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Hamada N, Okawa S, Ishiga M, Yuzurio S, Suwaki T, Yaguchi T, Kimura G, Tanimoto Y. An immunocompetent case of chronic pulmonary aspergillosis caused by Aspergillusviridinutans. Respir Investig 2024; 62:164-166. [PMID: 38141529 DOI: 10.1016/j.resinv.2023.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 09/08/2023] [Accepted: 11/22/2023] [Indexed: 12/25/2023]
Abstract
We encountered an extremely rare immunocompetent case of chronic pulmonary aspergillosis (CPA) caused by Aspergillus viridinutans. A 74-year-old woman was admitted with fever and hemoptysis. Chest computed tomography revealed a nodule in the left upper lobe. Bronchoscopy was performed, and the transbronchial biopsy specimen revealed Aspergillus fungi. Treatment of the nodule was initially ineffective with voriconazole but effective with liposomal amphotericin B. The causative organism was later identified as A. viridinutans based on the gene sequence of β-tubulin. This is the first immunocompetent case of CPA caused by A. viridinutans.
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Affiliation(s)
- Noboru Hamada
- Department of Respiratory Medicine, Okayama City Hospital, 3-20-1, Kitanagaseomote-cho, Kita-Ku, Okayama, 700-8557, Japan.
| | - Sachi Okawa
- Department of Respiratory Medicine, Okayama City Hospital, 3-20-1, Kitanagaseomote-cho, Kita-Ku, Okayama, 700-8557, Japan
| | - Mitsunori Ishiga
- Department of Allergy and Respiratory Medicine, National Hospital Organization, Minami Okayama Medical Center, 4066 Hayashima, Hayashima-cho Tsukubo-gun, Okayama, 701-0304, Japan
| | - Shouta Yuzurio
- Department of Respiratory Medicine, Okayama City Hospital, 3-20-1, Kitanagaseomote-cho, Kita-Ku, Okayama, 700-8557, Japan
| | - Toshimitsu Suwaki
- Department of Respiratory Medicine, Okayama City Hospital, 3-20-1, Kitanagaseomote-cho, Kita-Ku, Okayama, 700-8557, Japan
| | - Takashi Yaguchi
- Medical Mycology Research Center, Chiba Unioversity, 1-8-1, Inohana, Cyuou-Ku, Chiba-City, Chiba, 260-8673, Japan
| | - Goro Kimura
- Department of Allergy and Respiratory Medicine, National Hospital Organization, Minami Okayama Medical Center, 4066 Hayashima, Hayashima-cho Tsukubo-gun, Okayama, 701-0304, Japan
| | - Yasushi Tanimoto
- Department of Allergy and Respiratory Medicine, National Hospital Organization, Minami Okayama Medical Center, 4066 Hayashima, Hayashima-cho Tsukubo-gun, Okayama, 701-0304, Japan
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Majima H, Arai T, Kamei K, Watanabe A. In vivo efficacy of pitavastatin combined with itraconazole against Aspergillus fumigatus in silkworm models. Microbiol Spectr 2023; 11:e0266623. [PMID: 37655910 PMCID: PMC10581172 DOI: 10.1128/spectrum.02666-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 07/06/2023] [Indexed: 09/02/2023] Open
Abstract
Azole resistance in Aspergillus fumigatus is a worldwide concern and new antifungal drugs are required to overcome this problem. Statin, a 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitor, has been reported to suppress the growth of A. fumigatus, but little is known about its in vivo antifungal effect against A. fumigatus. In this study, we evaluated the in vivo efficacy of pitavastatin (PIT) combined with itraconazole (ITC) against azole-susceptible and azole-resistant strains with silkworm models. Prolongation of survival was confirmed in the combination-therapy (PIT and ITC) group compared to the no-treatment group in both azole-susceptible and azole-resistant strain models. Furthermore, when the azole-susceptible strain was used, the combination-therapy resulted in a higher survival rate than with ITC alone. Histopathological analysis of the silkworms revealed a reduction of the hyphal amount in both azole-susceptible and azole-resistant strain models. Quantitative evaluation of fungal DNA by qPCR in azole-susceptible strain models clarified the reduction of fungal burden in the combination-therapy group compared with the no-treatment group and ITC-alone group. These results indicate that the efficacy of PIT was enhanced when combined with ITC in vivo. As opposed to most statins, PIT has little drug-drug interaction with azoles in humans and can be used safely with ITC. This combination therapy may be a promising option as an effective treatment in clinical settings in the future. IMPORTANCE Azole resistance among A. fumigatus isolates has recently been increasingly recognized as a cause of treatment failure, and alternative antifungal therapies are required to overcome this problem. Our study shows the in vivo efficacy of PIT combined with ITC against A. fumigatus using silkworm models by several methods including evaluation of survival rates, histopathological analysis, and assessment of fungal burden. Contrary to most statins, PIT can be safely administered with azoles because of less drug-drug interactions, so this study should help us to verify how to make use of the drug in clinical settings in the future.
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Affiliation(s)
- Hidetaka Majima
- Division of Clinical Research, Medical Mycology Research Center, Chiba University, Chiba, Japan
| | - Teppei Arai
- Division of Clinical Research, Medical Mycology Research Center, Chiba University, Chiba, Japan
| | - Katsuhiko Kamei
- Department of Infectious Disease, Japanese Red Cross Ishinomaki Hospital, Ishinomaki, Japan
- Division of Infection Control and Prevention, Medical Mycology Research Center, Chiba University, Chiba, Japan
| | - Akira Watanabe
- Division of Clinical Research, Medical Mycology Research Center, Chiba University, Chiba, Japan
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Dhabaan G, Kus J, Kumar D, Humar A, Husain S, Mazzulli T. Molecular identification of Aspergillus fumigatus complex from lung transplant recipients using multilocus sequencing analysis (MLSA). JOURNAL OF THE ASSOCIATION OF MEDICAL MICROBIOLOGY AND INFECTIOUS DISEASE CANADA = JOURNAL OFFICIEL DE L'ASSOCIATION POUR LA MICROBIOLOGIE MEDICALE ET L'INFECTIOLOGIE CANADA 2022; 7:54-63. [PMID: 36340850 PMCID: PMC9603012 DOI: 10.3138/jammi-2021-0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 10/20/2021] [Accepted: 10/30/2021] [Indexed: 06/16/2023]
Abstract
BACKGROUND Aspergillus infection causes significant morbidity and mortality among lung transplant recipients (LTRs). It is primarily caused by Aspergillus fumigatus. Other closely related species belonging to the section Fumigati have also been found. These cryptic species are often misidentified as A. fumigatus. Thus, we used multilocus sequencing analysis (MLSA) of the calmodulin, β-tubulin, and hydrophobin gene sequences to identify these species and to determine the frequency with which they occur among LTRs. METHODS A total of 81 A. fumigatus isolates were initially isolated from bronchoalveolar lavage fluid or sputum specimens collected from lung transplant patients. These isolates were then sub-cultured and genotyped using MLSA. Of these isolates, 53, 17, and 11 were isolated from double LTRs, single LTRs, and pre-LTRs, respectively. RESULTS All isolates (100%) carried DNA sequences identical to those of A. fumigatus reference strains and thus clustered in the same clade with A. fumigatus. Analysis of the MLSA data revealed that A. fumigatus species were the only species recovered in this population of LTRs. The MLSA results were consistent with those routinely obtained by conventional mycological procedures in the microbiology laboratory. CONCLUSIONS A. fumigatus appears to be the primary causative agent of colonization or invasive aspergillosis among LTRs. No cryptic species were identified.
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Affiliation(s)
- Ghulam Dhabaan
- Department of Microbiology, Sinai Health System/University Health Network, Toronto, Ontario, Canada
- Division of Infectious Diseases, University Health Network, University of Toronto, Toronto, Ontario, Canada
- Public Health of Ontario Laboratory, Toronto, Ontario, Canada
| | - Julianne Kus
- Public Health of Ontario Laboratory, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Deepali Kumar
- Division of Infectious Diseases, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Atul Humar
- Division of Infectious Diseases, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Shahid Husain
- Division of Infectious Diseases, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Tony Mazzulli
- Department of Microbiology, Sinai Health System/University Health Network, Toronto, Ontario, Canada
- Public Health of Ontario Laboratory, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
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Molina-Hernandez JB, Laika J, Peralta-Ruiz Y, Palivala VK, Tappi S, Cappelli F, Ricci A, Neri L, Chaves-López C. Influence of Atmospheric Cold Plasma Exposure on Naturally Present Fungal Spores and Physicochemical Characteristics of Sundried Tomatoes ( Solanum lycopersicum L.). Foods 2022; 11:210. [PMID: 35053942 PMCID: PMC8774998 DOI: 10.3390/foods11020210] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 12/31/2021] [Accepted: 01/02/2022] [Indexed: 01/27/2023] Open
Abstract
This research aimed to evaluate the impact of atmospheric cold plasma (ACP) treatment on the fungal spores naturally present in sundried tomatoes, as well as their influence on the physico-chemical properties and antioxidant activity. ACP was performed with a Surface Dielectric Barrier Discharge (SDBD), applying 6 kV at 23 kHz and exposure times up to 30 min. The results showed a significant reduction of mesophilic aerobic bacteria population and of filamentous fungi after the longer ACP exposure. In particular, the effect of the treatment was assessed on Aspergillus rugulovalvus (as sensible strain) and Aspergillus niger (as resistant strain). The germination of the spores was observed to be reliant on the species, with nearly 88% and 32% of non-germinated spores for A. rugulovalvus and A. niger, respectively. Fluorescence probes revealed that ACP affects spore viability promoting strong damage to the wall and cellular membrane. For the first time, the sporicidal effect of ACP against A. rugulovalvus is reported. Physicochemical parameters of sundried tomatoes such as pH and water activity (aw) were not affected by the ACP treatment; on the contrary, the antioxidant activity was not affected while the lycopene content was significantly increased with the increase in ACP exposure time (p ≤ 0.05) probably due to increased extractability.
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Affiliation(s)
- Junior Bernardo Molina-Hernandez
- Faculty of Bioscience and Technology for Food, Agriculture and Environment, University of Teramo, Via R. Balzarini 1, 64100 Teramo, Italy; (J.B.M.-H.); (J.L.); (Y.P.-R.); (V.K.P.); (A.R.); (L.N.)
| | - Jessica Laika
- Faculty of Bioscience and Technology for Food, Agriculture and Environment, University of Teramo, Via R. Balzarini 1, 64100 Teramo, Italy; (J.B.M.-H.); (J.L.); (Y.P.-R.); (V.K.P.); (A.R.); (L.N.)
| | - Yeimmy Peralta-Ruiz
- Faculty of Bioscience and Technology for Food, Agriculture and Environment, University of Teramo, Via R. Balzarini 1, 64100 Teramo, Italy; (J.B.M.-H.); (J.L.); (Y.P.-R.); (V.K.P.); (A.R.); (L.N.)
- Programa de Ingeniería Agroindustrial, Facultad de Ingeniería, Universidad del Atlántico, Carrera 30 Número 8-49, Puerto Colombia 081008, Colombia
| | - Vinay Kumar Palivala
- Faculty of Bioscience and Technology for Food, Agriculture and Environment, University of Teramo, Via R. Balzarini 1, 64100 Teramo, Italy; (J.B.M.-H.); (J.L.); (Y.P.-R.); (V.K.P.); (A.R.); (L.N.)
| | - Silvia Tappi
- Department of Agricultural and Food Sciences, University of Bologna, 47521 Cesena, Italy;
- Inter-Departmental Centre for Agri-Food Industrial Research, University of Bologna, Via Quinto Bucci 336, 47521 Cesena, Italy
| | | | - Antonella Ricci
- Faculty of Bioscience and Technology for Food, Agriculture and Environment, University of Teramo, Via R. Balzarini 1, 64100 Teramo, Italy; (J.B.M.-H.); (J.L.); (Y.P.-R.); (V.K.P.); (A.R.); (L.N.)
| | - Lilia Neri
- Faculty of Bioscience and Technology for Food, Agriculture and Environment, University of Teramo, Via R. Balzarini 1, 64100 Teramo, Italy; (J.B.M.-H.); (J.L.); (Y.P.-R.); (V.K.P.); (A.R.); (L.N.)
| | - Clemencia Chaves-López
- Faculty of Bioscience and Technology for Food, Agriculture and Environment, University of Teramo, Via R. Balzarini 1, 64100 Teramo, Italy; (J.B.M.-H.); (J.L.); (Y.P.-R.); (V.K.P.); (A.R.); (L.N.)
