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Lipovy B, Hladik M, Vyklicka K, Kocmanova I, Lengerova M, Kren L, Srnik M, Bohm J, Andrla P, Borilova Linhartova P. Rare multi-fungal sepsis: a case of triple-impact immunoparalysis. Folia Microbiol (Praha) 2024:10.1007/s12223-024-01165-0. [PMID: 38647991 DOI: 10.1007/s12223-024-01165-0] [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: 09/05/2023] [Accepted: 04/10/2024] [Indexed: 04/25/2024]
Abstract
Patients with burn injury and inhalation injury are highly susceptible to infectious complications, including opportunistic pathogens, due to the loss of skin cover and mucosal damage of respiratory tract as well as the disruption of homeostasis. This case report, a 34-year-old man suffered critical burns, provides the first literature description of triple-impact immunoparalysis (critical burns, inhalation injury, and SARS-CoV-2 infection), leading to a lethal multifocal infection caused by several fungi including very rare environmental representatives Metschnikowia pulcherrima and Wickerhamomyces anomalus. The co-infection by these common environmental yeasts in a human is unique and has not yet been described in the literature. Importantly, our patient developed refractory septic shock and died despite targeted antifungal therapy including the most potent current antifungal agent-isavuconazole. It can be assumed that besides immunoparalysis, effectiveness of therapy by isavuconazole was impaired by the large distribution volume in this case. As this is a common situation in intensive care patients, routine monitoring of plasmatic concentration of isavuconazole can be helpful in personalization of the treatment and dose optimization. Whatmore, many fungal species often remain underdiagnosed during infectious complications, which could be prevented by implementation of new methods, such as next-generation sequencing, into clinical practice.
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Affiliation(s)
- Bretislav Lipovy
- Department of Burns and Plastic Surgery, Faculty of Medicine, Institution Shared With University Hospital Brno, Masaryk University, Jihlavska 20, Brno, Czech Republic
- CEITEC - Central European Institute of Technology, Brno University of Technology, Purkynova 656/123, Brno, Czech Republic
| | - Martin Hladik
- Department of Burns and Plastic Surgery, Faculty of Medicine, Institution Shared With University Hospital Brno, Masaryk University, Jihlavska 20, Brno, Czech Republic
| | - Katerina Vyklicka
- RECETOX, Faculty of Science, Masaryk University, Kotlarska 2, Brno, Czech Republic
| | - Iva Kocmanova
- Department of Clinical Microbiology and Immunology, University Hospital Brno, Jihlavska 20, Brno, Czech Republic
| | - Martina Lengerova
- Department of Internal Medicine - Haematology and Oncology, Faculty of Medicine, Institution Shared With University Hospital Brno, Masaryk University, Jihlavska 20, Brno, Czech Republic
| | - Leos Kren
- Department of Pathology, Faculty of Medicine, Institution Shared With University Hospital Brno, Masaryk University, Jihlavska 20, Brno, Czech Republic
| | - Michal Srnik
- Department of Forensic Medicine, Institutions Shared With St. Anne's Faculty Hospital, Faculty of Medicine, Masaryk University, Pekarska 664/53, Brno, Czech Republic
| | - Jan Bohm
- RECETOX, Faculty of Science, Masaryk University, Kotlarska 2, Brno, Czech Republic
| | - Petr Andrla
- RECETOX, Faculty of Science, Masaryk University, Kotlarska 2, Brno, Czech Republic
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Sakai Y, Taniguchi T, Herai Y, Yahaba M, Watanabe A, Kamei K, Igari H. Fungemia With Wickerhamomyces anomalus: A Case Report and Literature Review. Cureus 2024; 16:e53550. [PMID: 38445156 PMCID: PMC10912825 DOI: 10.7759/cureus.53550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2024] [Indexed: 03/07/2024] Open
Abstract
We report the case of an 84-year-old man with a history of IgG4-related sclerosing cholangitis who was diagnosed with advanced esophageal cancer and underwent radiation and chemotherapy. An implantable central venous access port was placed for chemotherapy and total parenteral nutrition. The patient presented with a fever and received antimicrobial therapy for acute cholangitis but remained febrile, and subsequently, yeast was detected in the aerobic bottle of blood culture obtained from the central venous line. The yeast was identified as Wickerhamomyces anomalus. Liposomal amphotericin B was administered, and the central line access port was removed. After confirmation of negative blood cultures and 14 days post treatment, he underwent reinsertion of the central line access port. Due to persistent pain at the insertion site, fluconazole was added for an additional 14 days, and the patient was discharged and transferred to another hospital. Wickerhamomyces anomalus is a rare fungal infection with other synonyms including Pichia anomala, Hansenula anomala, and Candida pelliculosa. A literature review of 53 case reports of Wickerhamomyces anomalus, Pichia anomala, Hansenula anomala, and Candida pelliculosa was conducted, with a total of 211 cases reviewed. Fungemia was reported in 94% of cases, with central venous catheterization, parental feeding, low birth weight, and immunocompromised status identified as major risk factors. The majority of cases were pediatric, particularly neonatal, and there were reports of nosocomial infections causing outbreaks, with some cases involving the eye such as endophthalmitis or keratitis.
