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Belda W, Passero LFD, de Carvalho CHC, Mojica PCR, Vale PA. Chromoblastomycosis: New Perspective on Adjuvant Treatment with Acitretin. Diseases 2023; 11:162. [PMID: 37987273 PMCID: PMC10660773 DOI: 10.3390/diseases11040162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/04/2023] [Accepted: 11/06/2023] [Indexed: 11/22/2023] Open
Abstract
Chromoblastomycosis (CBM) is a neglected human disease, caused by different species of pigmented dematiaceous fungi that cause granulomatous and suppurative dermatosis. This infection is difficult to treat and there are limited therapeutic options, including terbinafine, itraconazole, and tioconazole. Classic treatment is administered for a long period of time, but some patients do not respond properly, and therefore, such therapeutic approaches possess low cure rates. Therefore, it is vital to develop new strategies for the treatment of CBM. In this regard, it has been observed that the association of immunomodulatory molecules such as glucan with therapy carried out with antifungal drugs improves cutaneous lesions in comparison to treatment with antifungal drugs alone, suggesting that drug association may be an interesting and significant approach to incorporate into CBM therapy. Thus, the aim of this work was to associate classical antifungal therapy with the adjuvants imiquimod and acitretin. In the present case, we reported a patient with extensive CBM caused by Fonsaecae pedrosoi, that affected an extensive area of the right leg, that was left without treatment for 11 years. He was treated with a classical combination of itraconazole and terbinafine via the oral route plus topical imiquimod and oral acitretin, as an adjuvant therapy. After five months of treatment, a significant regression of verrucous plaques was observed, suggesting that the use of these adjuvants combined with the classical antifungal drugs, intraconazole plus terbinafine, can reduce treatment time and rapidly improve the patient's quality of life. This result confirms that the use of coadjuvant drugs may be effective in the treatment of this infectious disease.
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Affiliation(s)
- Walter Belda
- Dermatology Department, Medical School, University of São Paulo, Sao Paulo 05403-000, Brazil; (C.H.C.d.C.); (P.C.R.M.); (P.A.V.)
- Laboratory of Pathology of Infectious Diseases, Medical School, University of São Paulo, Sao Paulo 01246-000, Brazil
| | - Luiz Felipe Domingues Passero
- Institute of Biosciences, São Paulo State University (UNESP), Sao Vicente 11330-900, Brazil;
- Institute for Advanced Studies of Ocean, São Paulo State University (UNESP), Sao Vicente 11350-011, Brazil
| | | | - Paula Celeste Rubiano Mojica
- Dermatology Department, Medical School, University of São Paulo, Sao Paulo 05403-000, Brazil; (C.H.C.d.C.); (P.C.R.M.); (P.A.V.)
| | - Pablo Andrade Vale
- Dermatology Department, Medical School, University of São Paulo, Sao Paulo 05403-000, Brazil; (C.H.C.d.C.); (P.C.R.M.); (P.A.V.)
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Francisco EC, Ebbing M, Colombo AL, Hagen F. Identification of Clinical Trichosporon asteroides Strains by MALDI-TOF Mass Spectrometry: Evaluation of the Bruker Daltonics Commercial System and an In-House Developed Library. Mycopathologia 2023; 188:243-249. [PMID: 37067663 DOI: 10.1007/s11046-023-00723-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 02/27/2023] [Indexed: 04/18/2023]
Abstract
Trichosporon asteroides is an emerging yeast-like pathogen commonly misidentified by commercial biochemical identification systems. We evaluated the performance of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry for the identification of 21 clinical T. asteroides strains using the Bruker Daltonics database (BDAL) and an in-house developed library. Mass spectra were obtained by the FlexControl system v.3.4, and characterizations were performed in the Biotyper BDAL database v.4.1 and the developed in-house library. Species identification for T. asteroides failed as all 21 strains were misidentified as T. japonicum (log-scores 1.89-2.19). Extending the existing database was crucial to achieving 100% correct species-level identification and accurate distinction between species. Our results indicate that the commercial BDAL database has no discriminatory power to distinguish between T. japonicum and T. asteroides. Whereas improvement of the current BDAL database is pending, we strongly advise system users not to exclude the possibility of the failure to report T. asteroides.
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Affiliation(s)
- Elaine Cristina Francisco
- Division of Infectious Diseases, Escola Paulista de Medicina - Universidade Federal de São Paulo, São Paulo, 04024-002, Brazil.
- Department of Medical Mycology, Westerdijk Fungal Biodiversity Institute, Uppsalalaan 8, 3584 CT, Utrecht, The Netherlands.
| | - Mexx Ebbing
- Department of Medical Mycology, Westerdijk Fungal Biodiversity Institute, Uppsalalaan 8, 3584 CT, Utrecht, The Netherlands
| | - Arnaldo Lopes Colombo
- Division of Infectious Diseases, Escola Paulista de Medicina - Universidade Federal de São Paulo, São Paulo, 04024-002, Brazil
| | - Ferry Hagen
- Department of Medical Mycology, Westerdijk Fungal Biodiversity Institute, Uppsalalaan 8, 3584 CT, Utrecht, The Netherlands.
- Institute of Biodiversity and Ecosystem Dynamics (IBED), University of Amsterdam, Amsterdam, The Netherlands.
- Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands.
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Francisco EC, Hagen F. JMM Profile: Trichosporon yeasts: from superficial pathogen to threat for haematological-neutropenic patients. J Med Microbiol 2022; 71. [PMID: 36748684 DOI: 10.1099/jmm.0.001621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Trichosporon yeasts are classical agents of superficial mycoses, and they are ranked as the first to second predominant basidiomycetous yeast able to cause invasive infections. The clinical presentation of Trichosporon infections varies with the affected anatomical site, with fungaemia present in the majority of invasive trichosporonosis cases. Only a limited number of antifungal compounds can be used to treat Trichosporon infections. Azoles are the first choice due to their intrinsic resistance to echinocandins. Better laboratory methods and up-to-date databases of commercial platforms are required to improve identification, susceptibility testing and surveillance of this potentially threating infection.