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Non- fumigatus Aspergillus infection associated with a negative Aspergillus precipitin test in patients with chronic pulmonary aspergillosis. J Clin Microbiol 2021; 60:e0201821. [PMID: 34878803 PMCID: PMC8849204 DOI: 10.1128/jcm.02018-21] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Aspergillus antibody testing is key for the clinical diagnosis of chronic pulmonary aspergillosis (CPA) with high sensitivity. However, false-negative results in patients with CPA might be obtained, depending on the Aspergillus species. The aim of this study was to investigate which factors are associated with false-negative results in Aspergillus precipitin tests and whether the sensitivity of precipitin tests in CPA is influenced by Aspergillus fumigatus and non-fumigatus Aspergillus species. Between February 2012 and December 2020, 116 consecutive antifungal treatment-naïve patients with CPA were identified and included in this retrospective chart review. Aspergillus species isolated from the respiratory tract of patients were identified by DNA sequencing. Characteristics of patients with positive and negative results for Aspergillus precipitin tests were compared. The sensitivity of the Aspergillus precipitin tests was compared between patients with A. fumigatus-associated CPA and non-fumigatus Aspergillus-associated CPA. A non-fumigatus Aspergillus species was the only factor significantly associated with negative Aspergillus precipitin test results in patients with CPA in the multivariate analysis (hazard ratio: 8.3, 95% confidence interval: 3.2-22.1, p < 0.0001). The positivity of the Aspergillus precipitin test in patients with non-fumigatus Aspergillus-associated CPA was lower than that in patients with A. fumigatus-associated CPA (84.8% vs. 37.9%; p < 0.0001). These results revealed that the presence of non-fumigatus Aspergillus-associated CPA should be considered with a negative Aspergillus precipitin test; this finding may prevent diagnostic delay or misdiagnosis for CPA.
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Watanabe K, Yaguchi T, Hirose D. Ubiquitous Distribution of Azole-Resistant Aspergillus fumigatus- Related Species in Outdoor Environments in Japan. Med Mycol J 2021; 62:71-78. [PMID: 34853253 DOI: 10.3314/mmj.21-00014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Aspergillus fumigatus-related species are responsible for causing aspergillosis, which is a fatal infectious disease. Recently, there has been a series of reports of A. fumigatus-related species that are resistant to azole drugs used in clinical practice for the treatment of fungal infections. Some of these species have been isolated from outdoor environments. Testing the drug susceptibility of the strains from outdoor environments, therefore, is important. In this study, we isolated and cultured 72 strains of A. fumigatus-related species from the outdoor environment in Japan. The isolates identified via morphological observation and molecular phylogenetic analysis were Aspergillus felis, Aspergillus lentulus, Aspergillus pseudoviridinutans, Aspergillus udagawae, and Aspergillus wyomingensis. The results of the drug susceptibility testing revealed that A. felis (6 of 14 strains) and A. pseudoviridinutans (13 of 17 strains) were resistant to itraconazole (ITCZ), with 4 mg/L or higher minimum inhibitory concentrations (MICs). The voriconazole (VRCZ)-resistant strains with 4 mg/L or higher MICs were A. felis (14 of 14), A. lentulus (4 of 4), A. pseudoviridinutans (15 of 17), A. udagawae (23 of 34), A. wyomingensis (1 of 3), and A. pseudoviridinutans (1 of 3). Among them, A. felis (1 of 14) and A. pseudoviridinutans (7 of 17) demonstrated 8 mg/L or higher MICs for ITCZ and VRCZ. These results indicate that A. fumigatus-related species resistant to ITCZ and VRCZ are widely distributed in outdoor environments in Japan.
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Takeda K, Suzuki J, Watanabe A, Sekiguchi R, Sano T, Watanabe M, Narumoto O, Kawashima M, Fukami T, Sasaki Y, Tamura A, Nagai H, Matsui H, Kamei K. The accuracy and clinical impact of the morphological identification of Aspergillus species in the age of cryptic species: A single-centre study. Mycoses 2021; 65:164-170. [PMID: 34783396 DOI: 10.1111/myc.13397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/10/2021] [Accepted: 11/11/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Aspergillus spp. is identified morphologically without antifungal susceptibility tests (ASTs) in most clinical laboratories. The aim of this study was to examine the clinical impact of the morphological identification of Aspergillus spp. to ensure the adequate clinical management of Aspergillus infections. PATIENTS/METHODS Aspergillus isolates (n = 126) from distinct antifungal treatment-naïve patients with aspergillosis were first identified morphologically, followed by species-level identification via DNA sequencing. An AST for itraconazole (ITC) and voriconazole (VRC) was performed on each Aspergillus isolate. RESULTS Based on the genetic test results, morphology-based identification was accurate for >95% of the isolates at the species sensu lato level although the test concordance of Aspergillus spp. with low detection rates was low. The rates of cryptic species were found to be 1.2% among the isolates of A. fumigatus complex and 96.8% in the A. niger complex. Cryptic species with lower susceptibilities to antifungal drugs than sensu stricto species among the same Aspergillus section were as follows: The A. lentulus (n = 1) isolates had low susceptibilities to azoles among the A. fumigatus complex species (n = 86), and A. tubingensis isolates (n = 18) exhibited lower susceptibility to azoles among the A. niger complex species (n = 31). CONCLUSION Diagnostic accuracy was high at the A. fumigatus and A. niger complex level. However, in the presence of cryptic species, a solely morphological identification was insufficient. Particularly, ITC and VRC might be inappropriate for aspergillosis treatment when the A. niger complex is identified morphologically because it is possible that the Aspergillus isolate is A. tubingensis.
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Affiliation(s)
- Keita Takeda
- Center for Pulmonary Diseases, National Hospital Organization Tokyo National Hospital, Tokyo, Japan
| | - Junko Suzuki
- Center for Pulmonary Diseases, National Hospital Organization Tokyo National Hospital, Tokyo, Japan
| | - Akira Watanabe
- Division of Clinical Research, Medical Mycology Research Center, Chiba University, Chiba, Japan
| | - Ryo Sekiguchi
- Center for Pulmonary Diseases, National Hospital Organization Tokyo National Hospital, Tokyo, Japan
| | - Tomoya Sano
- Center for Pulmonary Diseases, National Hospital Organization Tokyo National Hospital, Tokyo, Japan
| | - Masato Watanabe
- Center for Pulmonary Diseases, National Hospital Organization Tokyo National Hospital, Tokyo, Japan
| | - Osamu Narumoto
- Center for Pulmonary Diseases, National Hospital Organization Tokyo National Hospital, Tokyo, Japan
| | - Masahiro Kawashima
- Center for Pulmonary Diseases, National Hospital Organization Tokyo National Hospital, Tokyo, Japan
| | - Takeshi Fukami
- Department of Thoracic Surgery, National Hospital Organization Tokyo National Hospital, Tokyo, Japan
| | - Yuka Sasaki
- Center for Pulmonary Diseases, National Hospital Organization Tokyo National Hospital, Tokyo, Japan
| | - Atsuhisa Tamura
- Center for Pulmonary Diseases, National Hospital Organization Tokyo National Hospital, Tokyo, Japan
| | - Hideaki Nagai
- Center for Pulmonary Diseases, National Hospital Organization Tokyo National Hospital, Tokyo, Japan
| | - Hirotoshi Matsui
- Center for Pulmonary Diseases, National Hospital Organization Tokyo National Hospital, Tokyo, Japan
| | - Katsuhiko Kamei
- Division of Clinical Research, Medical Mycology Research Center, Chiba University, Chiba, Japan
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Majima H, Arai T, Kusuya Y, Takahashi H, Watanabe A, Miyazaki Y, Kamei K. Genetic differences between Japan and other countries in cyp51A polymorphisms of Aspergillus fumigatus. Mycoses 2021; 64:1354-1365. [PMID: 34558115 DOI: 10.1111/myc.13370] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/15/2021] [Accepted: 09/16/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Mutations in cyp51A gene are known as main mechanisms of azole resistance in Aspergillus fumigatus, whereas azole-susceptible strains also carry cyp51A mutations (polymorphisms). The polymorphisms found in Europe mainly consist of two combinations of mutations, that is combinations of five single-nucleotide polymorphisms (SNPs) of cyp51A, referred to as cyp51A-5SNPs, and combinations of three SNPs of cyp51A, referred to as cyp51A-3SNPs. Few studies have compared the distributions of cyp51A polymorphisms between different regions. OBJECTIVES The aim of this study was to investigate the regional differences of cyp51A polymorphisms. METHODS We compared the proportions of cyp51A polymorphisms in clinical and environmental strains isolated in various countries, and analysed the strains phylogenetically using short tandem repeats (STRs) and whole-genome sequence (WGS). RESULTS Among the Japanese strains, 15 out of 98 (15.3%) clinical strains and 8 out of 95 (8.4%) environmental strains had cyp51A polymorphisms. A mutation of cyp51AN248K was the most prevalent polymorphism in both clinical (n = 14, 14.3%) and environmental strains (n = 3, 3.2%). Only one environmental strain harboured cyp51A-5SNPs, which was reported to be the most prevalent in Europe. For phylogenetic analyses using STRs and WGS, 183 and 134 strains, respectively, were employed. They showed that most of the strains with cyp51AN248K clustered in the clades different from those of the strains with cyp51A-5SNPs and cyp51A-3SNPs as well as from those with TR34 /L98H mutations. CONCLUSIONS This study suggests that there are genetic differences between cyp51A polymorphisms of A. fumigatus in Japan and Europe.
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Affiliation(s)
- Hidetaka Majima
- Division of Clinical Research, Medical Mycology Research Center, Chiba University, Chiba, Japan.,Department of Respiratory Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Teppei Arai
- Division of Clinical Research, Medical Mycology Research Center, Chiba University, Chiba, Japan
| | - Yoko Kusuya
- Division of Bioresources, Medical Mycology Research Center, Chiba University, Chiba, Japan
| | - Hiroki Takahashi
- Division of Bioresources, Medical Mycology Research Center, Chiba University, Chiba, Japan
| | - Akira Watanabe
- Division of Clinical Research, Medical Mycology Research Center, Chiba University, Chiba, Japan
| | - Yasunari Miyazaki
- Department of Respiratory Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Katsuhiko Kamei
- Division of Clinical Research, Medical Mycology Research Center, Chiba University, Chiba, Japan
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Davies G, Singh O, Prattes J, Hoenigl M, Sheppard PW, Thornton CR. Aspergillus fumigatus and Its Allergenic Ribotoxin Asp f I: Old Enemies but New Opportunities for Urine-Based Detection of Invasive Pulmonary Aspergillosis Using Lateral-Flow Technology. J Fungi (Basel) 2020; 7:19. [PMID: 33396482 PMCID: PMC7823411 DOI: 10.3390/jof7010019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/17/2020] [Accepted: 12/30/2020] [Indexed: 12/21/2022] Open
Abstract
Invasive pulmonary aspergillosis (IPA) caused by Aspergillus fumigatus is a life-threatening lung disease of immunocompromised patients. Diagnosis currently relies on non-specific chest CT, culture of the fungus from invasive lung biopsy, and detection of the cell wall carbohydrate galactomannan (GM) in serum or in BAL fluids recovered during invasive bronchoscopy. Urine provides an ideal bodily fluid for the non-invasive detection of pathogen biomarkers, with current urine-based immunodiagnostics for IPA focused on GM. Surrogate protein biomarkers might serve to improve disease detection. Here, we report the development of a monoclonal antibody (mAb), PD7, which is specific to A. fumigatus and related species in the section Fumigati, and which binds to its 18 kDa ribotoxin Asp f I. Using PD7, we show that the protein is secreted during hyphal development, and so represents an ideal candidate for detecting invasive growth. We have developed a lateral-flow device (Afu-LFD®) incorporating the mAb which has a limit of detection of ~15 ng Asp f I/mL urine. Preliminary evidence of the test's diagnostic potential is demonstrated with urine from a patient with acute lymphoid leukaemia with probable IPA. The Afu-LFD® therefore provides a potential novel opportunity for non-invasive urine-based detection of IPA caused by A. fumigatus.
