification. The purpose of this review is to provide an overview and a comparison of the different tools currently available for the diagnosis of fusariosis.
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Affiliation(s)
| | - Balázs Brankovics
- />CBS-KNAW Fungal Biodiversity Centre, Uppsalalaan 8, 3584 CT Utrecht, The Netherlands
- />Institute of Biodiversity and Ecosystem Dynamics, University of Amsterdam, Amsterdam, The Netherlands
| | - Jearidienne Iltes
- />CBS-KNAW Fungal Biodiversity Centre, Uppsalalaan 8, 3584 CT Utrecht, The Netherlands
| | - Theo A. J. van der Lee
- />Plant Research International Wageningen UR, Droevendaalsesteeg 1, 6708 PB Wageningen, The Netherlands
| | - Cees Waalwijk
- />Plant Research International Wageningen UR, Droevendaalsesteeg 1, 6708 PB Wageningen, The Netherlands
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García-Ruiz JC, Olazábal I, Adán Pedroso RM, López-Soria L, Velasco-Benito V, Sánchez-Aparicio JA, Navajas A, Montejo M, Moragues MD. Disseminated fusariosis and hematologic malignancies, a still devastating association. Report of three new cases. Rev Iberoam Micol 2015; 32:190-6. [PMID: 25936697 DOI: 10.1016/j.riam.2014.11.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Revised: 11/12/2014] [Accepted: 11/21/2014] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Fungi of the genus Fusarium are primarily plant pathogens and saprobes that produce disseminated infections in immunologically deficient humans. After aspergillosis, disseminated fusariosis is the second most common cause of invasive infection by filamentous fungi in patients with hematologic malignancies or those undergoing transplants of hematopoietic progenitors. AIMS Disseminated fusariosis (DF) is considered an extremely rare infection and has reached a stable incidence rate, but its high mortality rate and the lack of an optimal management protocol have raised increasing interest in this mycosis. METHODS We present three cases of DF produced by Fusarium oxysporum species complex, Fusarium solani species complex and the highly unusual Fusarium dimerum in patients with advanced hematological malignancies diagnosed in our hospital between 2007 and 2011. The species level identification of the Fusarium isolates was established by sequencing their TEF1 gene. RESULTS The isolates showed low susceptibility to most of the antifungal agents analyzed, except that observed for F. dimerum to amphotericin B (AmB) and terbinafine, and F. oxysporum species complex to AmB. Interestingly, the strain of F. solani species complex exhibited high MIC values for AmB and voriconazole, notwithstanding these drugs were used for treatment with good results. Other relevant aspects to be considered in the treatment of DF are surgically cleaning foci of infection, withdrawing presumably contaminated catheters and recovery from neutropenia. CONCLUSIONS The prevention of infection in colonized patients, the maintenance of a high level of diagnostic suspicion for early diagnosis, and the combined, vigorous and prolonged use of L-AmB and voriconazole are essential to decrease the mortality rate of this devastating infection.
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Affiliation(s)
- Juan Carlos García-Ruiz
- Servicio de Hematología y Hemoterapia, BioCruces Health Research Institute, Hospital Universitario Cruces, Plaza de Cruces s/n, 48903 Barakaldo, Bizkaia, Spain
| | - Iñigo Olazábal
- Servicio de Hematología y Hemoterapia, BioCruces Health Research Institute, Hospital Universitario Cruces, Plaza de Cruces s/n, 48903 Barakaldo, Bizkaia, Spain
| | - Rosa María Adán Pedroso
- Servicio de Pediatría, BioCruces Health Research Institute, Hospital Universitario Cruces, Barakaldo, Bizkaia, Spain
| | - Leyre López-Soria
- Servicio de Microbiología, Hospital Universitario Cruces, Barakaldo, Bizkaia, Spain
| | - Verónica Velasco-Benito
- Servicio de Anatomía Patológica, BioCruces Health Research Institute, Hospital Universitario Cruces, Barakaldo, Bizkaia, Spain
| | | | - Aurora Navajas
- Servicio de Pediatría, BioCruces Health Research Institute, Hospital Universitario Cruces, Barakaldo, Bizkaia, Spain
| | - Miguel Montejo
- Unidad de Enfermedades Infecciosas, Hospital Universitario Cruces, BioCruces Health Research Institute, Universidad del País Vasco (UPV/EHU), Barakaldo, Bizkaia, Spain
| | - María-Dolores Moragues
- Departamento de Enfermería, Escuela de Enfermería, Universidad del País Vasco UPV/EHU, Leioa, Bizkaia, Spain.