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Affiliation(s)
- Elaine Cristina Francisco
- Division of Infectious Diseases, Escola Paulista de Medicina-Universidade Federal de São Paulo, São Paulo 04039-032, Brazil.,Westerdijk Fungal Biodiversity Institute, Uppsalalaan 8, 3584 CT, Utrecht, Netherlands
| | - Ferry Hagen
- Westerdijk Fungal Biodiversity Institute, Uppsalalaan 8, 3584 CT, Utrecht, Netherlands.,Department of Medical Microbiology, University Medical Center Utrecht, Heidelberglaan 100, Utrecht, 3584 CX, Netherlands.,Institute for Biodiversity and Ecosystem Dynamics, University of Amsterdam, Science Park 904, 1012 WX, Amsterdam,, Netherlands
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4
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Evangelista AJ, Ferreira TL. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry in the diagnosis of microorganisms. Future Microbiol 2022; 17:1409-1419. [PMID: 36169347 DOI: 10.2217/fmb-2022-0067] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Microbiology culture is the gold standard method for identifying microorganisms. This identification protocol takes several days to complete. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) is a technique that can identify different microorganisms quickly and accurately. The objective of this work was to evaluate the use of MALDI-TOF MS in the routine of clinical laboratories to identify microorganisms and to identify their resistance to antimicrobials. This study evaluated the relevance of the MALDI-TOF MS technique for microbiological diagnosis through a literature review. The authors found that MALDI-TOF MS can identify bacteria, fungi, viruses and parasites, even in blood cultures, and also serves to assess antimicrobial resistance. Thus, MALDI-TOF MS can become an indispensable tool in laboratory diagnosis.
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Parashar A, Rastogi V, Rudramurthy SM, Ghosh AK, Chander J, Kindo AJ. Faster and accurate identification of clinically important Trichosporon using MALDI TOF MS. Indian J Med Microbiol 2022:S0255-0857(22)00095-0. [PMID: 35738950 DOI: 10.1016/j.ijmmb.2022.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 04/11/2022] [Accepted: 05/28/2022] [Indexed: 11/22/2022]
Abstract
PURPOSE Trichosporon species are emerging human pathogens, accounting for the second most common cause of non-candidal mycosis. Rapid and reliable identification of these agents allows a better understanding of their epidemiology and therapeutic management. The Matrix-Assisted Laser Desorption Ionization-Time-of-Flight Mass Spectrometry (MALDI-TOF MS) technique has the potential to be precise, fast and cost-effective. However, the precision of identification totally depends upon the type of protein extraction method used and embedded database in the system. Our objectives were to standardize the protein extraction technique and expand the present Bruker database by creating an in-house database and validating it with diverse clinical Trichosporon species of Indian origin. METHODS Two different protein extraction protocols (on-plate and off-plate) were evaluated. The off-plate protocol was finalized for the identification. MALDI TOF MS with the existing Bruker database was evaluated for its ability to identify a total of 79 intergenic spacer 1 (IGS1) gene sequence confirmed clinical isolates of 5 different Trichosporon species. RESULTS As outcome, off plate protocol yielded higher accuracy (73% on the species level and 95% on the genus level) than on-plate (25% on the genus level) in terms of log scores. The existing database for Trichosporon species was enriched with 28 sequence confirmed isolates, which improved accuracy from 73% to 100% and were identified up to species level with a log score >2.3. CONCLUSIONS Used with standardized protein-extraction protocol along with an expanded database, MALDI-TOF MS could be a rapid and reliable approach to identify clinical Trichosporon species routinely in the laboratory.
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Ali GA, Husain A, Salah H, Goravey W. Trichosporon asahii fungemia and COVID-19 co-infection: An emerging fungal pathogen; case report and review of the literature. IDCases 2021; 25:e01244. [PMID: 34367918 DOI: 10.1016/j.idcr.2021.e01244] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Trichosporon asahii fungemia is an emerging invasive pathogen in critically ill Coronavirus disease 2019 patients. Judicious use of immunosuppressant medications is advisable in critically ill Coronavirus disease 2019. Periodically fungal surveillance program is recommended in critically ill COVID-19 patients. Voriconazole is the first option of therapy for Trichosporon asahii infection.
With the evolving COVID-19 pandemic, increasing concerns about invasive fungal infections have been reported particularly with the use of potent immunosuppressant medications to treat the immunological storms in patients with severe COVID-19 illnesses. Trichosporon asahii (T. asahii) is an emerging highly resistant pathogen with considerable mortality particularly in critically ill patients and immunocompromised individuals. We describe a case of a 58-year-old patient who developed T. asahii fungemia after using immunosuppressant agents for his severe COVID-19 related cytokines release syndrome. Pseudohyphae, arthroconidia, and lateral blastoconidia were seen in the stain, and later confirmed to be T. asahii. Voriconazole successfully treated this multi-drug-resistant fungal infection. The clinical presentation, assessment, and management are reviewed to raise awareness of the circumstances leading to coinfection with this emerging resistant yeast.
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Ahangarkani F, Ilkit M, Vaseghi N, Zahedi N, Zomorodian K, Khodavaisy S, Afsarian MH, Abbasi K, de Groot T, Meis JF, Badali H. MALDI-TOF MS characterisation, genetic diversity and antifungal susceptibility of Trichosporon species from Iranian clinical samples. Mycoses 2021; 64:918-925. [PMID: 33998718 DOI: 10.1111/myc.13306] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 05/06/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Trichosporonosis is an emerging fungal infection caused by Trichosporon species, a genus of yeast-like fungi, which are frequently encountered in human infections ranging from mild cutaneous lesions to fungemia in immunocompromised patients. The incidence of trichosporonosis has increased in recent years, owing to higher numbers of individuals at risk for this infection. Although amphotericin B, posaconazole and isavuconazole are generally effective against Trichosporon species, some isolates may have variable susceptibility to these antifungals. OBJECTIVES Herein, we evaluated the species distribution, genetic diversity and antifungal susceptibility profiles of Trichosporon isolates in Iran. METHODS The yeasts were identified by matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF MS). Phylogenetic analysis was performed based on amplified fragment length polymorphism (AFLP). The in vitro susceptibilities of eight antifungal agents were analysed using the Clinical and Laboratory Standards Institute broth microdilution methods. RESULTS The isolates belonged to the species T asahii (n = 20), T japonicum (n = 4) and T faecale (n = 3). A dendrogram of the AFLP analysis demonstrated that T asahii and non-asahii Trichosporon strains (T japonicum and T faecale) are phylogenetically distinct. While voriconazole was the most active agent (GM MIC = 0.075 μg/ml), high fluconazole MICs (8 μg/ml) were observed for a quarter of Trichosporon isolates. The GM MIC value of amphotericin B for T asahii and non-asahii Trichosporon species was 0.9 μg/ml. CONCLUSIONS The distribution and antifungal susceptibility patterns of the identified Trichosporon species could inform therapeutic choices for treating these emerging life-threatening fungi.