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Affiliation(s)
- Genna Davies
- ISCA Diagnostics Ltd., Hatherly Laboratories, Prince of Wales Road, Exeter EX4 4PS, UK;
- Biosciences and MRC Centre for Medical Mycology, Hatherly Laboratories, University of Exeter, Prince of Wales Road, Exeter EX4 4PS, UK;
| | - Oski Singh
- Biosciences and MRC Centre for Medical Mycology, Hatherly Laboratories, University of Exeter, Prince of Wales Road, Exeter EX4 4PS, UK;
| | - Juergen Prattes
- Department of Internal Medicine, Section of Infectious Diseases and Tropical Medicine, Medical University of Graz, A-8036 Graz, Austria; (J.P.); (M.H.)
| | - Martin Hoenigl
- Department of Internal Medicine, Section of Infectious Diseases and Tropical Medicine, Medical University of Graz, A-8036 Graz, Austria; (J.P.); (M.H.)
- Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, CA 92093, USA
| | - Paul W. Sheppard
- Vacye Associates, Lowerdown Cottage, Lowerdown, Bovey Tracey TQ13 9LF, UK;
| | - Christopher R. Thornton
- ISCA Diagnostics Ltd., Hatherly Laboratories, Prince of Wales Road, Exeter EX4 4PS, UK;
- Biosciences and MRC Centre for Medical Mycology, Hatherly Laboratories, University of Exeter, Prince of Wales Road, Exeter EX4 4PS, UK;
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Arastehfar A, Lass-Flörl C, Garcia-Rubio R, Daneshnia F, Ilkit M, Boekhout T, Gabaldon T, Perlin DS. The Quiet and Underappreciated Rise of Drug-Resistant Invasive Fungal Pathogens. J Fungi (Basel) 2020; 6:E138. [PMID: 32824785 PMCID: PMC7557958 DOI: 10.3390/jof6030138] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 07/22/2020] [Accepted: 08/11/2020] [Indexed: 12/13/2022] Open
Abstract
Human fungal pathogens are attributable to a significant economic burden and mortality worldwide. Antifungal treatments, although limited in number, play a pivotal role in decreasing mortality and morbidities posed by invasive fungal infections (IFIs). However, the recent emergence of multidrug-resistant Candida auris and Candida glabrata and acquiring invasive infections due to azole-resistant C. parapsilosis, C. tropicalis, and Aspergillus spp. in azole-naïve patients pose a serious health threat considering the limited number of systemic antifungals available to treat IFIs. Although advancing for major fungal pathogens, the understanding of fungal attributes contributing to antifungal resistance is just emerging for several clinically important MDR fungal pathogens. Further complicating the matter are the distinct differences in antifungal resistance mechanisms among various fungal species in which one or more mechanisms may contribute to the resistance phenotype. In this review, we attempt to summarize the burden of antifungal resistance for selected non-albicansCandida and clinically important Aspergillus species together with their phylogenetic placement on the tree of life. Moreover, we highlight the different molecular mechanisms between antifungal tolerance and resistance, and comprehensively discuss the molecular mechanisms of antifungal resistance in a species level.
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Affiliation(s)
- Amir Arastehfar
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ 07110, USA;
| | - Cornelia Lass-Flörl
- Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, 6020 Innsbruck, Austria;
| | - Rocio Garcia-Rubio
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ 07110, USA;
| | - Farnaz Daneshnia
- Westerdijk Fungal Biodiversity Institute, 3584 CT Utrecht, The Netherlands; (F.D.); (T.B.)
| | - Macit Ilkit
- Division of Mycology, University of Çukurova, 01330 Adana, Turkey;
| | - Teun Boekhout
- Westerdijk Fungal Biodiversity Institute, 3584 CT Utrecht, The Netherlands; (F.D.); (T.B.)
- Institute of Biodiversity and Ecosystem Dynamics (IBED), University of Amsterdam, 1012 WX Amsterdam, The Netherlands
| | - Toni Gabaldon
- Life Sciences Programme, Barcelona, Supercomputing Center (BSC-CNS), Jordi Girona, 08034 Barcelona, Spain;
- Mechanisms of Disease Programme, Institute for Research in Biomedicine (IRB), 08024 Barcelona, Spain
- Institució Catalana de Recerca i Estudis Avançats (ICREA), 08010 Barcelona, Spain
| | - David S. Perlin
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ 07110, USA;
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Takeda K, Suzuki J, Watanabe A, Arai T, Koiwa T, Shinfuku K, Narumoto O, Kawashima M, Fukami T, Tamura A, Nagai H, Matsui H, Kamei K. High detection rate of azole-resistant Aspergillus fumigatus after treatment with azole antifungal drugs among patients with chronic pulmonary aspergillosis in a single hospital setting with low azole resistance. Med Mycol 2020; 59:327-334. [PMID: 32642756 DOI: 10.1093/mmy/myaa052] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 06/01/2020] [Accepted: 06/04/2020] [Indexed: 12/16/2022] Open
Abstract
The prevalence of azole-resistant Aspergillus fumigatus (ARAF) among chronic pulmonary aspergillosis (CPA) patients treated with azoles in Japan is unknown. The aim of this study was to determine the detection rate of ARAF in isolates from CPA patients who were treated with azoles for varying durations. The potential mechanism of acquiring resistance was examined by sequencing cyp51A and hmg1, two genes associated with ARAF. A. fumigatus isolates (n = 120) were collected from CPA patients (n = 104) between February 2012 and February 2019, at National Hospital Organization Tokyo National Hospital. The isolates were tested for susceptibility to the azole drugs itraconazole (ITCZ) and voriconazole (VRCZ). The detection rate of ARAF among all isolates was 8.3% (n = 10). Of the 10 resistant isolates, eight were ITCZ-resistant and five were VRCZ-resistant. Among 47 isolates obtained from 36 CPA patients who were treated with ITCZ (for an average of 256 days) and/or VRCZ (for an average of 29 days), the resistance rates were 17.0% and 10.6%, respectively. In addition, 46.2% of 13 isolates obtained from CPA patients with ongoing azole treatment at the time of antifungal therapy failure were resistant to azoles. Among the 10 ARAF isolates, a point mutation was detected in cyp51A in seven isolates and in hmg1 in two isolates. ARAF was detected at a high rate in CPA patients, particularly in those with ongoing long-term azole treatment, at the time of azole antifungal therapy failure.
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Affiliation(s)
- Keita Takeda
- Center for Pulmonary Diseases, National Hospital Organization Tokyo National Hospital, Tokyo, Japan.,Department of Basic Mycobacteriology, Graduate School of Biomedical Science, Nagasaki University, Nagasaki, Japan
| | - Junko Suzuki
- Center for Pulmonary Diseases, National Hospital Organization Tokyo National Hospital, Tokyo, Japan
| | - Akira Watanabe
- Division of Clinical Research, Medical Mycology Research Centre, Chiba University, Chiba, Japan
| | - Teppei Arai
- Division of Clinical Research, Medical Mycology Research Centre, Chiba University, Chiba, Japan
| | - Tomohiro Koiwa
- Center for Pulmonary Diseases, National Hospital Organization Tokyo National Hospital, Tokyo, Japan
| | - Kyota Shinfuku
- Center for Pulmonary Diseases, National Hospital Organization Tokyo National Hospital, Tokyo, Japan
| | - Osamu Narumoto
- Center for Pulmonary Diseases, National Hospital Organization Tokyo National Hospital, Tokyo, Japan
| | - Masahiro Kawashima
- Center for Pulmonary Diseases, National Hospital Organization Tokyo National Hospital, Tokyo, Japan
| | - Takeshi Fukami
- Department of Thoracic Surgery, National Hospital Organization Tokyo National Hospital, Tokyo, Japan
| | - Atsuhisa Tamura
- Center for Pulmonary Diseases, National Hospital Organization Tokyo National Hospital, Tokyo, Japan
| | - Hideaki Nagai
- Center for Pulmonary Diseases, National Hospital Organization Tokyo National Hospital, Tokyo, Japan
| | - Hirotoshi Matsui
- Center for Pulmonary Diseases, National Hospital Organization Tokyo National Hospital, Tokyo, Japan
| | - Katsuhiko Kamei
- Division of Clinical Research, Medical Mycology Research Centre, Chiba University, Chiba, Japan
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12
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Mohamadnia A, Salehi Z, Namvar Z, Tabarsi P, Pourabdollah-Toutkaboni M, Rezaie S, Marjani M, Moniri A, Abtahian Z, Mahdaviani SA, Mortezaee V, Askari E, Sharifynia S. Molecular identification, phylogenetic analysis and antifungal susceptibility patterns of Aspergillusnidulans complex and Aspergillusterreus complex isolated from clinical specimens. J Mycol Med 2020; 30:101004. [PMID: 32534826 DOI: 10.1016/j.mycmed.2020.101004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 03/15/2020] [Accepted: 05/26/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Aspergillus sections Terrei and Nidulantes are the less common causes of invasive aspergillosis and pulmonary aspergillosis (PA) in immunocompromised patients when compared to A. fumigatus and A. flavus. Identifying these fungi as the infectious agent is crucial because of the resistance to amphotericin B (AMB) and increased lethality. The aim of this study was to identify the molecular status, evaluate the genetic diversity and examine the antifungal susceptibility profile of the uncommon Aspergillus species. Forty-five uncommon Aspergillus species were identified based on the microscopic and macroscopic criteria. Then, the molecular identification was performed using the sequencing beta tubulin (benA) gene. In vitro antifungal susceptibility to amphotericin B (AMB), itraconazole (ITC), ravuconazole (RAV), voriconazole (VRC), caspofungin (CFG) isavuconazole (ISA) and posaconazole (POS) test was performed according to the CLSI M38-A2 guidelines. RESULTS A. terreus was the most species detected, followed by A. nidulans, A. latus, A.ochraceus, and A. citrinoterreus, respectively. The analysis of the benA gene showed the presence of 12 distinct genotypes among the A. terreus isolates. The other species did not show any intraspecies variation. CFG exhibited the lowest MEC50/MIC50 (0.007μg/mL), followed by POS (0.125μg/mL), VRC, ITC, ISA (0.25μg/mL), RAV (0.5μg/mL), and AMB (8μg/mL). Among all the isolates, only 15.5% (7/45) were susceptible to AMB. CONCLUSION Antifungal susceptibility pattern of the uncommon Aspergillus species is useful to improve patient management and increase knowledge concerning the local epidemiology. Moreover, this information is necessary when an outbreak dealing with drug-resistant infections occurs.
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Affiliation(s)
- A Mohamadnia
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Z Salehi
- Department of Mycology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran 14115-331, Iran
| | - Z Namvar
- Department of Biotechnology, Animal Breeding Center, Tehran, Iran
| | - P Tabarsi
- Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - M Pourabdollah-Toutkaboni
- Pediatric Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - S Rezaie
- Division of Molecular Biology, Department of Medical Mycology and Parasitology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - M Marjani
- Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - A Moniri
- Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Z Abtahian
- Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - S A Mahdaviani
- Pediatric Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - V Mortezaee
- Department of Medical mycology, Mazandaran University of Medical Sciences, Sari, Iran
| | - E Askari
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - S Sharifynia
- Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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13
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Yagi K, Ushikubo M, Maeshima A, Konishi M, Fujimoto K, Tsukamoto M, Araki K, Kamei K, Oyamada Y, Oshima H. Invasive pulmonary aspergillosis due to Aspergillus lentulus in an adult patient: A case report and literature review. J Infect Chemother 2019; 25:547-551. [PMID: 30824299 DOI: 10.1016/j.jiac.2019.02.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 01/28/2019] [Accepted: 02/05/2019] [Indexed: 11/24/2022]
Abstract
Aspergillus fumigatus is the commonest cause of pulmonary aspergillosis; however, a recently developed molecular genetic technique identified A. lentulus as a sibling species. Most of the isolates were found in solid organ recipients, often associated with a fatal outcome. Moreover, there is concern that A. lentulus has low susceptibility to multiple antifungal agents. Herein, we report an adult immunocompromised patient with proven invasive pulmonary aspergillosis (IPA) caused by A. lentulus, which was identified through molecular genetic analysis. The patient was diagnosed with IPA by bronchoscopy 3 weeks after initiating systemic corticosteroid therapy for anti-neutrophil cytoplasmic antibody-associated vasculitis. The clinical course of IPA due to A. lentulus showed improvement after treatment with the antifungal agent voriconazole. In summary, we report an adult immunocompromised patient without a history of transplantation who was diagnosed with IPA due to A. lentulus successfully treated with voriconazole, and we also report the findings of a literature review on IPA caused by A. lentulus.