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Kredics L, Narendran V, Shobana CS, Vágvölgyi C, Manikandan P. Filamentous fungal infections of the cornea: a global overview of epidemiology and drug sensitivity. Mycoses 2015; 58:243-60. [PMID: 25728367 DOI: 10.1111/myc.12306] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2014] [Revised: 01/27/2015] [Accepted: 02/13/2015] [Indexed: 11/30/2022]
Abstract
Fungal keratitis is a serious suppurative, usually ulcerative corneal infection which may result in blindness or reduced vision. Epidemiological studies indicate that the occurrence of fungal keratitis is higher in warm, humid regions with agricultural economy. The most frequent filamentous fungal genera among the causal agents are Fusarium, Aspergillus and Curvularia. A more successful therapy of fungal keratitis relies on precise identification of the pathogen to the species level using molecular tools. As the sequence analysis of the internal transcribed spacer (ITS) region of the ribosomal RNA gene cluster (rDNA) is not discriminative enough to reveal a species-level diagnosis for several filamentous fungal species highly relevant in keratitis infections, analysis of other loci is also required for an exact diagnosis. Molecular identifications may also reveal the involvement of fungal species which were not previously reported from corneal infections. The routinely applied chemotherapy of fungal keratitis is based on the topical and systemic administration of polyenes and azole compounds. Antifungal susceptibility testing of the causal agents is of special importance due to the emergence and spread of resistance. Testing the applicability of further available antifungals and screening for new, potential compounds for the therapy of fungal keratitis are of highlighted interest.
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Affiliation(s)
- László Kredics
- Department of Microbiology, Faculty of Science and Informatics, University of Szeged, Szeged, Hungary
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Use of matrix-assisted laser desorption ionization-time of flight mass spectrometry for identification of molds of the Fusarium genus. J Clin Microbiol 2014; 53:465-76. [PMID: 25411180 DOI: 10.1128/jcm.02213-14] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The rates of infection with Fusarium molds are increasing, and a diverse number of Fusarium spp. belonging to different species complexes can cause infection. Conventional species identification in the clinical laboratory is time-consuming and prone to errors. We therefore evaluated whether matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) is a useful alternative. The 289 Fusarium strains from the Belgian Coordinated Collections of Microorganisms (BCCM)/Institute of Hygiene and Epidemiology Mycology (IHEM) culture collection with validated sequence-based identities and comprising 40 species were used in this study. An identification strategy was developed, applying a standardized MALDI-TOF MS assay and an in-house reference spectrum database. In vitro antifungal testing was performed to assess important differences in susceptibility between clinically relevant species/species complexes. We observed that no incorrect species complex identifications were made by MALDI-TOF MS, and 82.8% of the identifications were correct to the species level. This success rate was increased to 91% by lowering the cutoff for identification. Although the identification of the correct species complex member was not always guaranteed, antifungal susceptibility testing showed that discriminating between Fusarium species complexes can be important for treatment but is not necessarily required between members of a species complex. With this perspective, some Fusarium species complexes with closely related members can be considered as a whole, increasing the success rate of correct identifications to 97%. The application of our user-friendly MALDI-TOF MS identification approach resulted in a dramatic improvement in both time and accuracy compared to identification with the conventional method. A proof of principle of our MALDI-TOF MS approach in the clinical setting using recently isolated Fusarium strains demonstrated its validity.