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Affiliation(s)
- Fatemeh Ahangarkani
- Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands.,Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Macit Ilkit
- Division of Mycology, Department of Microbiology, Faculty of Medicine, University of Cukurova, Adana, Turkey
| | - Narges Vaseghi
- Department of Pathobiology, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Nina Zahedi
- Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Kamiar Zomorodian
- Basic Sciences in Infectious Diseases Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sadegh Khodavaisy
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hosein Afsarian
- Department of Medical Mycology and Parasitology, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran
| | - Kiana Abbasi
- Department of Microbiology, Zanjan Branch, Islamic Azad University, Zanjan, Iran
| | - Theun de Groot
- Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands
| | - Jacques F Meis
- Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands.,ECMM Excellence Center for Medical Mycology, Centre of Expertise in Mycology Radboudumc/ Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands.,Bioprocess Engineering and Biotechnology Graduate Program, Federal University of Paraná, Curitiba, Brazil
| | - Hamid Badali
- Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.,Fungus Testing Laboratory, Department of Pathology and Laboratory Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
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8
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Gorrens E, Van Moll L, Frooninckx L, De Smet J, Van Campenhout L. Isolation and Identification of Dominant Bacteria From Black Soldier Fly Larvae ( Hermetia illucens) Envisaging Practical Applications. Front Microbiol 2021; 12:665546. [PMID: 34054771 PMCID: PMC8155639 DOI: 10.3389/fmicb.2021.665546] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 04/15/2021] [Indexed: 11/13/2022] Open
Abstract
This study aimed to establish a representative strain collection of dominant aerobic bacteria from black soldier fly larvae (Hermetia illucens, BSFL). The larvae were fed either chicken feed or fiber-rich substrates to obtain a collection of BSFL-associated microorganisms. Via an approach based on only considering the highest serial dilutions of BSFL extract (to select for the most abundant strains), a total of 172 bacteria were isolated. Identification of these isolates revealed that all bacteria belonged to either the Proteobacteria (66.3%), the Firmicutes (30.2%), the Bacteroidetes (2.9%) or the Actinobacteria (0.6%). Twelve genera were collected, with the most abundantly present ones (i.e., minimally present in at least three rearing cycles) being Enterococcus (29.1%), Escherichia (22.1%), Klebsiella (19.8%), Providencia (11.6%), Enterobacter (7.6%), and Morganella (4.1%). Our collection of dominant bacteria reflects largely the bacterial profiles of BSFL already described in literature with respect to the most important phyla and genera in the gut, but some differences can be noticed depending on substrate, biotic and abiotic factors. Furthermore, this bacterial collection will be the starting point to improve in vitro digestion models for BSFL, to develop mock communities and to find symbionts that can be added during rearing cycles to enhance the larval performances, after functional characterization of the isolates, for instance with respect to enzymatic potential.
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Affiliation(s)
- Ellen Gorrens
- Department of Microbial and Molecular Systems (M2S), Lab4Food, KU Leuven, Geel, Belgium.,Leuven Food Science and Nutrition Research Centre (LFoRCe), KU Leuven, Leuven, Belgium
| | - Laurence Van Moll
- Department of Microbial and Molecular Systems (M2S), Lab4Food, KU Leuven, Geel, Belgium.,Leuven Food Science and Nutrition Research Centre (LFoRCe), KU Leuven, Leuven, Belgium.,Laboratory for Microbiology, Parasitology and Hygiene (LMPH), Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, University of Antwerp, Antwerp, Belgium
| | - Lotte Frooninckx
- Thomas More University of Applied Sciences, RADIUS, Geel, Belgium
| | - Jeroen De Smet
- Department of Microbial and Molecular Systems (M2S), Lab4Food, KU Leuven, Geel, Belgium.,Leuven Food Science and Nutrition Research Centre (LFoRCe), KU Leuven, Leuven, Belgium
| | - Leen Van Campenhout
- Department of Microbial and Molecular Systems (M2S), Lab4Food, KU Leuven, Geel, Belgium.,Leuven Food Science and Nutrition Research Centre (LFoRCe), KU Leuven, Leuven, Belgium
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Bongomin F, Otu A, Calisti G, Richardson MD, Barnard J, Venkateswaran R, Vergidis P. Trichosporon japonicum Fungemia and Ventricular Assist Device Infection in an Immunocompetent Patient. Open Forum Infect Dis 2019; 6:ofz343. [PMID: 31660411 PMCID: PMC6761985 DOI: 10.1093/ofid/ofz343] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 07/22/2019] [Indexed: 11/15/2022] Open
Abstract
Trichosporon species are emerging opportunistic yeasts that cause life-threatening disseminated disease in severely immunocompromised patients. Trichosporon japonicum is a very rare cause of invasive trichosporonosis. We describe a case of Trichosporon japonicum fungemia in an immunocompetent patient with a transcutaneous biventricular assist device.
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Affiliation(s)
- Felix Bongomin
- Department of Medical Microbiology & Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda
| | - Akaninyene Otu
- Department of Infectious Diseases, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK; The University of Manchester, Manchester, UK
| | - Giorgio Calisti
- Department of Microbiology, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Malcolm D Richardson
- Mycology Reference Centre Manchester, ECMM Centre of Excellence in Clinical and Laboratory Mycology and Clinical Studies, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - James Barnard
- Department of Cardiothoracic Surgery, Wythenshawe Hospital Manchester University NHS Foundation Trust, Manchester, UK
| | - Rajamiyer Venkateswaran
- Department of Cardiothoracic Surgery, Wythenshawe Hospital Manchester University NHS Foundation Trust, Manchester, UK.,Division of Cardiovascular Sciences, The University of Manchester, Manchester, UK
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Ngouana TK, Toghueo RMK, Kenfack IF, Lachaud L, Nana AK, Tadjou L, Kouanfack C, Boyom FF, Bertout S. Epidemiology and antifungal susceptibility testing of non-albicansCandida species colonizing mucosae of HIV-infected patients in Yaoundé (Cameroon). J Mycol Med 2019; 29:233-8. [PMID: 31204235 DOI: 10.1016/j.mycmed.2019.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 06/04/2019] [Accepted: 06/04/2019] [Indexed: 12/17/2022]
Abstract
Non-albicans Candida (NAC) species have emerged as potent pathogenic yeasts among HIV-infected patients. Authors evaluated the epidemiology and antifungal susceptibility testing of non-albicansCandida species colonizing Yaoundé (capital of the Republic of Cameroon, Central Africa) HIV-infected patients. The mucosal specimens were collected and submitted to the mycological diagnosis. Yeast isolates were identified by the Matrix Assisted Laser Desorption Ionisation - Time of Flight Mass Spectrometry (MALDI-TOF MS). The antifungal susceptibility testing was achieved by the CLSI-M27 protocols, and the interpretation of clinical break points (CBPs) and epidemiological cutoff values were in accordance with the CLSI-M60 and M59 recommendations. Four hundred and two patients were recruited and 1218 samples collected. The colonisation frequency was 24.1% and 304 yeasts isolated. Yeast isolates were 113 (37.2%) C. albicans, 2 (0.7%) C. africana and 172 (56.6%) NAC isolates. The NAC isolates were grouped into 13 species including C. krusei (18.1%), C. glabrata (10.9%), C. tropicalis (8.5%) and C. parapsilosis (5.9%) as the major ones. All the isolates appeared to be wild-type for amphotericin B and itraconazole. One (1/33) isolate of C. glabrata was resistant to fluconazole. C. arapsilosis isolates appeared all susceptible to fluconazole. C. tropicalis isolates presented 50% (13/26) resistance to fluconazole. The achieved results bring out new insights about epidemiology of NAC species in Cameroon. The results also highlight the resistance of NAC species to current antifungal drugs.