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Affiliation(s)
- Kazuma Yagi
- Department of Respiratory Medicine, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.
| | - Mari Ushikubo
- Department of Connective Tissue Diseases, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Arafumi Maeshima
- Department of Pathology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Misako Konishi
- Department of Connective Tissue Diseases, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Kazuyuki Fujimoto
- Department of Respiratory Medicine, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Masako Tsukamoto
- Department of Connective Tissue Diseases, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Kazuhiro Araki
- Department of Connective Tissue Diseases, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Katsuhiko Kamei
- Division of Infectious Diseases, Medical Mycology Research Center, Chiba University, Chiba, Japan
| | - Yoshitaka Oyamada
- Department of Respiratory Medicine, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Hisaji Oshima
- Department of Connective Tissue Diseases, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
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14
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Hubka V, Barrs V, Dudová Z, Sklenář F, Kubátová A, Matsuzawa T, Yaguchi T, Horie Y, Nováková A, Frisvad J, Talbot J, Kolařík M. Unravelling species boundaries in the Aspergillus viridinutans complex (section Fumigati): opportunistic human and animal pathogens capable of interspecific hybridization. PERSOONIA 2018; 41:142-174. [PMID: 30728603 PMCID: PMC6344812 DOI: 10.3767/persoonia.2018.41.08] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 03/14/2018] [Indexed: 12/13/2022]
Abstract
Although Aspergillus fumigatus is the major agent of invasive aspergillosis, an increasing number of infections are caused by its cryptic species, especially A. lentulus and the A. viridinutans species complex (AVSC). Their identification is clinically relevant because of antifungal drug resistance and refractory infections. Species boundaries in the AVSC are unresolved since most species have uniform morphology and produce interspecific hybrids in vitro. Clinical and environmental strains from six continents (n = 110) were characterized by DNA sequencing of four to six loci. Biological compatibilities were tested within and between major phylogenetic clades, and ascospore morphology was characterised. Species delimitation methods based on the multispecies coalescent model (MSC) supported recognition of ten species including one new species. Four species are confirmed opportunistic pathogens; A. udagawae followed by A. felis and A. pseudoviridinutans are known from opportunistic human infections, while A. felis followed by A. udagawae and A. wyomingensis are agents of feline sino-orbital aspergillosis. Recently described human-pathogenic species A. parafelis and A. pseudofelis are synonymized with A. felis and an epitype is designated for A. udagawae. Intraspecific mating assay showed that only a few of the heterothallic species can readily generate sexual morphs in vitro. Interspecific mating assays revealed that five different species combinations were biologically compatible. Hybrid ascospores had atypical surface ornamentation and significantly different dimensions compared to parental species. This suggests that species limits in the AVSC are maintained by both pre- and post-zygotic barriers and these species display a great potential for rapid adaptation and modulation of virulence. This study highlights that a sufficient number of strains representing genetic diversity within a species is essential for meaningful species boundaries delimitation in cryptic species complexes. MSC-based delimitation methods are robust and suitable tools for evaluation of boundaries between these species.
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Affiliation(s)
- V. Hubka
- Department of Botany, Faculty of Science, Charles University, Benátská 2, 128 01 Prague 2, Czech Republic
- Laboratory of Fungal Genetics and Metabolism, Institute of Microbiology of the CAS, v.v.i, Vídeňská 1083, 142 20 Prague 4, Czech Republic
- First Faculty of Medicine, Charles University, Kateřinská 32, 121 08 Prague 2, Czech Republic
| | - V. Barrs
- Sydney School of Veterinary Science, Faculty of Science, and Marie Bashir Institute of Infectious Diseases & Biosecurity, University of Sydney, Camperdown, NSW, Australia
| | - Z. Dudová
- Department of Botany, Faculty of Science, Charles University, Benátská 2, 128 01 Prague 2, Czech Republic
- First Faculty of Medicine, Charles University, Kateřinská 32, 121 08 Prague 2, Czech Republic
| | - F. Sklenář
- Department of Botany, Faculty of Science, Charles University, Benátská 2, 128 01 Prague 2, Czech Republic
- Laboratory of Fungal Genetics and Metabolism, Institute of Microbiology of the CAS, v.v.i, Vídeňská 1083, 142 20 Prague 4, Czech Republic
| | - A. Kubátová
- Department of Botany, Faculty of Science, Charles University, Benátská 2, 128 01 Prague 2, Czech Republic
| | - T. Matsuzawa
- University of Nagasaki, 1-1-1 Manabino, Nagayo-cho, Nishi-Sonogi-gun, Nagasaki 851-2195, Japan
| | - T. Yaguchi
- Medical Mycology Research Center, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba 260-8673, Japan
| | - Y. Horie
- Medical Mycology Research Center, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba 260-8673, Japan
| | - A. Nováková
- Laboratory of Fungal Genetics and Metabolism, Institute of Microbiology of the CAS, v.v.i, Vídeňská 1083, 142 20 Prague 4, Czech Republic
| | - J.C. Frisvad
- Department of Biotechnology and Biomedicine, Technical University of Denmark, Kongens Lyngby, Denmark
| | - J.J. Talbot
- Sydney School of Veterinary Science, Faculty of Science, and Marie Bashir Institute of Infectious Diseases & Biosecurity, University of Sydney, Camperdown, NSW, Australia
| | - M. Kolařík
- Laboratory of Fungal Genetics and Metabolism, Institute of Microbiology of the CAS, v.v.i, Vídeňská 1083, 142 20 Prague 4, Czech Republic
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15
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Güngör Ö, Sampaio-Maia B, Amorim A, Araujo R, Erturan Z. Determination of Azole Resistance and TR 34/L98H Mutations in Isolates of Aspergillus Section Fumigati from Turkish Cystic Fibrosis Patients. Mycopathologia 2018; 183:913-920. [PMID: 30187246 DOI: 10.1007/s11046-018-0297-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 08/24/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND Aspergillus fumigatus is the species section Fumigati most frequently isolated from the respiratory tract of cystic fibrosis (CF) patients. Recent studies suggest that mutations in the Cyp51 gene, particularly TR34/L98H, are responsible for azole resistance. OBJECTIVES AND METHODS The focus of this study was on section Fumigati isolates isolated from the respiratory tract samples of CF patients. More specifically, the goal was to detect A. fumigatus isolates, test their antifungal susceptibility to itraconazole, voriconazole and posaconazole, and finally determine the presence of TR34/L98H and other mutations in the isolates Cyp51A gene. RESULTS AND CONCLUSIONS A set of 31 isolates of Aspergillus section Fumigati were obtained from the sputum samples of 6 CF patients and subsequently identified to species level by microsatellite genotyping. All isolates were determined as A. fumigatus and involved 14 different genotypes. The minimal inhibitory concentrations to the three azoles were determined by the E-test method, and the Cyp51A gene was sequenced. One of the genotypes was found to be resistant to all azoles but no mutations were detected in the Cyp51A gene, especially the TR34/L98H mutation. Therefore, mutations in genes other than Cyp51A or other distinct mechanisms may be responsible for this reported multiazole resistance found in a Turkish CF patient.
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Affiliation(s)
- Özge Güngör
- Istanbul Medical Faculty, Department of Medical Microbiology, Istanbul University, 34093, Capa, Istanbul, Turkey.
| | - Benedita Sampaio-Maia
- Faculty of Dental Medicine, University of Porto, Porto, Portugal
- INEB, Instituto Nacional de Engenharia Biomédica da Universidade do Porto, Porto, Portugal
- i3S, Instituto de Investigação e Inovação em Saúde da Universidade do Porto, Porto, Portugal
| | - Antonio Amorim
- i3S, Instituto de Investigação e Inovação em Saúde da Universidade do Porto, Porto, Portugal
- Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Porto, Portugal
- Faculdade de Ciências, Universidade do Porto, Porto, Portugal
| | - Ricardo Araujo
- i3S, Instituto de Investigação e Inovação em Saúde da Universidade do Porto, Porto, Portugal
- Department of Medical Biotechnology, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Zayre Erturan
- Istanbul Medical Faculty, Department of Medical Microbiology, Istanbul University, 34093, Capa, Istanbul, Turkey
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16
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Pena GA, Alonso V, Manini MV, Pellegrino M, Cavaglieri LR. Molecular characterization of Aspergillus fumigatus isolated from raw cow milk in Argentina. Int J Food Microbiol 2018; 275:1-7. [PMID: 29602047 DOI: 10.1016/j.ijfoodmicro.2018.03.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 03/14/2018] [Accepted: 03/23/2018] [Indexed: 11/15/2022]
Affiliation(s)
- Gabriela A Pena
- Departamento de Microbiología e Inmunología, Facultad de Ciencias Exactas, Físico-Químicas y Naturales, Universidad Nacional de Río Cuarto, Ruta 36 Km. 601, 5800 Río Cuarto, Córdoba, Argentina; Member of Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Rivadavia 1917, C1033AAV Buenos Aires, Argentina
| | - Verónica Alonso
- Departamento de Microbiología e Inmunología, Facultad de Ciencias Exactas, Físico-Químicas y Naturales, Universidad Nacional de Río Cuarto, Ruta 36 Km. 601, 5800 Río Cuarto, Córdoba, Argentina; Member of Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Rivadavia 1917, C1033AAV Buenos Aires, Argentina
| | - Marina Velasco Manini
- Departamento de Microbiología e Inmunología, Facultad de Ciencias Exactas, Físico-Químicas y Naturales, Universidad Nacional de Río Cuarto, Ruta 36 Km. 601, 5800 Río Cuarto, Córdoba, Argentina
| | - M Pellegrino
- Departamento de Microbiología e Inmunología, Facultad de Ciencias Exactas, Físico-Químicas y Naturales, Universidad Nacional de Río Cuarto, Ruta 36 Km. 601, 5800 Río Cuarto, Córdoba, Argentina; Member of Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Rivadavia 1917, C1033AAV Buenos Aires, Argentina
| | - Lilia R Cavaglieri
- Departamento de Microbiología e Inmunología, Facultad de Ciencias Exactas, Físico-Químicas y Naturales, Universidad Nacional de Río Cuarto, Ruta 36 Km. 601, 5800 Río Cuarto, Córdoba, Argentina; Member of Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Rivadavia 1917, C1033AAV Buenos Aires, Argentina.
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17
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Lyskova P, Hubka V, Svobodova L, Barrs V, Dhand NK, Yaguchi T, Matsuzawa T, Horie Y, Kolarik M, Dobias R, Hamal P. Antifungal Susceptibility of the Aspergillus viridinutans Complex: Comparison of Two In Vitro Methods. Antimicrob Agents Chemother 2018; 62:e01927-17. [PMID: 29437620 PMCID: PMC5913995 DOI: 10.1128/aac.01927-17] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 01/28/2018] [Indexed: 12/20/2022] Open
Abstract
Cryptic species of Aspergillus fumigatus, including the Aspergillus viridinutans species complex, are increasingly reported to be causes of invasive aspergillosis. Their identification is clinically relevant, as these species frequently have intrinsic resistance to common antifungals. We evaluated the susceptibilities of 90 environmental and clinical isolates from the A. viridinutans species complex, identified by DNA sequencing of the calmodulin gene, to seven antifungals (voriconazole, posaconazole, itraconazole, amphotericin B, anidulafungin, micafungin, and caspofungin) using the reference European Committee on Antimicrobial Susceptibility Testing (EUCAST) method. The majority of species demonstrated elevated MICs of voriconazole (geometric mean [GM] MIC, 4.46 mg/liter) and itraconazole (GM MIC, 9.85 mg/liter) and had variable susceptibility to amphotericin B (GM MIC, 2.5 mg/liter). Overall, the MICs of posaconazole and the minimum effective concentrations of echinocandins were low. The results obtained by the EUCAST method were compared with the results obtained with Sensititre YeastOne (YO) panels. Overall, there was 67% agreement (95% confidence interval [CI], 62 to 72%) between the results obtained by the EUCAST method and those obtained with YO panels when the results were read at 48 h and 82% agreement (95% CI, 78 to 86%) when the results were read at 72 h. There was a significant difference in agreement between antifungals; agreement was high for amphotericin B, voriconazole, and posaconazole (70 to 86% at 48 h and 88 to 93% at 72 h) but was very low for itraconazole (37% at 48 h and 57% at 72 h). The agreement was also variable between species, with the maximum agreement being observed for A. felis isolates (85 and 93% at 48 and 72 h, respectively). Elevated MICs of voriconazole and itraconazole were cross-correlated, but there was no correlation between the other azoles tested.