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de Souza M, Matsuzawa T, Lyra L, Busso-Lopes AF, Gonoi T, Schreiber AZ, Kamei K, Moretti ML, Trabasso P. Fusarium napiforme systemic infection: case report with molecular characterization and antifungal susceptibility tests. SPRINGERPLUS 2014; 3:492. [PMID: 25210666 PMCID: PMC4159480 DOI: 10.1186/2193-1801-3-492] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 08/27/2014] [Indexed: 12/18/2022]
Abstract
Introduction During the last decades, Fusarium spp. has been reported as a significant cause of disease in humans, especially in immunocompromised patients, who have high risk of invasive life-threatening disease. Fusarium species usually reported as cause of human disease are F. solani, F. oxysporum and F. verticillioides. Case description We describe the second case in the literature of disseminated fusariosis caused by Fusarium napiforme, that occurred in a 60-year-old woman with multiple myeloma after subsequent cycles of chemotherapy. Discussion and Evaluation We identified the F. napiforme not only by standard morphologic criteria by macroscopic and microscopic characteristics, but also confirmed by molecular biology methods, including sequencing. The antifungal susceptibility of the F. napiforme isolates were tested to seven antifungal drugs; the azoles were the most active drug against all the isolates tested. Conclusions Fusarium spp. are of relevance in medical mycology, and their profiles of low susceptibility to antifungal drugs highlight the importance for faster and more accurate diagnostic tests, what can contribute to an earlier and precise diagnosis and treatment.
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Affiliation(s)
- Marcela de Souza
- Department of Internal Medicine, School of Medicine, University of Campinas, Campinas, São Paulo Brazil ; LIM 46 - Laboratory of Parasitology - HC/FMUSP, Kragujevac, São Paulo Brazil
| | | | - Luzia Lyra
- Department of Clinical Pathology, School of Medicine, University of Campinas, Campinas, São Paulo Brazil
| | | | - Tohru Gonoi
- Medical Mycology Research Center, Chiba University, Chiba, Japan
| | | | - Katsuhiko Kamei
- Medical Mycology Research Center, Chiba University, Chiba, Japan
| | - Maria Luiza Moretti
- Department of Internal Medicine, School of Medicine, University of Campinas, Campinas, São Paulo Brazil
| | - Plínio Trabasso
- Department of Internal Medicine, School of Medicine, University of Campinas, Campinas, São Paulo Brazil
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Buchta V, Feuermannová A, Váša M, Bašková L, Kutová R, Kubátová A, Vejsová M. Outbreak of fungal endophthalmitis due to Fusarium oxysporum following cataract surgery. Mycopathologia 2014; 177:115-21. [PMID: 24381050 DOI: 10.1007/s11046-013-9721-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Accepted: 12/08/2013] [Indexed: 11/29/2022]
Abstract
Outbreak of exogenous Fusarium endophthalmitis after cataract surgery was evaluated. Twenty patients developed postoperative endophthalmitis. In 19 eyes, pars plana vitrectomy (PPV) was performed, in 14 cases (74 %) with primary intraocular lens explantation. In one case, the PPV was not performed because of poor general condition of the patient. Symptoms of endophthalmitis (damaged vision, iritis, tyndallization in anterior chamber, hypopyon) occurred at intervals of 16-79 days (mean 31.3 days). Fungal etiology was documented in 12 eyes (60 %). Fusarium oxysporum was evidenced by culture and/or microscopy and confirmed by PCR and sequencing analysis. Eighteen (90 %) patients were treated with oral voriconazole (400 mg/day) for a period of 4-6 weeks. The final visual acuity was 6/15 in 1 case (5 %), 6/60 and worse in 17 eyes (85 %), and in 2 cases (10 %), enucleation had to be performed. Viscoelastic filling material was suggested the most likely source of infection. Endophthalmitis caused by Fusarium spp. are a potentially big threat for patients with serious impact on vision. Successful management of the infection is highly dependent on early diagnosis including species identification and antifungal susceptibility testing, and on aggressive and long-term treatment.