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Zhang D, Lu X, Liao Y, Xia Z, Peng Z, Yang X, Yang R. Rapid and Simple Detection of Trichosporon asahii by Optimized Colony PCR. Biomed Res Int 2019; 2019:1803278. [PMID: 31218222 DOI: 10.1155/2019/1803278] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 04/23/2019] [Indexed: 12/26/2022]
Abstract
Trichosporon asahii is the major pathogen causing invasive trichosporonosis. Conventional methods of its detection are time-consuming or costly and often require complex DNA extraction and purification steps, which hinders rapid clinical diagnosis. In this study, we evaluated colony PCR, which directly uses colonies or trace clinical samples as the template for amplification, for rapid detection of T. asahii infection. Four methods, namely, direct colony, freeze-thaw, glass beads, and enzymolysis, were compared to select the best DNA extraction strategy. We subsequently designed and screened species-specific primers targeting the intergenic spacer 1 (IGS1) of the ribosomal DNA of T. asahii and used them to detect mock infection clinical samples. The species-specific colony PCR based on glass beads proved advantageous, with short procedure time (154.8 ± 0.6 min), good sensitivity (detection limit, 102 CFU/mL), and specificity for T. asahii, indicating that this method can be used for the rapid and simple identification of clinical samples of T. asahii infection.
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Guo LN, Yu SY, Hsueh PR, Al-Hatmi AMS, Meis JF, Hagen F, Xiao M, Wang H, Barresi C, Zhou ML, de Hoog GS, Xu YC. Invasive Infections Due to Trichosporon: Species Distribution, Genotyping, and Antifungal Susceptibilities from a Multicenter Study in China. J Clin Microbiol 2019; 57:e01505-18. [PMID: 30463892 DOI: 10.1128/JCM.01505-18] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 11/08/2018] [Indexed: 12/17/2022] Open
Abstract
A total of 133 clinical Trichosporon isolates were collected in the National China Hospital Invasive Fungal Surveillance Net (CHIF-NET) program in 2009 to 2016. Accurate identification was performed by sequencing of the intergenic spacer 1 (IGS1) region. Among these isolates, Trichosporon asahii (108 isolates [81.2%]) was the leading species, followed by Trichosporon dermatis (7 isolates [5.3%]), Trichosporon asteroides (5 isolates [3.8%]), Trichosporon inkin (5 isolates [3.8%]), Trichosporon dohaense (3 isolates [2.3%]), and 1 isolate (0.7%) each of Trichosporon faecale, Trichosporon jirovecii, Trichosporon mucoides, Trichosporon coremiiforme, and Trichosporon montevideense Both the Vitek mass spectrometry (MS) (bioMérieux, Marcy l'Etoile, France) and Bruker Biotyper MS (Bruker Daltonics GmbH, Germany) platforms gave high levels (>97.5%) of correct identification when the species were present in the database. The geometric mean (GM) of amphotericin B MICs for T. asahii was 2-fold higher than that for non-asahii Trichosporon High fluconazole MICs (≥8 μg/ml) were observed for 25% of T. asahii isolates (27/108 isolates) and 16% of non-asahii Trichosporon (4/25 isolates) isolates. Itraconazole MICs were ≤0.5 μg/ml for 89.5% of the isolates. Voriconazole was the most potent antifungal agent in vitro, with a GM of 0.09 μg/ml. Genotyping of the isolates using IGS1 sequence alignment revealed that genotype 1 was most common (41.7%), followed by genotype 4 (31.5%), genotype 3 (23.1%), genotype 5 (0.9%), genotype 6 (0.9%), and genotype 7 (1.8%). Our data on species distribution, genotypes, and antifungal susceptibilities may contribute to a better understanding of the epidemiology of invasive Trichosporon infections throughout China.
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Patel R. A Moldy Application of MALDI: MALDI-ToF Mass Spectrometry for Fungal Identification. J Fungi (Basel) 2019; 5:E4. [PMID: 30609833 DOI: 10.3390/jof5010004] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 12/07/2018] [Accepted: 12/25/2018] [Indexed: 12/20/2022] Open
Abstract
As a result of its being inexpensive, easy to perform, fast and accurate, matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-ToF MS) is quickly becoming the standard means of bacterial identification from cultures in clinical microbiology laboratories. Its adoption for routine identification of yeasts and even dimorphic and filamentous fungi in cultures, while slower, is now being realized, with many of the same benefits as have been recognized on the bacterial side. In this review, the use of MALDI-ToF MS for identification of yeasts, and dimorphic and filamentous fungi grown in culture will be reviewed, with strengths and limitations addressed.
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Bonifaz A, Tirado-Sánchez A, Araiza J, Rodríguez-Leviz A, Guzmán-Sánchez D, Gutiérrez-Mendoza S, Castrejón L. White Piedra: Clinical, Mycological, and Therapeutic Experience of Fourteen Cases. Skin Appendage Disord 2018; 5:135-141. [PMID: 31049333 DOI: 10.1159/000493374] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Accepted: 08/23/2018] [Indexed: 11/19/2022] Open
Abstract
Background White piedra (WP) is an asymptomatic superficial mycosis that affects the hair stems, forming whitish nodules caused by various species of the genus Trichosporon. Objective To present a case series of WP of the head, its epidemiological data, as well as clinical, mycological, and therapeutic experience. Methods We conducted a 12-year retrospective and observational study of WP cases tested by dermoscopy, mycological study, and the identification of species through morphology, biochemistry, and proteomics (matrix-assisted laser desorption/ionization time-of-flight mass spectrometry). The treatment was based on ketoco-nazole shampoo as well as keratolytics. Results We included 14 cases of WP, all located in the head and 1 case with both head and scrotum affected. Nine cases (64.3%) presented in children aged < 15 years. The majority of the cases (13/14, 92.8%) were women. Two cases were associated with hyperkeratosis and intertrigo. Most patients had long hair and excessive moisture. In all cases hair nodules were observed and Trichosporon inkin (11/14, 78.6%) was usually isolated. Eleven cases (78.6%) were cured by administering 2% ketoconazole shampoo. Conclusion WP was observed in school-age girls. The diagnosis was based on the observation of hair nodules and its main etiologic agent was T. inkin, with good response to treatment in most cases.