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Affiliation(s)
- Pavlina Lyskova
- Department of Microbiology, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
- Laboratory of Medical Mycology, Department of Parasitology, Mycology and Mycobacteriology Prague, Public Health Institute in Usti nad Labem, Prague, Czech Republic
| | - Vit Hubka
- Department of Botany, Faculty of Science, Charles University, Prague, Czech Republic
- Laboratory of Fungal Genetics and Metabolism, Institute of Microbiology of the CAS, Prague, Czech Republic
| | - Lucie Svobodova
- Department of Microbiology, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
| | - Vanessa Barrs
- Sydney School of Veterinary Science and Marie Bashir Institute of Infectious Diseases and Biosecurity, University of Sydney, Camperdown, New South Wales, Australia
| | - Navneet K Dhand
- Sydney School of Veterinary Science and Marie Bashir Institute of Infectious Diseases and Biosecurity, University of Sydney, Camperdown, New South Wales, Australia
| | - Takashi Yaguchi
- Medical Mycology Research Center, Chiba University, Chiba, Japan
| | | | - Yoshikazu Horie
- Medical Mycology Research Center, Chiba University, Chiba, Japan
| | - Miroslav Kolarik
- Department of Botany, Faculty of Science, Charles University, Prague, Czech Republic
- Laboratory of Fungal Genetics and Metabolism, Institute of Microbiology of the CAS, Prague, Czech Republic
| | - Radim Dobias
- Department of Microbiology, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
- Laboratory of Clinical Mycology, Institute of Public Health, Ostrava, Czech Republic
| | - Petr Hamal
- Department of Microbiology, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
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18
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Lung Abscess Due to Aspergillus lentulus and Pseudomonas aeruginosa in a Patient With Granulomatosis With Polyangiitis. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2018. [DOI: 10.1097/ipc.0000000000000536] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Toyotome T. Causative Agents of Aspergillosis Including Cryptic Aspergillus Species and A. fumigatus. Med Mycol J 2017; 57:J149-J154. [PMID: 27904060 DOI: 10.3314/mmj.16.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Aspergillosis is an important deep mycosis. The causative agents are Aspergillus fumigatus, Aspergillus flavus, Aspergillus niger, and Aspergillus terreus, of which A. fumigatus is the most prevalent. Cryptic Aspergillus spp., which morphologically resemble representative species of each Aspergillus section, also cause aspergillosis. Most of the cryptic species reveal different susceptibility patterns and/or different secondary metabolite profiles, also called exometabolome in this manuscript, from those representative species. On the other hand, azole-resistant A. fumigatus strains in clinical specimens and in the environment have been reported. Therefore, it is imperative to precisely identify the species, including cryptic Aspergillus spp., and evaluate the susceptibility of isolates.In this manuscript, some of the causative cryptic Aspergillus spp. are briefly reviewed. In addition, the exometabolome of Aspergillus section Fumigati is described. Finally, azole resistance of A. fumigatus is also discussed, in reference to several studies from Japan.
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Affiliation(s)
- Takahito Toyotome
- Obihiro University of Agriculture and Veterinary Medicine Diaghostic Center for Animal Health and Food Safety
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Giusiano GE, Piontelli E, Fernández MS, Mangiaterra ML, Cattana ME, Kocsubé S, Varga J. Biodiversity of species of Aspergillus section Fumigati in semi-desert soils in Argentina. Rev Argent Microbiol 2017; 49:247-254. [PMID: 28551307 DOI: 10.1016/j.ram.2017.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 01/23/2017] [Accepted: 02/20/2017] [Indexed: 11/19/2022] Open
Abstract
The distribution of Aspergillus species in soil has been widely studied all over the world. The aim of this study was the phenotypic and genotypic characterization of species Aspergillus belonging to section Fumigati present in soils from two Argentinian semi-desert areas having different geological conditions. Altogether, 23 isolates belonging to Aspergillus section Fumigati were recovered and identified using a polyphasic approach including phenotypic and molecular identifications. Aspergillus fumigatus sensu stricto and Aspergillus fumigatiaffinis had the highest frequency, of occurrence while isolates closely related to Aspergillus udagawae and Aspergillus felis were rarely observed. A. fumigatiaffinis and isolates closer to A. udagawae were isolated for the first time from Argentinian soils and this is the first report on the occurrence of species belonging to the A. felis clade in South America. Recent scientific interests in biodiversity, as well as the increasing importance of aspergilli as causative agents of human and animal diseases increase the need to understand the diversity and occurrence of these fungi in nature.
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Affiliation(s)
- Gustavo E Giusiano
- Universidad Nacional del Nordeste, CONICET, Instituto de Medicina Regional, Departamento de Micología, Resistencia, Chaco, Argentina.
| | - Eduardo Piontelli
- Universidad de Valparaíso, Escuela de Medicina, Cátedra de Micología, Valparaíso, Chile
| | - Mariana S Fernández
- Universidad Nacional del Nordeste, CONICET, Instituto de Medicina Regional, Departamento de Micología, Resistencia, Chaco, Argentina
| | - Magdalena L Mangiaterra
- Universidad Nacional del Nordeste, CONICET, Instituto de Medicina Regional, Departamento de Micología, Resistencia, Chaco, Argentina
| | - María E Cattana
- Universidad Nacional del Nordeste, CONICET, Instituto de Medicina Regional, Departamento de Micología, Resistencia, Chaco, Argentina
| | - Sándor Kocsubé
- Department of Microbiology, Faculty of Science and Informatics, University of Szeged, Szeged, Hungary
| | - János Varga
- Department of Microbiology, Faculty of Science and Informatics, University of Szeged, Szeged, Hungary
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Nakamura S, Sato H, Tanaka R, Kusuya Y, Takahashi H, Yaguchi T. Ribosomal subunit protein typing using matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) for the identification and discrimination of Aspergillus species. BMC Microbiol 2017; 17:100. [PMID: 28441930 PMCID: PMC5405522 DOI: 10.1186/s12866-017-1009-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 04/12/2017] [Indexed: 11/10/2022] Open
Abstract
Background Accurate identification of Aspergillus species is a very important subject. Mass spectral fingerprinting using matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) is generally employed for the rapid identification of fungal isolates. However, the results are based on simple mass spectral pattern-matching, with no peak assignment and no taxonomic input. We propose here a ribosomal subunit protein (RSP) typing technique using MALDI-TOF MS for the identification and discrimination of Aspergillus species. The results are concluded to be phylogenetic in that they reflect the molecular evolution of housekeeping RSPs. Results The amino acid sequences of RSPs of genome-sequenced strains of Aspergillus species were first verified and compared to compile a reliable biomarker list for the identification of Aspergillus species. In this process, we revealed that many amino acid sequences of RSPs (about 10–60%, depending on strain) registered in the public protein databases needed to be corrected or newly added. The verified RSPs were allocated to RSP types based on their mass. Peak assignments of RSPs of each sample strain as observed by MALDI-TOF MS were then performed to set RSP type profiles, which were then further processed by means of cluster analysis. The resulting dendrogram based on RSP types showed a relatively good concordance with the tree based on β-tubulin gene sequences. RSP typing was able to further discriminate the strains belonging to Aspergillus section Fumigati. Conclusions The RSP typing method could be applied to identify Aspergillus species, even for species within section Fumigati. The discrimination power of RSP typing appears to be comparable to conventional β-tubulin gene analysis. This method would therefore be suitable for species identification and discrimination at the strain to species level. Because RSP typing can characterize the strains within section Fumigati, this method has potential as a powerful and reliable tool in the field of clinical microbiology. Electronic supplementary material The online version of this article (doi:10.1186/s12866-017-1009-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sayaka Nakamura
- Research Institute for Sustainable Chemistry, National Institute of Advanced Industrial Science and Technology (AIST), Higashi 1-1-1, Tsukuba, Ibaraki, 305-8565, Japan
| | - Hiroaki Sato
- Research Institute for Sustainable Chemistry, National Institute of Advanced Industrial Science and Technology (AIST), Higashi 1-1-1, Tsukuba, Ibaraki, 305-8565, Japan.
| | - Reiko Tanaka
- Medical Mycology Research Center, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8673, Japan
| | - Yoko Kusuya
- Medical Mycology Research Center, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8673, Japan
| | - Hiroki Takahashi
- Medical Mycology Research Center, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8673, Japan
| | - Takashi Yaguchi
- Medical Mycology Research Center, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8673, Japan
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Tetsuka N, Yaguchi T, Machida H, Ito S, Miyairi I. Invasive pulmonary aspergillosis due to azole-resistant Aspergillus lentulus. Pediatr Int 2017; 59:362-363. [PMID: 28317305 DOI: 10.1111/ped.13193] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 10/05/2016] [Accepted: 10/17/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Nobuyuki Tetsuka
- Division of Infectious Diseases, National Center for Child Health and Development, Tokyo, Japan
| | - Takashi Yaguchi
- Medical Mycology Research Center, Chiba University, Chiba, Japan
| | - Hiroyuki Machida
- Division of Nephrology and Rheumatology, National Center for Child Health and Development, Tokyo, Japan
| | - Shuichi Ito
- Division of Nephrology and Rheumatology, National Center for Child Health and Development, Tokyo, Japan
| | - Isao Miyairi
- Division of Infectious Diseases, National Center for Child Health and Development, Tokyo, Japan
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Seki A, Yoshida A, Matsuda Y, Kawata M, Nishimura T, Tanaka J, Misawa Y, Nakano Y, Asami R, Chida K, Kikuchi K, Arai T. Fatal fungal endocarditis by Aspergillus udagawae: an emerging cause of invasive aspergillosis. Cardiovasc Pathol 2017; 28:14-17. [PMID: 28259839 DOI: 10.1016/j.carpath.2017.02.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 01/30/2017] [Accepted: 02/03/2017] [Indexed: 11/26/2022] Open
Abstract
Aspergillus udagawae has morphological similarities to Aspergillusfumigatus; however, it shows a low susceptibility to common antifungal drugs and poor in vitro sporulation. We present the first reported case of infectious endocarditis caused by A. udagawae. An awareness of this newly described Aspergillus species is vital for further clarification.
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Affiliation(s)
- Atsuko Seki
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan.
| | - Atsushi Yoshida
- Department of Infectious Diseases, Tokyo Women's Medical Hospital, Tokyo, Japan
| | - Yoko Matsuda
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Mitsuhiro Kawata
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Takashi Nishimura
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Jun Tanaka
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | | | - Yuta Nakano
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Ryoko Asami
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Koji Chida
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Ken Kikuchi
- Department of Infectious Diseases, Tokyo Women's Medical Hospital, Tokyo, Japan
| | - Tomio Arai
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
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24
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Hagiwara D, Takahashi H, Fujimoto M, Sugahara M, Misawa Y, Gonoi T, Itoyama S, Watanabe A, Kamei K. Multi-azole resistant Aspergillus fumigatus harboring Cyp51A TR46/Y121F/T289A isolated in Japan. J Infect Chemother 2016; 22:577-9. [DOI: 10.1016/j.jiac.2016.01.015] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 12/16/2015] [Accepted: 01/19/2016] [Indexed: 11/27/2022]
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Lamoth F. Aspergillus fumigatus-Related Species in Clinical Practice. Front Microbiol 2016; 7:683. [PMID: 27242710 PMCID: PMC4868848 DOI: 10.3389/fmicb.2016.00683] [Citation(s) in RCA: 92] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 04/26/2016] [Indexed: 11/13/2022] Open
Abstract
Aspergillus fumigatus is the main etiologic agent of invasive aspergillosis (IA). Other Aspergillus species belonging to the section Fumigati (A. fumigatus complex) may occasionally be the cause of IA. These strains are often misidentified, as they cannot be distinguished from A. fumigatus by conventional morphological analysis and sequencing methods. This lack of recognition may have important consequences as these A. fumigatus-related species often display some level of intrinsic resistance to azoles and other antifungal drugs. A. lentulus, A. udagawae, A. viridinutans, and A. thermomutatus (Neosartorya pseudofischeri) have been associated with refractory cases of IA. Microbiologists should be able to suspect the presence of these cryptic species behind a putative A. fumigatus isolate on the basis of some simple characteristics, such as defect in sporulation and/or unusual antifungal susceptibility profile. However, definitive species identification requires specific sequencing analyses of the beta-tubulin or calmodulin genes, which are not available in most laboratories. Multiplex PCR assays or matrix-assisted laser desorption ionization - time-of-flight mass spectrometry (MALDI-TOF MS) gave promising results for rapid and accurate distinction between A. fumigatus and other Aspergillus spp. of the section Fumigati in clinical practice. Improved diagnostic procedures and antifungal susceptibility testing may be helpful for the early detection and management of these particular IA cases.