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Affiliation(s)
- Vladimír Buchta
- Department of Clinical Microbiology, University Hospital and Charles University Medical Faculty, Sokolska 581, 500 05, Hradec Kralove, Czech Republic,
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Homa M, Shobana CS, Singh YRB, Manikandan P, Selvam KP, Kredics L, Narendran V, Vágvölgyi C, Galgóczy L. Fusarium keratitis in South India: causative agents, their antifungal susceptibilities and a rapid identification method for the Fusarium solani species complex. Mycoses 2013; 56:501-511. [PMID: 23437826 DOI: 10.1111/myc.12062] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Revised: 01/23/2013] [Accepted: 01/23/2013] [Indexed: 09/07/2023]
Abstract
Seventy Fusarium isolates derived from human keratomycosis were identified based on partial sequences of the β-tubulin (β-TUB) and translation elongation factor 1α (EF-1α) genes. Most of the isolates were confirmed as members of the F. solani species complex (75.71%), followed by the F. dimerum species complex (8.57%), the F. fujikuroi species complex (8.57%), the F. oxysporum species complex (4.29%) and the F. incarnatum-equiseti species complex (2.86%). A combined phylogenetic tree was estimated including all the 70 isolates. Isolates belonging to different species complexes formed separate clades. In this study, we also report the first isolation of F. napiforme from human keratomycosis. A new method based on a specific EcoRI restriction site in the EF-1α gene was developed for the rapid identification of F. solani. In vitro antifungal susceptibilities of the isolates to seven antifungals were determined by broth microdilution method. Terbinafine, natamycin and amphotericin B proved to be the most effective drugs, followed by voriconazole. The minimal inhibitory concentrations of clotrimazole, econazole and itraconazole were generally high (≥64 μg ml(-1) ). The interactions between the two most effective antifungals (natamycin and terbinafine) were determined by checkerboard microdilution method. Synergism (71.8%) or no interaction (28.2%) was revealed between the two compounds.
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Affiliation(s)
- Mónika Homa
- Faculty of Science and Informatics, Department of Microbiology, University of Szeged, H-6726 Szeged, Hungary
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Guarro J. Fusariosis, a complex infection caused by a high diversity of fungal species refractory to treatment. Eur J Clin Microbiol Infect Dis 2013; 32:1491-500. [DOI: 10.1007/s10096-013-1924-7] [Citation(s) in RCA: 146] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Accepted: 07/03/2013] [Indexed: 11/30/2022]
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Synergysm of voriconazole or itraconazole with other antifungal agents against species of Fusarium. Rev Iberoam Micol 2013; 30:200-4. [DOI: 10.1016/j.riam.2013.01.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2012] [Revised: 11/30/2012] [Accepted: 01/08/2013] [Indexed: 11/20/2022] Open
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Thomas PA, A Teresa P, Theodore J, Geraldine P. PCR for the molecular diagnosis of mycotic keratitis. Expert Rev Mol Diagn 2013; 12:703-18. [PMID: 23153238 DOI: 10.1586/erm.12.65] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Mycotic keratitis, an infection of the cornea caused by fungi, is a medical emergency, with patients presenting with considerable pain and distress. For effective management of the condition, a specific diagnosis must be made rapidly to permit early initiation of antifungal therapy. Currently, direct microscopic examination and culture of corneal material constitute the 'gold standard' for diagnosis. However, rapid, sensitive yet specific tests are needed to detect a small number of, or nonviable, fungi. PCR has many potential advantages when used as a diagnostic aid for mycotic keratitis; the present review covers these advantages, and possible limitations. An expert assessment is also made of studies that have used PCR for the diagnosis of mycotic keratitis. The review concludes with a Five-year view of the potential impact of PCR in management of mycotic keratitis.
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Affiliation(s)
- Philip A Thomas
- Institute of Ophthalmology, Joseph Eye Hospital, Tiruchirapalli 620001, India.