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Affiliation(s)
- Alexandro Bonifaz
- Dermatology Service and Mycology Department, Hospital General de México Dr. Eduardo Liceaga, Mexico City, Mexico
| | - Andrés Tirado-Sánchez
- Dermatology Service and Mycology Department, Hospital General de México Dr. Eduardo Liceaga, Mexico City, Mexico.,Internal Medicine Department, Hospital General de Zona 29, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Javier Araiza
- Dermatology Service and Mycology Department, Hospital General de México Dr. Eduardo Liceaga, Mexico City, Mexico
| | - Alejandra Rodríguez-Leviz
- Pathology Laboratory (Electronic Microscopy), Hospital Infantil de México Dr. Federico Gómez, Mexico City, Mexico
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Arastehfar A, Fang W, Pan W, Lackner M, Liao W, Badiee P, Zomorodian K, Badali H, Hagen F, Lass-Flörl C, Boekhout T. YEAST PANEL multiplex PCR for identification of clinically important yeast species: stepwise diagnostic strategy, useful for developing countries. Diagn Microbiol Infect Dis 2018; 93:112-119. [PMID: 30377018 DOI: 10.1016/j.diagmicrobio.2018.09.007] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 09/07/2018] [Accepted: 09/12/2018] [Indexed: 12/14/2022]
Abstract
Identification of opportunistic yeasts in developing countries is mainly performed by phenotypic assays, which are time-consuming and prone to errors. Wrong species identification may result in suboptimal treatment and inaccurate epidemiological data. To improve rapidity and accuracy of species identification, a diagnostic strategy using a stepwise "YEAST PANEL multiplex PCR assays" targeting 21 clinically important yeast species of Candida, Trichosporon, Rhodotorula, Cryptococcus, and Geotrichum was designed. Four hundred CBS reference strains were used for optimization and specificity testing. Eight hundred clinical species were prepared in blinded sets for multiplex polymerase chain reaction (PCR) and matrix-assisted laser desorption time of flight mass spectrophotometry (MALDI-TOF MS) investigation. Results obtained from YEAST PANEL multiplex PCR assay were 100% consistent with those of MALDI-TOF MS. Utilization of pure colony testing showed distinct amplicons for each species, thus eliminating the need for DNA extraction. The targeted yeast species of this assay are responsible for 95% of the yeast infections. In conclusion, due to the high accuracy and coverage of a broad range of yeasts, this assay could be useful for identification in routine laboratories and epidemiological studies.
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Affiliation(s)
- Amir Arastehfar
- Westerdijk Fungal Biodiversity Institute, Utrecht, the Netherlands
| | - Wenjie Fang
- Westerdijk Fungal Biodiversity Institute, Utrecht, the Netherlands; Department of Dermatology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China; Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Weihua Pan
- Department of Dermatology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China; Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China.
| | - Michaela Lackner
- Division of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Wanqing Liao
- Department of Dermatology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China; Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Parisa Badiee
- Prof. Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kamiar Zomorodian
- Basic Sciences in Infectious Diseases Research Center, and Department of Medical Mycology and Parasitology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamid Badali
- Department of Medical Mycology and Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ferry Hagen
- Westerdijk Fungal Biodiversity Institute, Utrecht, the Netherlands
| | - Cornelia Lass-Flörl
- Division of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Teun Boekhout
- Westerdijk Fungal Biodiversity Institute, Utrecht, the Netherlands; Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China; Institute of Biodiversity and Ecosystem Dynamics, University of Amsterdam, Amsterdam, the Netherlands.
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Yu SY, Guo LN, Xiao M, Kudinha T, Kong F, Wang H, Cheng JW, Zhou ML, Xu H, Xu YC. Trichosporon dohaense, a rare pathogen of human invasive infections, and literature review. Infect Drug Resist 2018; 11:1537-1547. [PMID: 30288064 PMCID: PMC6160283 DOI: 10.2147/idr.s174301] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background Trichosporon dohaense is a rare fungal species that has not been described in human invasive infections. Patients and methods In this study, we investigated two T. dohaense isolates from patients with invasive infections in two hospitals in China, as part of the China Hospital Invasive Fungal Surveillance Net (CHIF-NET) program. Both patients were under immunocompromised conditions. Results On chromogenic agar, T. dohaense isolates were dark blue, similar to the color of Candida. tropicalis, but the characteristic moist colony appearance was quite different from that of T. asahii. The two isolates were misidentified as T. asahii and T. inkin by the VITEK 2 YST system. The rDNA internal transcribed spacer (ITS) region and the D1/D2 domain sequences of the two T. dohaense isolates were 100% identical to T. dohaense type strain CBS10761T. The sequence of the intergenic spacer region-1 also clearly distinguished the species. Of the three matrix-assisted laser desorption/ionization time-of-flight mass spectrometry systems, Bruker Biotyper and Autobio MS correctly identified the two isolates to species level, whereas Vitek MS systems misidentified them as T. ovoides or T. asteroides. Echinocandins exhibited no in vitro activities against the two T. dohaense isolates. In addition, the isolates exhibited intermediate susceptibility to fluconazole (with minimal inhibitory concentrations [MICs] of 8 and 16 µg/mL) and itraconazole, voriconazole, and posaconazole (MICs of 0.25-1 µg/mL). T. dohaense demonstrated susceptibility to amphotericin B with MIC of 1 µg/mL. The MICs of fluconazole and voriconazole in our study were higher than the MIC50 of 62 for T. asahii isolates (4 and 0.064 µg/mL) in the CHIF-NET program. Conclusion This case study points to a possible emergence of T. dohaense as an opportunistic human invasive fungal pathogen, and the reduced susceptibility should be noted.