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Affiliation(s)
- Yui Sakai
- Infectious Diseases, Chiba University School of Medicine, Chiba, JPN
| | | | - Yoriko Herai
- Infectious Diseases, Chiba University Hospital, Chiba, JPN
- Respiratory Medicine, Misato Central General Hospital, Misato, JPN
| | - Misuzu Yahaba
- Infectious Diseases, Chiba University Hospital, Chiba, JPN
| | - Akira Watanabe
- Clinical Research, Chiba University Medical Mycology Research Centre, Chiba, JPN
| | - Katsuhiko Kamei
- Clinical Research, Chiba University Medical Mycology Research Centre, Chiba, JPN
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Glushakova A, Kachalkin A, Rodionova E. The role of fruits as reservoirs for resistant and virulent strains of opportunistic yeasts. World J Microbiol Biotechnol 2023; 39:313. [PMID: 37733093 DOI: 10.1007/s11274-023-03758-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 09/07/2023] [Indexed: 09/22/2023]
Abstract
Strains of the Candida parapsilosis and Meyerozyma guilliermondii species complexes isolated from the internal tissues of 26 fruit species from 21 countries were evaluated for their susceptibility to conventional antifungal compounds (fluconazole, voriconazole, amphotericin B) and hydrolytic activity. A total of 144 strains were studied. Resistance to at least one of the antifungal compounds tested was found in 26.4% of the endophytic strains examined. Most of the strains were insensitive to fluconazole. Multiresistance was detected only in two strains of C. parapsilosis sensu stricto from tropical apples. Phospholipase production and proteolytic and hemolytic activities were significantly higher in endophytes from tropical fruits. Resistant and virulent strains of opportunistic yeasts can thus spread worldwide via purchased fruit, which can harm people with a weakened immune status and children whose immune systems are not yet fully developed.
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Affiliation(s)
- Anna Glushakova
- Soil Science Faculty, Lomonosov Moscow State University, 119991, Moscow, Russia.
- I.I. Mechnikov Research Institute of Vaccines and Sera, Moscow, 105064, Russia.
| | - Aleksey Kachalkin
- Soil Science Faculty, Lomonosov Moscow State University, 119991, Moscow, Russia
- G.K. Skryabin Institute of Biochemistry and Physiology of Microorganisms of RAS, Pushchino, 142290, Russia
| | - Evgenia Rodionova
- I.I. Mechnikov Research Institute of Vaccines and Sera, Moscow, 105064, Russia
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4
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Miguel GA, Carlsen S, Arneborg N, Saerens SM, Laulund S, Knudsen GM. Non-Saccharomyces yeasts for beer production: Insights into safety aspects and considerations. Int J Food Microbiol 2022; 383:109951. [DOI: 10.1016/j.ijfoodmicro.2022.109951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 09/14/2022] [Accepted: 09/22/2022] [Indexed: 11/05/2022]
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Overview on the Infections Related to Rare Candida species. Pathogens 2022; 11:pathogens11090963. [PMID: 36145394 PMCID: PMC9505029 DOI: 10.3390/pathogens11090963] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/19/2022] [Accepted: 08/21/2022] [Indexed: 11/30/2022] Open
Abstract
Atypical Candida spp. infections are rising, mostly due to the increasing numbers of immunocompromised patients. The most common Candida spp. is still Candida albicans; however, in the last decades, there has been an increase in non-Candida albicans Candida species infections (e.g., Candida glabrata, Candida parapsilosis, and Candida tropicalis). Furthermore, in the last 10 years, the reports on uncommon yeasts, such as Candida lusitaniae, Candida intermedia, or Candida norvegensis, have also worryingly increased. This review summarizes the information, mostly related to the last decade, regarding the infections, diagnosis, treatment, and resistance of these uncommon Candida species. In general, there has been an increase in the number of articles associated with the incidence of these species. Additionally, in several cases, there was a suggestive antifungal resistance, particularly with azoles, which is troublesome for therapeutic success.