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31
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Disseminated Amphotericin-Resistant Fusariosis in Acute Leukemia Patients: Report of Two Cases. Mycopathologia 2012; 175:107-14. [DOI: 10.1007/s11046-012-9585-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2012] [Accepted: 09/18/2012] [Indexed: 10/27/2022]
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Escalante-Pérez M, Jaborsky M, Reinders J, Kurzai O, Hedrich R, Ache P. Poplar extrafloral nectar is protected against plant and human pathogenic fungus. MOLECULAR PLANT 2012; 5:1157-1159. [PMID: 22859733 DOI: 10.1093/mp/sss072] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Furustrand Tafin U, Meis JF, Trampuz A. Isothermal microcalorimetry for antifungal susceptibility testing of Mucorales, Fusarium spp., and Scedosporium spp. Diagn Microbiol Infect Dis 2012; 73:330-7. [DOI: 10.1016/j.diagmicrobio.2012.05.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2012] [Revised: 05/08/2012] [Accepted: 05/08/2012] [Indexed: 11/26/2022]
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Watanabe M, Yonezawa T, Lee KI, Kumagai S, Sugita-Konishi Y, Goto K, Hara-Kudo Y. Molecular phylogeny of the higher and lower taxonomy of the Fusarium genus and differences in the evolutionary histories of multiple genes. BMC Evol Biol 2011; 11:322. [PMID: 22047111 PMCID: PMC3270093 DOI: 10.1186/1471-2148-11-322] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2011] [Accepted: 11/03/2011] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Species of the Fusarium genus are important fungi which is associated with health hazards in human and animals. The taxonomy of this genus has been a subject of controversy for many years. Although many researchers have applied molecular phylogenetic analysis to examine the taxonomy of Fusarium species, their phylogenetic relationships remain unclear only few comprehensive phylogenetic analyses of the Fusarium genus and a lack of suitable nucleotides and amino acid substitution rates. A previous stugy with whole genome comparison among Fusairum species revealed the possibility that each gene in Fusarium genomes has a unique evolutionary history, and such gene may bring difficulty to the reconstruction of phylogenetic tree of Fusarium. There is a need not only to check substitution rates of genes but also to perform the exact evaluation of each gene-evolution. RESULTS We performed phylogenetic analyses based on the nucleotide sequences of the rDNA cluster region (rDNA cluster), and the β-tubulin gene (β-tub), the elongation factor 1α gene (EF-1α), and the aminoadipate reductase gene (lys2). Although incongruence of the tree topologies between lys2 and the other genes was detected, all genes supported the classification of Fusarium species into 7 major clades, I to VII. To obtain a reliable phylogeny for Fusarium species, we excluded the lys2 sequences from our dataset, and re-constructed a maximum likelihood (ML) tree based on the combined data of the rDNA cluster, β-tub, and EF-1α. Our ML tree indicated some interesting relationships in the higher and lower taxa of Fusarium species and related genera. Moreover, we observed a novel evolutionary history of lys2. We suggest that the unique tree topologies of lys2 are not due to an analytical artefact, but due to differences in the evolutionary history of genomes caused by positive selection of particular lineages. CONCLUSION This study showed the reliable species tree of the higher and lower taxonomy in the lineage of the Fusarium genus. Our ML tree clearly indicated 7 major clades within the Fusarium genus. Furthermore, this study reported differences in the evolutionary histories among multiple genes within this genus for the first time.