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Affiliation(s)
- Shu-Ying Yu
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China, .,Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China, .,Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing, China,
| | - Li-Na Guo
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China, .,Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing, China,
| | - Meng Xiao
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China, .,Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing, China,
| | - Timothy Kudinha
- Centre for Infectious Diseases and Microbiology Laboratory Services, ICPMR - Pathology West, University of Sydney, Westmead Hospital, Westmead, NSW, Australia.,Centre for Infectious Diseases and Microbiology Laboratory Services, Westmead Hospital, Westmead, NSW, Australia
| | - Fanrong Kong
- Centre for Infectious Diseases and Microbiology Laboratory Services, ICPMR - Pathology West, University of Sydney, Westmead Hospital, Westmead, NSW, Australia
| | - He Wang
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China, .,Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing, China,
| | - Jing-Wei Cheng
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China, .,Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China, .,Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing, China,
| | - Meng-Lan Zhou
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China, .,Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China, .,Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing, China,
| | - Hui Xu
- Department of Clinical Laboratory, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China,
| | - Ying-Chun Xu
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China, .,Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China, .,Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing, China,
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Florio W, Tavanti A, Barnini S, Ghelardi E, Lupetti A. Recent Advances and Ongoing Challenges in the Diagnosis of Microbial Infections by MALDI-TOF Mass Spectrometry. Front Microbiol 2018; 9:1097. [PMID: 29896172 PMCID: PMC5986882 DOI: 10.3389/fmicb.2018.01097] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 05/08/2018] [Indexed: 12/25/2022] Open
Abstract
Timeliness and accuracy in the diagnosis of microbial infections are associated with decreased mortality and reduced length of hospitalization, especially for severe, life-threatening infections. A rapid diagnosis also allows for early streamlining of empirical antimicrobial therapies, thus contributing to limit the emergence and spread of antimicrobial resistance. The introduction of matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) mass spectrometry (MS) for routine identification of microbial pathogens has profoundly influenced microbiological diagnostics, and is progressively replacing biochemical identification methods. Compared to currently used identification methods, MALDI-TOF MS has the advantage of identifying bacteria and yeasts directly from colonies grown on culture plates for primary isolation in a few minutes and with considerable material and labor savings. The reliability and accuracy of MALDI-TOF MS in identification of clinically relevant bacteria and yeasts has been demonstrated by several studies showing that the performance of MALDI-TOF MS is comparable or superior to phenotypic methods currently in use in clinical microbiology laboratories, and can be further improved by database updates and analysis software upgrades. Besides microbial identification from isolated colonies, new perspectives are being explored for MALDI-TOF MS, such as identification of pathogens directly from positive blood cultures, sub-species typing, and detection of drug resistance determinants. In this review, we summarize the state of the art in routine identification of microbial pathogens by MALDI-TOF MS, and highlight recent advancements of this technology in special applications, such as strain typing, assessment of drug susceptibility, and detection of virulence factors.
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Affiliation(s)
- Walter Florio
- Dipartimento di Ricerca Traslazionale e delle Nuove Tecnologie in Medicina e Chirurgia, Università di Pisa, Pisa, Italy
| | | | | | - Emilia Ghelardi
- Dipartimento di Ricerca Traslazionale e delle Nuove Tecnologie in Medicina e Chirurgia, Università di Pisa, Pisa, Italy
| | - Antonella Lupetti
- Dipartimento di Ricerca Traslazionale e delle Nuove Tecnologie in Medicina e Chirurgia, Università di Pisa, Pisa, Italy
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Sanata B, Adama Z, Ibrahim S, Apoline S, Mamoudou C, Constant S, Robert GT, Christophe H. Characterization of the fungal flora of dolo, a traditional fermented beverage of Burkina Faso, using MALDI-TOF mass spectrometry. World J Microbiol Biotechnol 2017; 33:172. [PMID: 28852966 DOI: 10.1007/s11274-017-2335-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Accepted: 08/12/2017] [Indexed: 11/29/2022]
Abstract
A cross-sectional study was conducted in Bobo-Dioulasso, Burkina Faso, to identify the yeast diversity associated with the manufacture of dolo, a traditional fermented beverage of Burkina Faso. From sixty specimens spread onto chromogenic medium plates, sixty-two strains were isolated then identified using MALDI-TOF analysis. Seven yeast species were identified, Saccharomyces cerevisiae (39%) followed by Pichia manshurica (18%) being the most frequent. Forty-three percent of the samples contained Candida species, notably Candida albicans. In conclusion, the combined use of a chromogenic medium and MALDI-TOF analysis reveals a higher diversity in yeast species present in the dolo than previously thought.
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Affiliation(s)
- Bamba Sanata
- Department of Parasitology-Mycology, University Hospital Sanou Souro, Bobo-Dioulasso, Burkina Faso.,Department of Parasitology-Mycology, Higher Institute of Health Sciences, Polytechnic University of Bobo-Dioulasso, Bobo-Dioulasso, Burkina Faso
| | - Zida Adama
- Department of Parasitology-Mycology, University Hospital Sanou Souro, Bobo-Dioulasso, Burkina Faso
| | - Sangaré Ibrahim
- Department of Parasitology-Mycology, University Hospital Sanou Souro, Bobo-Dioulasso, Burkina Faso.,Department of Parasitology-Mycology, Higher Institute of Health Sciences, Polytechnic University of Bobo-Dioulasso, Bobo-Dioulasso, Burkina Faso
| | - Sondo Apoline
- Faculty of Health Sciences, University of Ouagadougou, Ouagadougou, Burkina Faso
| | - Cissé Mamoudou
- Department of Parasitology-Mycology, Higher Institute of Health Sciences, Polytechnic University of Bobo-Dioulasso, Bobo-Dioulasso, Burkina Faso
| | - Sirima Constant
- Department of Parasitology-Mycology, University Hospital Sanou Souro, Bobo-Dioulasso, Burkina Faso
| | - Guiguemdé T Robert
- Department of Parasitology-Mycology, Higher Institute of Health Sciences, Polytechnic University of Bobo-Dioulasso, Bobo-Dioulasso, Burkina Faso.,Department of Bacteriology-Virology, Higher Institute of Health Sciences, Polytechnic University of Bobo-Dioulasso, Bobo-Dioulasso, Burkina Faso
| | - Hennequin Christophe
- Sorbonne Universités, UPMC Univ Paris 06, Inserm UMR S 1135, CNRS ERL 8255, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), F-75013, Paris, France. .,Service de Parasitologie-Mycologie, AP-HP, Hôpital St Antoine, 34 rue Crozatier, F-75012, Paris, France.
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de Almeida JN Jr, Favero Gimenes VM, Francisco EC, Machado Siqueira LP, Gonçalves de Almeida RK, Guitard J, Hennequin C, Colombo AL, Benard G, Rossi F. Evaluating and Improving Vitek MS for Identification of Clinically Relevant Species of Trichosporon and the Closely Related Genera Cutaneotrichosporon and Apiotrichum. J Clin Microbiol 2017; 55:2439-44. [PMID: 28539340 DOI: 10.1128/JCM.00461-17] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Accepted: 05/16/2017] [Indexed: 12/27/2022] Open
Abstract
Trichosporon species are relevant etiologic agents of hospital-acquired infections. High mortality rates are attributed to Trichosporon deep-seated infections in immunocompromised individuals, making fast and accurate species identification relevant for hastening the discovery of best-targeted therapy. Recently, Trichosporon taxonomy has been reassessed, and three genera have been proposed for the pathogenic species: Trichosporon, Cutaneotrichosporon, and Apiotrichum Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) has replaced old phenotypic methods for microorganism identification in clinical laboratories, but spectral profile databases have to be evaluated and improved for optimal species identification performance. Vitek MS (bioMérieux) is one of the commercially available MALDI-TOF MS platforms for pathogen identification, and its spectral profile databases remain poorly evaluated for Trichosporon, Cutaneotrichosporon, and Apiotrichum species identification. We herein evaluated and improved Vitek MS for the identification of the main clinical relevant species of Trichosporon, Cutaneotrichosporon, and Apiotrichum using a large set of strains and isolates belonging to different yeast collections in Brazil and France.