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Affiliation(s)
- Frédéric Lamoth
- Infectious Diseases Service, Department of Medicine, and Institute of Microbiology, Lausanne University HospitalLausanne, Switzerland
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26
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Gautier M, Normand AC, L'Ollivier C, Cassagne C, Reynaud-Gaubert M, Dubus JC, Brégeon F, Hendrickx M, Gomez C, Ranque S, Piarroux R. Aspergillus tubingensis: a major filamentous fungus found in the airways of patients with lung disease. Med Mycol 2016; 54:459-70. [PMID: 26773134 DOI: 10.1093/mmy/myv118] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 12/18/2015] [Indexed: 11/13/2022] Open
Abstract
The black Aspergillus group comprises A. niger and 18 other species, which are morphologically indistinguishable. Among this species subset, A. tubingensis, described in less than 30 human cases before 2014, is primarily isolated from ear, nose, and throat samples. Recently, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry has emerged as a powerful technique to identify microbes in diagnostic settings. We applied this method to identify 1,720 filamentous fungi routinely isolated from clinical samples our laboratory over a two-year study period. Accordingly, we found 85 isolates of A. niger, 58 of A. tubingensis, and six other black Aspergillus (4 A. carbonarius and 2 A. japonicus). A. tubingensis was the fifth most frequent mold isolated in our mycology laboratory, primarily isolated from respiratory samples (40/58 isolates). In this study, we mainly aimed to describe the clinical pattern of Aspergillus tubingensisWe analyzed the clinical features of the patients in whom A. tubingensis had been isolated from 40 respiratory samples. Thirty patients suffered from cystic fibrosis, chronic obstructive pulmonary disease or other types of chronic respiratory failure. Strikingly, 20 patients were experiencing respiratory acute exacerbation at the time the sample was collected. Antifungal susceptibility testing of 36 A. tubingensis isolates showed lower amphotericin B MICs (P < 10(-4)) and higher itraconazole and voriconazole MICs (P < 10(-4) and P = .0331, respectively) compared with 36 A. niger isolates. Further studies are required to better establish the role that this fungus plays in human diseases, especially in the context of cystic fibrosis and chronic pulmonary diseases.
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Affiliation(s)
- Magali Gautier
- Parasitology and Mycology, Assistance Publique-Hôpitaux de Marseille, CHU Timone-Adultes, 13385 Marseilles CEDEX 5, France
| | - Anne-Cécile Normand
- Parasitology and Mycology, Assistance Publique-Hôpitaux de Marseille, CHU Timone-Adultes, 13385 Marseilles CEDEX 5, France
| | - Coralie L'Ollivier
- Parasitology and Mycology, Assistance Publique-Hôpitaux de Marseille, CHU Timone-Adultes, 13385 Marseilles CEDEX 5, France
| | - Carole Cassagne
- Parasitology and Mycology, Assistance Publique-Hôpitaux de Marseille, CHU Timone-Adultes, 13385 Marseilles CEDEX 5, France
| | - Martine Reynaud-Gaubert
- Department of Respiratory diseases, CF Adult Centre and Lung Transplant Team; Assistance Publique-Hôpitaux de Marseille, CHU Nord, 13015 Marseilles, France URMITE CNRS IRD UMR 6236, IHU Méditerranée Infection, Aix-Marseille University, France
| | - Jean-Christophe Dubus
- Pediatric Pulmonology and CF Centre, Assistance Publique-Hôpitaux de Marseille, CHU Timone-Enfants, 13385 Marseilles CEDEX 5, France
| | - Fabienne Brégeon
- URMITE CNRS IRD UMR 6236, IHU Méditerranée Infection, Aix-Marseille University, France Service d'Explorations Fonctionnelles Respiratoires, Assistance Publique-Hôpitaux de Marseille, CHU Nord, 13015 Marseilles, France
| | - Marijke Hendrickx
- BCCM/IHEM: Scientific Institute of Public Health, Mycology and Aerobiology Section, Brussels, Belgium
| | - Carine Gomez
- Department of Respiratory diseases, CF Adult Centre and Lung Transplant Team; Assistance Publique-Hôpitaux de Marseille, CHU Nord, 13015 Marseilles, France URMITE CNRS IRD UMR 6236, IHU Méditerranée Infection, Aix-Marseille University, France
| | - Stéphane Ranque
- Parasitology and Mycology, Assistance Publique-Hôpitaux de Marseille, CHU Timone-Adultes, 13385 Marseilles CEDEX 5, France Aix-Marseille University, UMR MD3 IP-TPT, 13885 Marseilles, France
| | - Renaud Piarroux
- Parasitology and Mycology, Assistance Publique-Hôpitaux de Marseille, CHU Timone-Adultes, 13385 Marseilles CEDEX 5, France Aix-Marseille University, UMR MD3 IP-TPT, 13885 Marseilles, France
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27
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Frisvad JC, Larsen TO. Extrolites of Aspergillus fumigatus and Other Pathogenic Species in Aspergillus Section Fumigati. Front Microbiol 2016; 6:1485. [PMID: 26779142 PMCID: PMC4703822 DOI: 10.3389/fmicb.2015.01485] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Accepted: 12/09/2015] [Indexed: 11/13/2022] Open
Abstract
Aspergillus fumigatus is an important opportunistic human pathogen known for its production of a large array of extrolites. Up to 63 species have been described in Aspergillus section Fumigati, some of which have also been reliably reported to be pathogenic, including A. felis, A. fischeri, A. fumigatiaffinis, A. fumisynnematus, A. hiratsukae, A. laciniosus, A. lentulus, A. novofumigatus, A. parafelis, A. pseudofelis, A. pseudoviridinutans, A. spinosus, A. thermomutatus, and A. udagawae. These species share the production of hydrophobins, melanins, and siderophores and ability to grow well at 37°C, but they only share some small molecule extrolites, that could be important factors in pathogenicity. According to the literature gliotoxin and other exometabolites can be contributing factors to pathogenicity, but these exometabolites are apparently not produced by all pathogenic species. It is our hypothesis that species unable to produce some of these metabolites can produce proxy-exometabolites that may serve the same function. We tabulate all exometabolites reported from species in Aspergillus section Fumigati and by comparing the profile of those extrolites, suggest that those producing many different kinds of exometabolites are potential opportunistic pathogens. The exometabolite data also suggest that the profile of exometabolites are highly specific and can be used for identification of these closely related species.
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Affiliation(s)
- Jens C. Frisvad
- Section of Eukaryotic Biotechnology, Department of Systems Biology, Technical University of DenmarkKongens Lyngby, Denmark
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Pena GA, Coelho I, Reynoso MM, Soleiro C, Cavaglieri LR. Characterization and genetic variability of feed-borne and clinical animal/human Aspergillus fumigatus strains using molecular markers. Med Mycol 2015; 53:699-708. [PMID: 26129892 DOI: 10.1093/mmy/myv040] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 05/12/2015] [Indexed: 11/13/2022] Open
Abstract
Aspergillus fumigatus, the major etiological agent of human and animal aspergillosis, is a toxigenic fungus largely regarded as a single species by macroscopic and microscopic features. However, molecular studies have demonstrated that several morphologically identified A. fumigatus strains might be genetically distinct. This work was aimed to apply PCR-restriction length fragment polymorphisms (PCR-RFLP) and random amplification of polymorphic DNA (RAPD) molecular markers to characterize a set of feed-borne and clinical A. fumigatus sensu lato strains isolated from Argentina and Brazil and to determine and compare their genetic variability. All A. fumigatus strains had the same band profile and those typical of A. fumigatus sensu stricto positive controls by PCR-RFLP. Moreover, all Argentinian and Brazilian strains typified by RAPD showed similar band patterns to each other and to A. fumigatus sensu stricto reference strains regardless of their isolation source (animal feeds or human/animal clinical cases) and geographic origin. Genetic similarity coefficients ranged from 0.61 to 1.00, but almost all isolates showed 78% of genetic similarly suggesting that genetic variability was found at intraspecific level. Finally, benA sequencing confirmed its identification as A. fumigatus sensu stricto species. These results suggest that A. fumigatus sensu stricto is a predominant species into Aspergillus section Fumigati found in animal environments as well as in human/animal clinical cases, while other species may be rarely isolated. The strains involved in human and animal aspergillosis could come from the environment where this fungus is frequently found. Rural workers and animals would be constantly exposed.
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Affiliation(s)
- Gabriela A Pena
- Departamento de Microbiología e Inmunología, Facultad de Ciencias Exactas, Físico-Químicas y Naturales, Universidad Nacional de Río Cuarto. Ruta 36 Km. 601, (5800) Río Cuarto, Córdoba, Argentina Fellow of Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET). Rivadavia 1917, C1033AAV, Buenos Aires, Argentina
| | - Irene Coelho
- Departamento de Microbiologia e Imunología Veterinária. Universidade Federal Rural do Rio de Janeiro. Instituto de Veterinária. Rodovia BR 465 Km 7, Seropédica, Rio de Janeiro. 23890-000. Brazil Member of Conselho Nacional de Pesquisas Científicas (CNPq). Av. Antonio Carlos, 6627 Belo Horizonte, MG 31270-901, Brazil
| | - María M Reynoso
- Departamento de Microbiología e Inmunología, Facultad de Ciencias Exactas, Físico-Químicas y Naturales, Universidad Nacional de Río Cuarto. Ruta 36 Km. 601, (5800) Río Cuarto, Córdoba, Argentina Member of Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET). Rivadavia 1917, C1033AAV, Buenos Aires, Argentina
| | - Carla Soleiro
- Departamento de Microbiologia e Imunología Veterinária. Universidade Federal Rural do Rio de Janeiro. Instituto de Veterinária. Rodovia BR 465 Km 7, Seropédica, Rio de Janeiro. 23890-000. Brazil Fellow of Conselho Nacional de Pesquisas Científicas (CNPq). Av. Antonio Carlos, 6627 Belo Horizonte, MG 31270-901, Brazil
| | - Lilia R Cavaglieri
- Departamento de Microbiología e Inmunología, Facultad de Ciencias Exactas, Físico-Químicas y Naturales, Universidad Nacional de Río Cuarto. Ruta 36 Km. 601, (5800) Río Cuarto, Córdoba, Argentina Member of Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET). Rivadavia 1917, C1033AAV, Buenos Aires, Argentina
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29
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Aspergillus arcoverdensis, a new species of Aspergillus section Fumigati isolated from caatinga soil in State of Pernambuco, Brazil. MYCOSCIENCE 2015. [DOI: 10.1016/j.myc.2014.04.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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30
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Tamiya H, Ochiai E, Kikuchi K, Yahiro M, Toyotome T, Watanabe A, Yaguchi T, Kamei K. Secondary metabolite profiles and antifungal drug susceptibility of Aspergillus fumigatus and closely related species, Aspergillus lentulus, Aspergillus udagawae, and Aspergillus viridinutans. J Infect Chemother 2015; 21:385-91. [PMID: 25737146 DOI: 10.1016/j.jiac.2015.01.005] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Revised: 01/05/2015] [Accepted: 01/13/2015] [Indexed: 11/20/2022]
Abstract
The incidence of Aspergillus infection has been increasing in the past few years. Also, new Aspergillus fumigatus-related species, namely Aspergillus lentulus, Aspergillus udagawae, and Aspergillus viridinutans, were shown to infect humans. These fungi exhibit marked morphological similarities to A. fumigatus, albeit with different clinical courses and antifungal drug susceptibilities. The present study used liquid chromatography/time-of-flight mass spectrometry to identify the secondary metabolites secreted as virulence factors by these Aspergillus species and compared their antifungal susceptibility. The metabolite profiles varied widely among A. fumigatus, A. lentulus, A. udagawae, and A. viridinutans, producing 27, 13, 8, and 11 substances, respectively. Among the mycotoxins, fumifungin, fumiquinazoline A/B and D, fumitremorgin B, gliotoxin, sphingofungins, pseurotins, and verruculogen were only found in A. fumigatus, whereas auranthine was only found in A. lentulus. The amount of gliotoxin, one of the most abundant mycotoxins in A. fumigatus, was negligible in these related species. In addition, they had decreased susceptibility to antifungal agents such as itraconazole and voriconazole, even though metabolites that were shared in the isolates showing higher minimum inhibitory concentrations than epidemiological cutoff values were not detected. These strikingly different secondary metabolite profiles may lead to the development of more discriminative identification protocols for such closely related Aspergillus species as well as improved treatment outcomes.