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Affiliation(s)
- Maiko Watanabe
- Division of Microbiology, National Institute of Health Sciences, Kamiyoga 1-18-1, Setagaya-ku, Tokyo 158-8501, Japan
| | - Takahiro Yonezawa
- School of Life Sciences, Fudan University, 220, Handan Rd. 200433, Shanghai, China
| | - Ken-ichi Lee
- Veterinary Medical Science, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Yayoi 1-1-1, Bunkyo-ku, Tokyo 113-8657, Japan
| | - Susumu Kumagai
- Veterinary Medical Science, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Yayoi 1-1-1, Bunkyo-ku, Tokyo 113-8657, Japan
| | - Yoshiko Sugita-Konishi
- Division of Microbiology, National Institute of Health Sciences, Kamiyoga 1-18-1, Setagaya-ku, Tokyo 158-8501, Japan
| | - Keiichi Goto
- Food Research Laboratories, Mitsui Norin Co., Ltd., Miyabara 223-1, Fujieda-shi, Shizuoka 426-0133, Japan
| | - Yukiko Hara-Kudo
- Division of Microbiology, National Institute of Health Sciences, Kamiyoga 1-18-1, Setagaya-ku, Tokyo 158-8501, Japan
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Watanabe M, Yonezawa T, Lee KI, Kumagai S, Sugita-Konishi Y, Goto K, Hara-Kudo Y. Evaluation of genetic markers for identifying isolates of the species of the genus Fusarium. JOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE 2011; 91:2500-2504. [PMID: 21725977 DOI: 10.1002/jsfa.4507] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2011] [Revised: 04/14/2011] [Accepted: 05/15/2011] [Indexed: 05/31/2023]
Abstract
BACKGROUND Members of the genus Fusarium are well known as one of the most important plant pathogens causing food spoilage and loss worldwide. Moreover, they are associated with human and animal diseases through contaminated foods because they produce mycotoxins. To control fungal hazards of plants, animals and humans, there is a need for a rapid, easy and accurate identification system of Fusarium isolates with molecular methods. RESULTS To specify genes appropriate for identifying isolates of various Fusarium species, we sequenced the 18S rRNA gene (rDNA), internal transcribed spacer region 1, 5.8S rDNA, 28S rDNA, β-tubulin gene (β-tub), and aminoadipate reductase gene (lys2), and subsequently calculated the nucleotide sequence homology with pair-wise comparison of all tested strains and inferred the ratio of the nucleotide substitution rates of each gene. Inter-species nucleotide sequence homology of β-tub and lys2 ranged from 83.5 to 99.4% and 56.5 to 99.0%, respectively. The result indicated that sequence homologies of these genes against reference sequences in a database have a high possibility of identifying unknown Fusarium isolates when it is more than 99.0%, because these genes had no inter-species pair-wise combinations that had 100% homologies. Other markers often showed 100% homology in inter-species pair-wise combinations. The nucleotide substitution rate of lys2 was the highest among the six genes. CONCLUSION The lys2 is the most appropriate genetic marker with high resolution for identifying isolates of the genus Fusarium among the six genes we examined in this study.
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Affiliation(s)
- Maiko Watanabe
- Division of Microbiology, National Institute of Health Sciences, Tokyo, Japan.
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Muhammed M, Coleman JJ, Carneiro HA, Mylonakis E. The challenge of managing fusariosis. Virulence 2011; 2:91-6. [PMID: 21304267 DOI: 10.4161/viru.2.2.15015] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Fusarium is the second most frequent mold involved in fungal infections and is particularly important among immunocompromised patients. Culture methods and microscopy are still routinely used in clinical laboratories to identify Fusarium spp, and more sophisticated, timely, and effective methods for detecting Fusarium spp. in laboratory samples could improve the outcome of the patient. These investigational diagnostic approaches include serological assays and specific nested PCR assays that can yield positive and negative predictive values of over 90%. Other assays in development, such as mass spectroscopy techniques, can provide accurate and consistent results. The treatment of fusariosis in immunocompromised patients remains a challenge and the prognosis of systemic fusariosis in this population remains poor. Successful treatment is highly dependent on the particular Fusarium species involved in the infection. High dose intravenous amphotericin B formulation is recommended as the first line of therapy in management of fusariosis in patients. Voriconazole is also effective in treating fusariosis. Intolerance, contraindication, or failure of the amphotericin B formulation warrants the use of voriconazole as an alternative agent, and posaconazole is licensed as salvage therapy against invasive fusariosis. Adjunctive therapies such as surgical debridement of infected tissue, granulocyte colony stimulating factor (G-CSF) or granulocyte-macrophage colony stimulating factor (GM-CSF) infusions, or granulocyte transfusions are also tools for managing fusariosis. In conclusion, Fusarium infection is considered an emerging problem and should be suspected in immunocompromised patients experiencing systemic infection and should be treated accordingly.