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Duarte-Oliveira C, Rodrigues F, Gonçalves SM, Goldman GH, Carvalho A, Cunha C. The Cell Biology of the Trichosporon-Host Interaction. Front Cell Infect Microbiol 2017; 7:118. [PMID: 28439501 PMCID: PMC5383668 DOI: 10.3389/fcimb.2017.00118] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 03/23/2017] [Indexed: 11/13/2022] Open
Abstract
Fungi of the genus Trichosporon are increasingly recognized as causative agents of superficial and invasive fungal disease in humans. Although most species are considered commensals of the human skin and gastrointestinal tract, these basidiomycetes are an increasing cause of fungal disease among immunocompromised hosts, such as hematological patients and solid organ transplant recipients. The initiation of commensal or pathogenic programs by Trichosporon spp. involves the adaptation to the host microenvironment and its immune system. However, the exact virulence factors activated upon the transition to a pathogenic lifestyle, including the intricate biology of the cell wall, and how these interact with and subvert the host immune responses remain largely unknown. Here, we revisit our current understanding of the virulence attributes of Trichosporon spp., particularly T. asahii, and their interaction with the host immune system, and accommodate this knowledge within novel perspectives on fungal diagnostics and therapeutics.
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Affiliation(s)
- Cláudio Duarte-Oliveira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of MinhoBraga, Portugal.,ICVS/3B's - PT Government Associate LaboratoryBraga/Guimarães, Portugal
| | - Fernando Rodrigues
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of MinhoBraga, Portugal.,ICVS/3B's - PT Government Associate LaboratoryBraga/Guimarães, Portugal
| | - Samuel M Gonçalves
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of MinhoBraga, Portugal.,ICVS/3B's - PT Government Associate LaboratoryBraga/Guimarães, Portugal
| | - Gustavo H Goldman
- Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São PauloSão Paulo, Brazil
| | - Agostinho Carvalho
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of MinhoBraga, Portugal.,ICVS/3B's - PT Government Associate LaboratoryBraga/Guimarães, Portugal
| | - Cristina Cunha
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of MinhoBraga, Portugal.,ICVS/3B's - PT Government Associate LaboratoryBraga/Guimarães, Portugal
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de Almeida Júnior JN, Hennequin C. Invasive Trichosporon Infection: a Systematic Review on a Re-emerging Fungal Pathogen. Front Microbiol 2016; 7:1629. [PMID: 27799926 PMCID: PMC5065970 DOI: 10.3389/fmicb.2016.01629] [Citation(s) in RCA: 94] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Accepted: 09/29/2016] [Indexed: 12/11/2022] Open
Abstract
Objectives: This review aimed to better depict the clinical features and address the issue of therapeutic management of Trichosporon deep-seated infections. Methods: We comprehensively reviewed the cases of invasive Trichosporon infection reported in the literature from 1994 (date of taxonomic modification) to 2015. Data from antifungal susceptibility testing (AST) studies were also analyzed. Results: Two hundred and three cases were retained and split into four groups: homeopathy (n = 79), other immunodeficiency conditions (n = 41), miscellaneous (n = 58) and newborns (n = 25). Trichosporon asahii was the main causative species (46.7%) and may exhibit cross-resistance to different antifungal classes. The unfavorable outcome rate was at 44.3%. By multivariate analysis, breakthrough infection (OR 2.45) was associated with unfavorable outcome, whilst the use of an azole-based therapy improved the prognosis (OR 0.16). Voriconazole-based treatment was associated with favorable outcome in hematological patients (73.6 vs. 41.8%; p = 0.016). Compiled data from AST demonstrated that (i) T. asahii exhibits the highest MICs to amphotericin B and (ii) voriconazole has the best in vitro efficacy against clinical isolates of Trichosporon spp. Conclusions:Trichosporon infection is not only restricted to hematological patients. Analysis of compiled data from AST and clinical outcome support the use of voriconazole as first line therapy.
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Affiliation(s)
- João N de Almeida Júnior
- Central Laboratory Division-LIM03, Faculdade de Medicina da Universidade de São PauloSão Paulo, Brazil; Laboratory of Medical Mycology-LIM53, Instituto de Medicina Tropical da Universidade de São PauloSão Paulo, Brazil
| | - Christophe Hennequin
- Service de Parasitologie-Mycologie-AP-HP, Hôpital St AntoineParis, France; Institut National de la Santé et de la Recherche Médicale UMR 1135, Centre National de la Recherche Scientifique ERL 8255, Sorbonne Universités, University Pierre and Marie Curie (UPMC)Paris, France; Centre d'Immunologie et des Maladies Infectieuses, Bd de l'hôpitalParis, France
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22
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Grenfell RC, da Silva Junior AR, Del Negro GMB, Munhoz RB, Gimenes VMF, Assis DM, Rockstroh AC, Motta AL, Rossi F, Juliano L, Benard G, de Almeida Júnior JN. Identification of Candida haemulonii Complex Species: Use of ClinProTools(TM) to Overcome Limitations of the Bruker Biotyper(TM), VITEK MS(TM) IVD, and VITEK MS(TM) RUO Databases. Front Microbiol 2016; 7:940. [PMID: 27379069 PMCID: PMC4909767 DOI: 10.3389/fmicb.2016.00940] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 06/01/2016] [Indexed: 11/13/2022] Open
Abstract
Candida haemulonii is now considered a complex of two species and one variety: C. haemulonii sensu stricto, Candida duobushaemulonii and the variety C. haemulonii var. vulnera. Identification (ID) of these species is relevant for epidemiological purposes and for therapeutic management, but the different phenotypic commercial systems are unable to provide correct species ID for these emergent pathogens. Hence, we evaluated the MALDI-TOF MS performance for the ID of C. haemulonii species, analyzing isolates/strains of C. haemulonii complex species, Candida pseudohaemulonii and Candida auris by two commercial platforms, their databases and softwares. To differentiate C. haemulonii sensu sctricto from the variety vulnera, we used the ClinProToolsTM models and a single-peak analysis with the software FlexAnalysisTM. The BiotyperTM database gave 100% correct species ID for C. haemulonii sensu stricto, C. pseudohaemulonii and C. auris, with 69% of correct species ID for C. duobushaemulonii. Vitek MSTM IVD database gave 100% correct species ID for C. haemulonii sensu stricto, misidentifying all C. duobushaemulonii and C. pseudohaemulonii as C. haemulonii, being unable to identify C. auris. The Vitek MSTM RUO database needed to be upgraded with in-house SuperSpectra to discriminate C. haemulonii sensu stricto, C. duobushaemulonii, C. pseudohaemulonii, and C. auris strains/isolates. The generic algorithm model from ClinProToolsTM software showed recognition capability of 100% and cross validation of 98.02% for the discrimination of C. haemulonii sensu stricto from the variety vulnera. Single-peak analysis showed that the peaks 5670, 6878, or 13750 m/z can distinguish C. haemulonii sensu stricto from the variety vulnera.