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Nundaeng S, Suwannarach N, Limtong S, Khuna S, Kumla J, Lumyong S. An Updated Global Species Diversity and Phylogeny in the Genus Wickerhamomyces with Addition of Two New Species from Thailand. J Fungi (Basel) 2021; 7:957. [PMID: 34829244 PMCID: PMC8618796 DOI: 10.3390/jof7110957] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/07/2021] [Accepted: 11/08/2021] [Indexed: 12/15/2022] Open
Abstract
Ascomycetous yeast species in the genus Wickerhamomyces (Saccharomycetales, Wickerhamomycetaceae) are isolated from various habitats and distributed throughout the world. Prior to this study, 35 species had been validly published and accepted into this genus. Beneficially, Wickerhamomyces species have been used in a number of biotechnologically applications of environment, food, beverage industries, biofuel, medicine and agriculture. However, in some studies, Wickerhamomyces species have been identified as an opportunistic human pathogen. Through an overview of diversity, taxonomy and recently published literature, we have updated a brief review of Wickerhamomyces. Moreover, two new Wickerhamomyces species were isolated from the soil samples of Assam tea (Camellia sinensis var. assamica) that were collected from plantations in northern Thailand. Herein, we have identified these species as W. lannaensis and W. nanensis. The identification of these species was based on phenotypic (morphological, biochemical and physiological characteristics) and molecular analyses. Phylogenetic analyses of a combination of the internal transcribed spacer (ITS) region and the D1/D2 domains of the large subunit (LSU) of ribosomal DNA genes support that W. lannaensis and W. nanensis are distinct from other species within the genus Wickerhamomyces. A full description, illustrations and a phylogenetic tree showing the position of both new species have been provided. Accordingly, a new combination species, W. myanmarensis has been proposed based on the phylogenetic results. A new key for species identification is provided.
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Affiliation(s)
- Supakorn Nundaeng
- Master of Science Program in Applied Microbiology (International Program), Faculty of Science, Chiang Mai University, Chiang Mai 50200, Thailand;
- Department of Biology, Faculty of Science, Chiang Mai University, Chiang Mai 50200, Thailand; (N.S.); (S.K.)
| | - Nakarin Suwannarach
- Department of Biology, Faculty of Science, Chiang Mai University, Chiang Mai 50200, Thailand; (N.S.); (S.K.)
- Research Center of Microbial Diversity and Sustainable Utilization, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Savitree Limtong
- Department of Microbiology, Faculty of Science, Kasetsart University, Bangkok 10900, Thailand;
- Academy of Science, The Royal Society of Thailand, Bangkok 10300, Thailand
| | - Surapong Khuna
- Department of Biology, Faculty of Science, Chiang Mai University, Chiang Mai 50200, Thailand; (N.S.); (S.K.)
- Research Center of Microbial Diversity and Sustainable Utilization, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Jaturong Kumla
- Department of Biology, Faculty of Science, Chiang Mai University, Chiang Mai 50200, Thailand; (N.S.); (S.K.)
- Research Center of Microbial Diversity and Sustainable Utilization, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Saisamorn Lumyong
- Department of Biology, Faculty of Science, Chiang Mai University, Chiang Mai 50200, Thailand; (N.S.); (S.K.)