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Affiliation(s)
- Maged Muhammed
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA
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Fusarium sacchari: A Cause of Exogenous Fungal Endophthalmitis: First Case Report and Review of Literature. Mycopathologia 2010; 171:431-4. [DOI: 10.1007/s11046-010-9374-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2010] [Accepted: 10/06/2010] [Indexed: 10/18/2022]
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O'Donnell K, Sutton DA, Rinaldi MG, Sarver BAJ, Balajee SA, Schroers HJ, Summerbell RC, Robert VARG, Crous PW, Zhang N, Aoki T, Jung K, Park J, Lee YH, Kang S, Park B, Geiser DM. Internet-accessible DNA sequence database for identifying fusaria from human and animal infections. J Clin Microbiol 2010; 48:3708-18. [PMID: 20686083 PMCID: PMC2953079 DOI: 10.1128/jcm.00989-10] [Citation(s) in RCA: 317] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2010] [Revised: 07/01/2010] [Accepted: 07/27/2010] [Indexed: 12/25/2022] Open
Abstract
Because less than one-third of clinically relevant fusaria can be accurately identified to species level using phenotypic data (i.e., morphological species recognition), we constructed a three-locus DNA sequence database to facilitate molecular identification of the 69 Fusarium species associated with human or animal mycoses encountered in clinical microbiology laboratories. The database comprises partial sequences from three nuclear genes: translation elongation factor 1α (EF-1α), the largest subunit of RNA polymerase (RPB1), and the second largest subunit of RNA polymerase (RPB2). These three gene fragments can be amplified by PCR and sequenced using primers that are conserved across the phylogenetic breadth of Fusarium. Phylogenetic analyses of the combined data set reveal that, with the exception of two monotypic lineages, all clinically relevant fusaria are nested in one of eight variously sized and strongly supported species complexes. The monophyletic lineages have been named informally to facilitate communication of an isolate's clade membership and genetic diversity. To identify isolates to the species included within the database, partial DNA sequence data from one or more of the three genes can be used as a BLAST query against the database which is Web accessible at FUSARIUM-ID (http://isolate.fusariumdb.org) and the Centraalbureau voor Schimmelcultures (CBS-KNAW) Fungal Biodiversity Center (http://www.cbs.knaw.nl/fusarium). Alternatively, isolates can be identified via phylogenetic analysis by adding sequences of unknowns to the DNA sequence alignment, which can be downloaded from the two aforementioned websites. The utility of this database should increase significantly as members of the clinical microbiology community deposit in internationally accessible culture collections (e.g., CBS-KNAW or the Fusarium Research Center) cultures of novel mycosis-associated fusaria, along with associated, corrected sequence chromatograms and data, so that the sequence results can be verified and isolates are made available for future study.
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Affiliation(s)
- Kerry O'Donnell
- Bacterial Foodborne Pathogens and Mycology Research Unit, National Center for Agricultural Utilization Research, Agricultural Research Service, United States Department of Agriculture, Peoria, IL 61604-3999, USA.
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Riddell J, Woodside KJ, Leavitt MA, Newton DW, Punch JD. Fusarium incarnatum/equiseti hemodialysis graft infection. Infect Dis Rep 2010; 2:e14. [PMID: 24470894 PMCID: PMC3892584 DOI: 10.4081/idr.2010.e14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2010] [Revised: 09/17/2010] [Accepted: 09/17/2010] [Indexed: 11/23/2022] Open
Abstract
Hemodialysis graft infections typically occur as a result of contamination by skin flora at the time of insertion or become secondarily infected after high-grade bacteremia. Infection of implanted vascular devices with filamentous fungi is rare. We report a case of infection of an implanted polytetrafluoroethylene dialysis graft with Fusarium incarnatum/equiseti that did not grow in cultures of tissue but was identified by molecular means.