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Affiliation(s)
- Rafaella C Grenfell
- Department of Biophysics, Escola Paulista de Medicina, Universidade Federal de São Paulo São Paulo, Brazil
| | - Afonso R da Silva Junior
- Central Laboratory Division - LIM-03, Hospital das Clínicas da Faculdade de Medicina, Universidade de São Paulo São Paulo, Brazil
| | - Gilda M B Del Negro
- Laboratory of Medical Mycology - LIM-53, Hospital das Clínicas FMUSP and Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo São Paulo, Brazil
| | - Regina B Munhoz
- Central Laboratory Division - LIM-03, Hospital das Clínicas da Faculdade de Medicina, Universidade de São Paulo São Paulo, Brazil
| | - Viviane M F Gimenes
- Laboratory of Medical Mycology - LIM-53, Hospital das Clínicas FMUSP and Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo São Paulo, Brazil
| | | | | | - Adriana L Motta
- Central Laboratory Division - LIM-03, Hospital das Clínicas da Faculdade de Medicina, Universidade de São Paulo São Paulo, Brazil
| | - Flavia Rossi
- Central Laboratory Division - LIM-03, Hospital das Clínicas da Faculdade de Medicina, Universidade de São Paulo São Paulo, Brazil
| | - Luiz Juliano
- Department of Biophysics, Escola Paulista de Medicina, Universidade Federal de São Paulo São Paulo, Brazil
| | - Gil Benard
- Laboratory of Medical Mycology - LIM-53, Hospital das Clínicas FMUSP and Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo São Paulo, Brazil
| | - João N de Almeida Júnior
- Central Laboratory Division - LIM-03, Hospital das Clínicas da Faculdade de Medicina, Universidade de São PauloSão Paulo, Brazil; Laboratory of Medical Mycology - LIM-53, Hospital das Clínicas FMUSP and Instituto de Medicina Tropical de São Paulo, Universidade de São PauloSão Paulo, Brazil
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23
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Alby-Laurent F, Dollfus C, Ait-Oufella H, Rambaud J, Legrand O, Tabone MD, Hennequin C. Trichosporon
: another yeast-like organism responsible for immune reconstitution inflammatory syndrome in patients with hematological malignancy. Hematol Oncol 2016; 35:900-904. [DOI: 10.1002/hon.2309] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2015] [Revised: 04/08/2016] [Accepted: 04/27/2016] [Indexed: 11/12/2022]
Affiliation(s)
- Fanny Alby-Laurent
- Service d'Hémato-Oncologie Pédiatrique; AP-HP, Hôpital A. Trousseau; Paris France
- Service de Réanimation Pédiatrique; AP-HP, Hôpital A. Trousseau; Paris France
| | - Catherine Dollfus
- Service d'Hémato-Oncologie Pédiatrique; AP-HP, Hôpital A. Trousseau; Paris France
| | - Hafid Ait-Oufella
- Service de Réanimation Médicale; AP-HP, Hôpital St Antoine; Paris France
| | - Jerome Rambaud
- Service de Réanimation Pédiatrique; AP-HP, Hôpital A. Trousseau; Paris France
| | - Ollivier Legrand
- Service d'hématologie clinique et de thérapie cellulaire; AP-HP, Hôpital St Antoine; Paris France
| | | | - Christophe Hennequin
- Assistance Publique-Hôpitaux de Paris; Hôpital St Antoine, Service de Parasitologie-Mycologie; Paris France
- Inserm; U1135, CIMI-Paris; Paris France
- CNRS; ERL 8255, CIMI-Paris; Paris France
- Sorbonne Universités; UPMC Univ Paris 06, CR7, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris); Paris France
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24
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Rizzato C, Lombardi L, Zoppo M, Lupetti A, Tavanti A. Pushing the Limits of MALDI-TOF Mass Spectrometry: Beyond Fungal Species Identification. J Fungi (Basel) 2015; 1:367-83. [PMID: 29376916 DOI: 10.3390/jof1030367] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 10/05/2015] [Accepted: 10/07/2015] [Indexed: 12/12/2022] Open
Abstract
Matrix assisted laser desorption ionization time of flight (MALDI-TOF) is a powerful analytical tool that has revolutionized microbial identification. Routinely used for bacterial identification, MALDI-TOF has recently been applied to both yeast and filamentous fungi, confirming its pivotal role in the rapid and reliable diagnosis of infections. Subspecies-level identification holds an important role in epidemiological investigations aimed at tracing virulent or drug resistant clones. This review focuses on present and future applications of this versatile tool in the clinical mycology laboratory.
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25
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Suh SO, Houseknecht JL, Grosso KM, Carrion ME. Characterization of the medically important yeast Trichosporon mucoides and its close sister Trichosporon dermatis by traditional and advanced technologies. J Med Microbiol 2015; 64:1135-1143. [DOI: 10.1099/jmm.0.000134] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Sung-Oui Suh
- ATCC, 10801 University Blvd., Manassas, VA 20110, USA
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26
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Affiliation(s)
- Marçal Mariné
- Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, São Paulo, Brazil
| | - Neil Andrew Brown
- Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, São Paulo, Brazil
| | | | - Gustavo Henrique Goldman
- Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, São Paulo, Brazil
- Laboratório Nacional de Ciência e Tecnologia do Bioetanol—CTBE, Campinas, São Paulo, Brazil
- * E-mail:
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27
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Nobrega de Almeida J Jr, Del Negro GM, Grenfell RC, Vidal MS, Thomaz DY, de Figueiredo DS, Bagagli E, Juliano L, Benard G. Matrix-assisted laser desorption ionization-time of flight mass spectrometry for differentiation of the dimorphic fungal species Paracoccidioides brasiliensis and Paracoccidioides lutzii. J Clin Microbiol 2015; 53:1383-6. [PMID: 25631803 DOI: 10.1128/JCM.02847-14] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Isolates of Paracoccidioides brasiliensis and Paracoccidioides lutzii, previously characterized by molecular techniques, were identified for the first time by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). All isolates were correctly identified, with log score values of >2.0. Thus, MALDI-TOF MS is a new tool for differentiating species of the genus Paracoccidioides.
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