- Research Center of Microbial Diversity and Sustainable Utilization, Chiang Mai University, Chiang Mai 50200, Thailand
- Academy of Science, The Royal Society of Thailand, Bangkok 10300, Thailand
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Formulation and Safety Tests of a Wickerhamomyces anomalus-Based Product: Potential Use of Killer Toxins of a Mosquito Symbiotic Yeast to Limit Malaria Transmission. Toxins (Basel) 2021; 13:toxins13100676. [PMID: 34678969 PMCID: PMC8538654 DOI: 10.3390/toxins13100676] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/09/2021] [Accepted: 09/18/2021] [Indexed: 01/16/2023] Open
Abstract
Wickerhamomyces anomalus strain WaF17.12 is a yeast with an antiplasmodial property based on the production of a killer toxin. For its symbiotic association with Anopheles mosquitoes, it has been proposed for the control of malaria. In an applied view, we evaluated the yeast formulation by freeze-drying WaF17.12. The study was carried out by comparing yeast preparations stored at room temperature for different periods, demonstrating that lyophilization is a useful method to obtain a stable product in terms of cell growth reactivation and maintenance of the killer toxin antimicrobial activity. Moreover, cytotoxic assays on human cells were performed, showing no effects on the cell viability and the proinflammatory response. The post-formulation effectiveness of the killer toxin and the safety tests indicate that WaF17.12 is a promising bioreagent able to impair the malaria parasite in vector mosquitoes.
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Koutsoumanis K, Allende A, Alvarez‐Ordóñez A, Bolton D, Bover‐Cid S, Chemaly M, Davies R, De Cesare A, Hilbert F, Lindqvist R, Nauta M, Peixe L, Ru G, Simmons M, Skandamis P, Suffredini E, Cocconcelli PS, Fernández Escámez PS, Prieto‐Maradona M, Querol A, Sijtsma L, Suarez JE, Sundh I, Vlak J, Barizzone F, Hempen M, Herman L. Update of the list of QPS-recommended biological agents intentionally added to food or feed as notified to EFSA 14: suitability of taxonomic units notified to EFSA until March 2021. EFSA J 2021; 19:e06689. [PMID: 34257732 PMCID: PMC8262138 DOI: 10.2903/j.efsa.2021.6689] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The qualified presumption of safety (QPS) approach was developed to provide a regularly updated generic pre-evaluation of the safety of biological agents, intended for addition to food or feed, to support the work of EFSA's Scientific Panels. The QPS approach is based on an assessment of published data for each agent, with respect to its taxonomic identity, the body of relevant knowledge, safety concerns and occurrence of antimicrobial resistance. Safety concerns identified for a taxonomic unit (TU) are, where possible, confirmed at the species/strain or product level and reflected by 'qualifications'. In the period covered by this statement, no new information was found that would change the status of previously recommended QPS TUs. Schizochytrium limacinum, which is a synonym for Aurantiochytrium limacinum, was added to the QPS list. Of the 78 microorganisms notified to EFSA between October 2020 and March 2021, 71 were excluded; 16 filamentous fungi, 1 Dyella spp., 1 Enterococcus faecium, 7 Escherichia coli, 1 Streptomyces spp., 1 Schizochytrium spp. and 44 TUs that had been previously evaluated. Seven TUs were evaluated: Corynebacterium stationis and Kodamaea ohmeri were re-assessed because an update was requested for the current mandate. Anoxybacillus caldiproteolyticus, Bacillus paralicheniformis, Enterobacter hormaechei, Eremothecium ashbyi and Lactococcus garvieae were assessed for the first time. The following TUs were not recommended for QPS status: A. caldiproteolyticus due to the lack of a body of knowledge in relation to its use in the food or feed chain, E. hormaechei, L. garvieae and K. ohmeri due to their pathogenic potential, E. ashbyi and C. stationis due to a lack of body of knowledge on their occurrence in the food and feed chain and to their pathogenic potential. B. paralicheniformis was recommended for the QPS status with the qualification 'absence of toxigenic activity' and 'absence of genetic information to synthesize bacitracin'.