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Affiliation(s)
- Hiroyuki Tamiya
- Division of Fungal Infection, Medical Mycology Research Center, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8673, Japan; Department of Respiratory Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; Division of Clinical Research, Medical Mycology Research Center, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8677, Japan.
| | - Eri Ochiai
- Division of Fungal Infection, Medical Mycology Research Center, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8673, Japan
| | - Kazuyo Kikuchi
- Division of Bio-resources, Medical Mycology Research Center, Chiba University, Chiba, Japan
| | - Maki Yahiro
- Division of Fungal Infection, Medical Mycology Research Center, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8673, Japan
| | - Takahito Toyotome
- Division of Fungal Infection, Medical Mycology Research Center, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8673, Japan
| | - Akira Watanabe
- Division of Fungal Infection, Medical Mycology Research Center, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8673, Japan; Division of Clinical Research, Medical Mycology Research Center, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8677, Japan; Division of Control and Treatment of Infectious Diseases, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba 260-8677, Japan
| | - Takashi Yaguchi
- Division of Bio-resources, Medical Mycology Research Center, Chiba University, Chiba, Japan
| | - Katsuhiko Kamei
- Division of Fungal Infection, Medical Mycology Research Center, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8673, Japan; Division of Clinical Research, Medical Mycology Research Center, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8677, Japan; Division of Control and Treatment of Infectious Diseases, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba 260-8677, Japan
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Gautier M, Ranque S, Normand AC, Becker P, Packeu A, Cassagne C, L'Ollivier C, Hendrickx M, Piarroux R. Matrix-assisted laser desorption ionization time-of-flight mass spectrometry: revolutionizing clinical laboratory diagnosis of mould infections. Clin Microbiol Infect 2014; 20:1366-71. [DOI: 10.1111/1469-0691.12750] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Revised: 05/20/2014] [Accepted: 06/27/2014] [Indexed: 12/22/2022]
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Johnson G, Ferrini A, Dolan SK, Nolan T, Agrawal S, Doyle S, Bustin SA. Biomarkers for invasive aspergillosis: the challenges continue. Biomark Med 2014; 8:429-51. [PMID: 24712434 DOI: 10.2217/bmm.13.129] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
The incidence of invasive aspergillosis (IA), an opportunistic infection in immunocompromised individuals, is rising, but its early diagnosis remains challenging and treatment options are limited. Hence there is an urgent need to improve existing diagnostic procedures as well as develop novel approaches. The clinical usefulness of galactomannan and β-d-glucan, widely used assays detecting cell-wall antigens of Aspergillus, is unclear and depends on clinicians' awareness of their practical limitations. This leaves room for new methods that utilise genomic, proteomic and metabolomics approaches as well as novel detection procedures, for example point-of-care lateral-flow devices. Each of these strategies has its own limitations and it is likely that a combination of methods will be required to achieve optimal performance for the diagnosis of IA and subsequent appropriate patient management.
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Affiliation(s)
- Gemma Johnson
- Blizard Institute, Queen Mary University of London, London, UK
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33
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Sugui JA, Kwon-Chung KJ, Juvvadi PR, Latgé JP, Steinbach WJ. Aspergillus fumigatus and related species. Cold Spring Harb Perspect Med 2014; 5:a019786. [PMID: 25377144 DOI: 10.1101/cshperspect.a019786] [Citation(s) in RCA: 135] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The genus Aspergillus contains etiologic agents of aspergillosis. The clinical manifestations of the disease range from allergic reaction to invasive pulmonary infection. Among the pathogenic aspergilli, Aspergillus fumigatus is most ubiquitous in the environment and is the major cause of the disease, followed by Aspergillus flavus, Aspergillus niger, Aspergillus terreus, Aspergillus nidulans, and several species in the section Fumigati that morphologically resemble A. fumigatus. Patients that are at risk for acquiring aspergillosis are those with an altered immune system. Early diagnosis, species identification, and adequate antifungal therapy are key elements for treatment of the disease, especially in cases of pulmonary invasive aspergillosis that often advance very rapidly. Incorporating knowledge of the basic biology of Aspergillus species to that of the diseases that they cause is fundamental for further progress in the field.
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Affiliation(s)
- Janyce A Sugui
- Laboratory of Clinical Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20892
| | - Kyung J Kwon-Chung
- Laboratory of Clinical Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20892
| | - Praveen R Juvvadi
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Duke University, Durham, North Carolina 27715
| | - Jean-Paul Latgé
- Unité des Aspergillus, Institut Pasteur, Paris 75724, France
| | - William J Steinbach
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Duke University, Durham, North Carolina 27715 Department of Molecular Genetics and Microbiology, Duke University, Durham, North Carolina 27710
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34
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Treatment of infections by cryptic Aspergillus species. Mycopathologia 2014; 178:441-5. [PMID: 25216599 DOI: 10.1007/s11046-014-9811-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Accepted: 08/28/2014] [Indexed: 12/16/2022]
Abstract
The best treatment for patients with invasive aspergillosis caused by cryptic Aspergillus species remains uncertain, mainly due to the limited clinical data that have been published so far. In face of this limitation, patients should be treated with standard first-line therapy for invasive aspergillosis, with therapy being modified according to in vitro susceptibility testing. In this review, we summarize the importance of cryptic Aspergillus species in modern medicine, including their prevalence, methods for detection and response to antifungal drugs.
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35
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Genetic relatedness versus biological compatibility between Aspergillus fumigatus and related species. J Clin Microbiol 2014; 52:3707-21. [PMID: 25100816 DOI: 10.1128/jcm.01704-14] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Aspergillus section Fumigati contains 12 clinically relevant species. Among these Aspergillus species, A. fumigatus is the most frequent agent of invasive aspergillosis, followed by A. lentulus and A. viridinutans. Genealogical concordance and mating experiments were performed to examine the relationship between phylogenetic distance and mating success in these three heterothallic species. Analyses of 19 isolates from section Fumigati revealed the presence of three previously unrecognized species within the broadly circumscribed species A. viridinutans. A single mating type was found in the new species Aspergillus pseudofelis and Aspergillus pseudoviridinutans, but in Aspergillus parafelis, both mating types were present. Reciprocal interspecific pairings of all species in the study showed that the only successful crosses occurred with the MAT1-2 isolates of both A. parafelis and A. pseudofelis. The MAT1-2 isolate of A. parafelis was fertile when paired with the MAT1-1 isolates of A. fumigatus, A. viridinutans, A. felis, A. pseudoviridinutans, and A. wyomingensis but was not fertile with the MAT1-1 isolate of A. lentulus. The MAT1-2 isolates of A. pseudofelis were fertile when paired with the MAT1-1 isolate of A. felis but not with any of the other species. The general infertility in the interspecies crossings suggests that genetically unrelated species are also biologically incompatible, with the MAT1-2 isolates of A. parafelis and A. pseudofelis being the exception. Our findings underscore the importance of genealogical concordance analysis for species circumscription, as well as for accurate species identification, since misidentification of morphologically similar pathogens with differences in innate drug resistance may be of grave consequences for disease management.
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Fernandez-Molina JV, Abad-Diaz-de-Cerio A, Sueiro-Olivares M, Pellon A, Ramirez-Garcia A, Garaizar J, Pemán J, Hernando FL, Rementeria A. Rapid and specific detection of section Fumigati and Aspergillus fumigatus in human samples using a new multiplex real-time PCR. Diagn Microbiol Infect Dis 2014; 80:111-8. [PMID: 25063549 DOI: 10.1016/j.diagmicrobio.2014.06.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Revised: 06/11/2014] [Accepted: 06/11/2014] [Indexed: 10/25/2022]
Abstract
Invasive aspergillosis is an opportunistic infection caused primarily by Aspergillus fumigatus. However, other common fungal pathogens belonging to section Fumigati are often misidentified as A. fumigatus. Thus, we have developed a multiplex real-time PCR (qPCR) assay with primers and specific TaqMan probes based on internal transcribed spacer regions or benA gene to discriminate, in less than 3 h, species of section Fumigati and, specifically, A. fumigatus. The multiplex qPCR showed a limit of detection of 20 and 50 fg of DNA for section Fumigati and A. fumigatus, respectively. Moreover, it enabled detection of a single germinated conidia. The inclusion of some PCR facilitators together with the dilution of samples makes it possible to completely avoid PCR inhibitions in all bronchoalveolar lavage (BAL) samples assayed. This technique may be a useful complementary tool in the diagnosis of invasive pulmonary aspergillosis caused by A. fumigatus using BAL fluid.
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Affiliation(s)
- J V Fernandez-Molina
- Department of Immunology, Microbiology and Parasitology, Faculty of Science and Technology, University of the Basque Country (UPV/EHU), Spain
| | - A Abad-Diaz-de-Cerio
- Department of Immunology, Microbiology and Parasitology, Faculty of Science and Technology, University of the Basque Country (UPV/EHU), Spain
| | - M Sueiro-Olivares
- Department of Immunology, Microbiology and Parasitology, Faculty of Science and Technology, University of the Basque Country (UPV/EHU), Spain
| | - A Pellon
- Department of Immunology, Microbiology and Parasitology, Faculty of Science and Technology, University of the Basque Country (UPV/EHU), Spain
| | - A Ramirez-Garcia
- Department of Immunology, Microbiology and Parasitology, Faculty of Science and Technology, University of the Basque Country (UPV/EHU), Spain
| | - J Garaizar
- Department of Immunology, Microbiology and Parasitology, Faculty of Pharmacy, University of the Basque Country (UPV/EHU), Spain
| | - J Pemán
- Department of Microbiology, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - F L Hernando
- Department of Immunology, Microbiology and Parasitology, Faculty of Science and Technology, University of the Basque Country (UPV/EHU), Spain
| | - A Rementeria
- Department of Immunology, Microbiology and Parasitology, Faculty of Science and Technology, University of the Basque Country (UPV/EHU), Spain.
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Sabino R, Verissimo C, Parada H, Brandao J, Viegas C, Carolino E, Clemons KV, Stevens DA. Molecular screening of 246 Portuguese Aspergillus isolates among different clinical and environmental sources. Med Mycol 2014; 52:519-29. [DOI: 10.1093/mmy/myu006] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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39
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Kikuchi K, Watanabe A, Ito J, Oku Y, Wuren T, Taguchi H, Yarita K, Muraosa Y, Yahiro M, Yaguchi T, Kamei K. Antifungal susceptibility of Aspergillus fumigatus clinical isolates collected from various areas in Japan. J Infect Chemother 2014; 20:336-8. [DOI: 10.1016/j.jiac.2014.01.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Revised: 12/20/2013] [Accepted: 01/06/2014] [Indexed: 11/25/2022]
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40
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Nováková A, Hubka V, Dudová Z, Matsuzawa T, Kubátová A, Yaguchi T, Kolařík M. New species in Aspergillus section Fumigati from reclamation sites in Wyoming (U.S.A.) and revision of A. viridinutans complex. FUNGAL DIVERS 2013. [DOI: 10.1007/s13225-013-0262-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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41
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Soleiro C, Pena G, Cavaglieri L, Coelho I, Keller L, Dalcero A, Rosa C. Typing clinical and animal environment Aspergillus fumigatus
gliotoxin producer strains isolated from Brazil by PCR-RFLP markers. Lett Appl Microbiol 2013; 57:484-91. [DOI: 10.1111/lam.12136] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Revised: 07/12/2013] [Accepted: 07/18/2013] [Indexed: 11/25/2022]
Affiliation(s)
- C.A. Soleiro
- Departamento de Microbiologia e Imunología Veterinária; Universidade Federal Rural do Rio de Janeiro, Instituto de Veterinária; Seropédica Brazil
- Conselho Nacional de Pesquisas Científicas (CNPq); Belo Horizonte Brazil
| | - G.A. Pena
- Departamento de Microbiología e Inmunología; Facultad de Ciencias Exactas; Físico-Químicas y Naturales; Universidad Nacional de Río Cuarto; Río Cuarto Córdoba Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET); Buenos Aires Argentina
| | - L.R. Cavaglieri
- Departamento de Microbiología e Inmunología; Facultad de Ciencias Exactas; Físico-Químicas y Naturales; Universidad Nacional de Río Cuarto; Río Cuarto Córdoba Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET); Buenos Aires Argentina
| | - I. Coelho
- Departamento de Microbiologia e Imunología Veterinária; Universidade Federal Rural do Rio de Janeiro, Instituto de Veterinária; Seropédica Brazil
| | - L.M. Keller
- Departamento de Microbiologia e Imunología Veterinária; Universidade Federal Rural do Rio de Janeiro, Instituto de Veterinária; Seropédica Brazil
- Conselho Nacional de Pesquisas Científicas (CNPq); Belo Horizonte Brazil
| | - A.M. Dalcero
- Departamento de Microbiología e Inmunología; Facultad de Ciencias Exactas; Físico-Químicas y Naturales; Universidad Nacional de Río Cuarto; Río Cuarto Córdoba Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET); Buenos Aires Argentina
| | - C.A.R. Rosa
- Departamento de Microbiologia e Imunología Veterinária; Universidade Federal Rural do Rio de Janeiro, Instituto de Veterinária; Seropédica Brazil
- Conselho Nacional de Pesquisas Científicas (CNPq); Belo Horizonte Brazil
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42
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Isavuconazole activity against Aspergillus lentulus, Neosartorya udagawae, and Cryptococcus gattii, emerging fungal pathogens with reduced azole susceptibility. J Clin Microbiol 2013; 51:3090-3. [PMID: 23804388 DOI: 10.1128/jcm.01190-13] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Isavuconazole is an extended-spectrum triazole with in vitro activity against a wide variety of fungal pathogens. Clinical isolates of molds Aspergillus lentulus and Neosartorya udagawae and yeast Cryptococcus gattii VGII (implicated in the outbreak in the Pacific Northwest, North America) exhibit reduced susceptibilities to several azoles but higher susceptibilities to isavuconazole.