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Affiliation(s)
- James Riddell
- Department of Internal Medicine, Division of Infectious Diseases
| | - Kenneth J Woodside
- Department of Surgery, Division of Transplantation, ; Current address: Department of Surgery, Division of Transplant and Hepatobiliary Surgery, University Hospitals, Case Medical Center
| | | | - Duane W Newton
- Department of Pathology, Clinical Microbiology Laboratory, University of Michigan Medical School, Michigan, USA
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Molecular phylogenetic diversity of dermatologic and other human pathogenic fusarial isolates from hospitals in northern and central Italy. J Clin Microbiol 2010; 48:1076-84. [PMID: 20107100 DOI: 10.1128/jcm.01765-09] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Fifty-eight fusaria isolated from 50 Italian patients between 2004 and 2007 were subject to multilocus DNA sequence typing to characterize the spectrum of species and circulating sequence types (STs) associated with dermatological infections, especially onychomycoses and paronychia, and other fusarioses in northern and central Italy. Sequence typing revealed that the isolates were nearly evenly divided among the Fusarium solani species complex (FSSC; n = 18), the F. oxysporum species complex (FOSC; n = 20), and the Gibberella (Fusarium) fujikuroi species complex (GFSC; n = 20). The three-locus typing scheme used for members of the FSSC identified 18 novel STs distributed among six phylogenetically distinct species, yielding an index of discrimination of 1.0. Phylogenetic analysis of the FOSC two-locus data set identified nine STs, including four which were novel, and nine isolates of ST 33, the previously described widespread clonal lineage. With the inclusion of eight epidemiologically unrelated ST 33 isolates, the FOSC typing scheme scored a discrimination index of 0.787. The two-locus GFSC typing scheme, which was primarily designed to identify species, received the lowest discrimination index, with a score of 0.492. The GFSC scheme, however, was used to successfully identify 17 isolates as F. verticillioides, 2 as F. sacchari, and 1 as F. guttiforme. This is the first report that F. guttiforme causes a human mycotic infection, which was supported by detailed morphological analysis. In addition, the results of a pathogenicity experiment revealed that the human isolate of F. guttiforme was able to induce fusariosis of pineapple, heretofore its only known host.
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Novel multilocus sequence typing scheme reveals high genetic diversity of human pathogenic members of the Fusarium incarnatum-F. equiseti and F. chlamydosporum species complexes within the United States. J Clin Microbiol 2009; 47:3851-61. [PMID: 19828752 DOI: 10.1128/jcm.01616-09] [Citation(s) in RCA: 153] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Species limits within the clinically important Fusarium incarnatum-F. equiseti and F. chlamydosporum species complexes (FIESC and FCSC, respectively) were investigated using multilocus DNA sequence data. Maximum-parsimony and maximum-likelihood analyses of aligned DNA sequences from four loci resolved 28 species within the FIESC, within which the species were evenly divided among two clades designated Incarnatum and Equiseti, and four species within the FCSC. Sequence data from a fifth locus, beta-tubulin, was excluded from the study due to the presence of highly divergent paralogs or xenologs. The multilocus haplotype nomenclature adopted in a previous study (K. O'Donnell, D. A. Sutton, A. Fothergill, D. McCarthy, M. G. Rinaldi, M. E. Brandt, N. Zhang, and D. M. Geiser, J. Clin. Microbiol. 46:2477-2490, 2008) was expanded to all of the species within the FIESC and FCSC to provide the first DNA sequence-based typing schemes for these fusaria, thereby facilitating future epidemiological investigations. Multilocus DNA typing identified sixty-two sequence types (STs) among 88 FIESC isolates and 20 STs among 26 FCSC isolates. This result corresponds to indices of discrimination of 0.985 and 0.966, respectively, for the FIESC and FCSC four-locus typing scheme using Simpson's index of discrimination. Lastly, four human and two veterinary isolates, received as members of the FIESC or FCSC, were resolved as five phylogenetically distinct species nested outside these species complexes. To our knowledge, these five species heretofore have not been reported to cause mycotic infections (i.e., F. armeniacum, F. brachygibbosum, F. flocciferum, and two unnamed Fusarium species within the F. tricinctum species complex).
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