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43
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Aspergillus felis sp. nov., an emerging agent of invasive aspergillosis in humans, cats, and dogs. PLoS One 2013; 8:e64871. [PMID: 23798996 PMCID: PMC3683053 DOI: 10.1371/journal.pone.0064871] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2013] [Accepted: 04/17/2013] [Indexed: 11/19/2022] Open
Abstract
We describe a novel heterothallic species in Aspergillus section Fumigati, namely A. felis (neosartorya-morph) isolated from three host species with invasive aspergillosis including a human patient with chronic invasive pulmonary aspergillosis, domestic cats with invasive fungal rhinosinusitis and a dog with disseminated invasive aspergillosis. Disease in all host species was often refractory to aggressive antifungal therapeutic regimens. Four other human isolates previously reported as A. viridinutans were identified as A. felis on comparative sequence analysis of the partial β-tubulin and/or calmodulin genes. A. felis is a heterothallic mold with a fully functioning reproductive cycle, as confirmed by mating-type analysis, induction of teleomorphs within 7 to 10 days in vitro and ascospore germination. Phenotypic analyses show that A. felis can be distinguished from the related species A. viridinutans by its ability to grow at 45°C and from A. fumigatus by its inability to grow at 50°C. Itraconazole and voriconazole cross-resistance was common in vitro.
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44
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Discovery of a sexual cycle in Aspergillus lentulus, a close relative of A. fumigatus. EUKARYOTIC CELL 2013; 12:962-9. [PMID: 23650087 PMCID: PMC3697472 DOI: 10.1128/ec.00040-13] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Aspergillus lentulus was described in 2005 as a new species within the A. fumigatus sensu lato complex. It is an opportunistic human pathogen causing invasive aspergillosis with high mortality rates, and it has been isolated from clinical and environmental sources. The species is morphologically nearly identical to A. fumigatus sensu stricto, and this similarity has resulted in their frequent misidentification. Comparative studies show that A. lentulus has some distinguishing growth features and decreased in vitro susceptibility to several antifungal agents, including amphotericin B and caspofungin. Similar to the once-presumed-asexual A. fumigatus, it has only been known to reproduce mitotically. However, we now show that A. lentulus has a heterothallic sexual breeding system. A PCR-based mating-type diagnostic detected isolates of either the MAT1-1 or MAT1-2 genotype, and examination of 26 worldwide clinical and environmental isolates revealed similar ratios of the two mating types (38% versus 62%, respectively). MAT1-1 and MAT1-2 idiomorph regions were analyzed, revealing the presence of characteristic alpha and high-mobility-group (HMG) domain genes, together with other more unusual features such as a MAT1-2-4 gene. We then demonstrated that A. lentulus possesses a functional sexual cycle with mature cleistothecia, containing heat-resistant ascospores, being produced after 3 weeks of incubation. Recombination was confirmed using molecular markers. However, isolates of A. lentulus failed to cross with highly fertile strains of A. fumigatus, demonstrating reproductive isolation between these sibling species. The discovery of the A. lentulus sexual stage has significant implications for the management of drug resistance and control of invasive aspergillosis associated with this emerging fungal pathogen.
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45
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Gao LJ, Sun Y, Wan Z, Li RY, Yu J. CSP typing of Chinese Aspergillus fumigatus isolates: identification of additional CSP types. Med Mycol 2013; 51:683-7. [PMID: 23506321 DOI: 10.3109/13693786.2013.770609] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Cell surface protein (CSP) typing is a typing strategy that employs comparative DNA sequence analysis of the 12-mer tandem repeat region of the AFUA_3G08890 gene. The CSP typing scheme and modified nomenclature was applied to a collection of 162 clinical Aspergillus fumigatus isolates from China. A total of 16 CSP variants were observed, including five that were newly reported, indicating that phylogeographic differences may exist between the Chinese and the previously studied Australian, European and North American A. fumigatus populations. However, the most common CSP variants observed in this study are consistent with those in previous studies.
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Affiliation(s)
- Lu-Juan Gao
- Department of Dermatology, Peking University First Hospital, Research Centre for Medical Mycology, Peking University , Beijing , P. R. China
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46
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Barton RC. Laboratory diagnosis of invasive aspergillosis: from diagnosis to prediction of outcome. SCIENTIFICA 2013; 2013:459405. [PMID: 24278780 PMCID: PMC3820361 DOI: 10.1155/2013/459405] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Accepted: 11/14/2012] [Indexed: 06/02/2023]
Abstract
Invasive aspergillosis (IA), an infection caused by fungi in the genus Aspergillus, is seen in patients with immunological deficits, particularly acute leukaemia and stem cell transplantation, and has been associated with high rates of mortality in previous years. Diagnosing IA has long been problematic owing to the inability to culture the main causal agent A. fumigatus from blood. Microscopic examination and culture of respiratory tract specimens have lacked sensitivity, and biopsy tissue for histopathological examination is rarely obtainable. Thus, for many years there has been a great interest in nonculture-based techniques such as the detection of galactomannan, β -D-glucan, and DNA by PCR-based methods. Recent meta-analyses suggest that these approaches have broadly similar performance parameters in terms of sensitivity and specificity to diagnose IA. Improvements have been made in our understanding of the limitations of antigen assays and the standardisation of PCR-based DNA detection. Thus, in more recent years, the debate has focussed on how these assays can be incorporated into diagnostic strategies to maximise improvements in outcome whilst limiting unnecessary use of antifungal therapy. Furthermore, there is a current interest in applying these tests to monitor the effectiveness of therapy after diagnosis and predict clinical outcomes. The search for improved markers for the early and sensitive diagnosis of IA continues to be a challenge.
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Affiliation(s)
- Richard C. Barton
- Mycology Reference Centre, Department of Microbiology, Leeds Teaching Hospitals Trust, Leeds LS1 3EX, UK
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47
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New insight into amphotericin B resistance in Aspergillus terreus. Antimicrob Agents Chemother 2013; 57:1583-8. [PMID: 23318794 DOI: 10.1128/aac.01283-12] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Amphotericin B (AMB) is the predominant antifungal drug, but the mechanism of resistance is not well understood. We compared the in vivo virulence of an AMB-resistant Aspergillus terreus (ATR) isolate with that of an AMB-susceptible A. terreus isolate (ATS) using a murine model for disseminated aspergillosis. Furthermore, we analyzed the molecular basis of intrinsic AMB resistance in vitro by comparing the ergosterol content, cell-associated AMB levels, AMB-induced intracellular efflux, and prooxidant effects between ATR and ATS. Infection of immunosuppressed mice with ATS or ATR showed that the ATS strain was more lethal than the ATR strain. However, AMB treatment improved the outcome in ATS-infected mice while having no positive effect on the animals infected with ATR. The in vitro data demonstrated that ergosterol content is not the molecular basis for AMB resistance. ATR absorbed less AMB, discharged more intracellular compounds, and had better protection against oxidative damage than the susceptible strain. Our experiments showed that ergosterol content plays a minor role in intrinsic AMB resistance and is not directly associated with intracellular cell-associated AMB content. AMB might exert its antifungal activity by oxidative injury rather than by an increase in membrane permeation.
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48
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Peláez T, Álvarez-Pérez S, Mellado E, Serrano D, Valerio M, Blanco JL, Garcia ME, Muñoz P, Cuenca-Estrella M, Bouza E. Invasive aspergillosis caused by cryptic Aspergillus species: a report of two consecutive episodes in a patient with leukaemia. J Med Microbiol 2012; 62:474-478. [PMID: 23161769 DOI: 10.1099/jmm.0.044867-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
We report a case of two consecutive episodes of invasive aspergillosis caused by cryptic Aspergillus species in a patient with leukaemia. A first episode of pulmonary infection was caused by Aspergillus calidoustus and Aspergillus novofumigatus, and the second episode by A. novofumigatus and Aspergillus viridinutans. Fungal isolates were identified to species level using traditional and sequencing-based molecular methods.
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Affiliation(s)
- Teresa Peláez
- CIBER de Enfermedades Respiratorias (CIBERES CD06/06/0058), Palma de Mallorca, Spain.,Departamento de Medicina, Facultad de Medicina, Universidad Complutense, Madrid, Spain.,Instituto de Investigación Sanitaria del Hospital Gregorio Marañón, Madrid, Spain.,Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Sergio Álvarez-Pérez
- Instituto de Investigación Sanitaria del Hospital Gregorio Marañón, Madrid, Spain.,Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Emilia Mellado
- Servicio de Micología, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - David Serrano
- Servicio de Hematología, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria del Hospital Gregorio Marañón, Madrid, Spain
| | - Maricela Valerio
- Instituto de Investigación Sanitaria del Hospital Gregorio Marañón, Madrid, Spain.,Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - José L Blanco
- Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense, Madrid, Spain
| | - Marta E Garcia
- Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense, Madrid, Spain
| | - Patricia Muñoz
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,CIBER de Enfermedades Respiratorias (CIBERES CD06/06/0058), Palma de Mallorca, Spain.,Instituto de Investigación Sanitaria del Hospital Gregorio Marañón, Madrid, Spain.,Departamento de Medicina, Facultad de Medicina, Universidad Complutense, Madrid, Spain
| | - Manuel Cuenca-Estrella
- Servicio de Micología, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Emilio Bouza
- Departamento de Medicina, Facultad de Medicina, Universidad Complutense, Madrid, Spain.,Instituto de Investigación Sanitaria del Hospital Gregorio Marañón, Madrid, Spain.,CIBER de Enfermedades Respiratorias (CIBERES CD06/06/0058), Palma de Mallorca, Spain.,Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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Matsuzawa T, Tanaka R, Horie Y, Hui Y, Abliz P, Yaguchi T. The correlation among molecular phylogenetics, morphological data, and growth temperature of the genus Emericella, and a new species. MYCOSCIENCE 2012. [DOI: 10.1007/s10267-012-0188-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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50
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Yaguchi T, Imanishi Y, Matsuzawa T, Hosoya K, Hitomi J, Nakayama M. Method for identifying heat-resistant fungi of the genus Neosartorya. J Food Prot 2012; 75:1806-13. [PMID: 23043829 DOI: 10.4315/0362-028x.jfp-12-060] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Species of the genus Neosartorya are heat-resistant fungi that cause the spoilage of heat-processed acidic foods due to the formation of heat-resistant ascospores, and they produce mycotoxins, such as fumitremorgins and gliotoxin. Their anamorphs are phylogenetically and morphologically very close to Aspergillus fumigatus, which has never been reported as a spoilage agent in heat-processed food products. Therefore it is important to discriminate between the species of Neosartorya and A. fumigatus in the food industry. In the present study, we examined β-tubulin and calmodulin genes to identify Neosartorya and A. fumigatus at the species level and found a region for specifically detecting these species. We succeeded in developing the PCR method of differentiating and identifying Neosartorya and A. fumigatus using specific primer sets. Moreover, we developed specific primer sets to identify Neosartorya species, N. fischeri, N. glabra, N. hiratsukae, N. pseudofischeri, and N. spinosa-complex, which are important in food spoilage; these fungi vary in heat resistance and productivity of mycotoxins, depending on the species. PCR using these primer sets did not detect other fungi involved in food spoilage and environmental contamination. These identification methods are rapid and simple with extremely high specificity.
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Affiliation(s)
- Takashi Yaguchi
- Medical Mycology Research Center, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8673, Japan.
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