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Azole Susceptibility Profiles of More than 9,000 Clinical Yeast Isolates Belonging to 40 Common and Rare Species. Antimicrob Agents Chemother 2021; 65:AAC.02615-20. [PMID: 33820766 DOI: 10.1128/aac.02615-20] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 03/29/2021] [Indexed: 01/08/2023] Open
Abstract
Invasive yeast infections represent a major global public health issue, and only few antifungal agents are available. Azoles are one of the classes of antifungals used for treatment of invasive candidiasis. The determination of antifungal susceptibility profiles using standardized methods is important to identify resistant isolates and to uncover the potential emergence of intrinsically resistant species. Here, we report data on 9,319 clinical isolates belonging to 40 pathogenic yeast species recovered in France over 17 years. The antifungal susceptibility profiles were all determined at the National Reference Center for Invasive Mycoses and Antifungals based on the EUCAST broth microdilution method. The centralized collection and analysis allowed us to describe the trends of azole susceptibility of isolates belonging to common species, confirming the high susceptibility for Candida albicans (n = 3,295), Candida tropicalis (n = 641), and Candida parapsilosis (n = 820) and decreased susceptibility for Candida glabrata (n = 1,274) and Pichia kudriavzevii (n = 343). These profiles also provide interesting data concerning azole susceptibility of Cryptococcus neoformans species complex, showing comparable MIC distributions for the three species but lower MIC50s and MIC90s for serotype D (n = 208) compared to serotype A (n = 949) and AD hybrids (n = 177). Finally, these data provide useful information for rare and/or emerging species, such as Clavispora lusitaniae (n = 221), Saprochaete clavata (n = 184), Meyerozyma guilliermondii complex (n = 150), Candida haemulonii complex (n = 87), Rhodotorula mucilaginosa (n = 55), and Wickerhamomyces anomalus (n = 36).
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Meade E, Savage M, Slattery M, Garvey M. Investigation of Alternative Therapeutic and Biocidal Options to Combat Antifungal-Resistant Zoonotic Fungal Pathogens Isolated from Companion Animals. Infect Dis Rep 2021; 13:348-366. [PMID: 33920450 PMCID: PMC8167567 DOI: 10.3390/idr13020034] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 03/24/2021] [Accepted: 04/09/2021] [Indexed: 02/04/2023] Open
Abstract
Fungal skin infections and iatrogenic disease of companion animals continue to be an ongoing issue for veterinarians, where misdiagnosis or inapt medical treatment result in secondary conditions within animals. The widespread use of antifungals in both modern medicine and agriculture has resulted in concomitant resistance in species, where zoonotic transfer poses a risk to public health. Studies described herein assess the resistance of pathogenic species isolated from companion animals to a battery of conventional antimicrobial agents. Levels of resistance were detected using recognised in vitro methods, where additional novel therapeutic and biocide options were also extensively investigated. Results show high levels of resistance to the three main families of antifungal agents, namely caspofungin, Amp B and fluconazole. Resistance in Candida, Cryptococcal, Aspergillus and Trichophyton species is described herein, highlighting the need for defined species-specific antifungal breakpoints, and for Malassezia and Wickerhamomyces anomalus species which also have zoonotic potential. Novel compound phendione showed promising antimicrobial activity, with MICs determined for both fungal and bacterial species. The biocidal options investigated also showed potential to act as intermediate-level disinfectants, where peracetic acid proved most effective against fungal spore formers.
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Affiliation(s)
- Elaine Meade
- Department of Life Science, Institute of Technology, Ash Lane, F91YW50 Sligo, Ireland;
| | - Micheal Savage
- Lir Analytical LTD, Century Business Park, Unit 2, Athlone Rd, N39Y935 Longford, Ireland;
| | - Mark Slattery
- Mark Anthony Slattery, Veterinary Practice, F91DP62 Manorhamilton, Ireland;
| | - Mary Garvey
- Department of Life Science, Institute of Technology, Ash Lane, F91YW50 Sligo, Ireland;
- Lir Analytical LTD, Century Business Park, Unit 2, Athlone Rd, N39Y935 Longford, Ireland;
- Mark Anthony Slattery, Veterinary Practice, F91DP62 Manorhamilton, Ireland;
- Correspondence: ; Tel.: +353-71-9305529
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Cappelli A, Favia G, Ricci I. Wickerhamomyces anomalus in Mosquitoes: A Promising Yeast-Based Tool for the "Symbiotic Control" of Mosquito-Borne Diseases. Front Microbiol 2021; 11:621605. [PMID: 33552032 PMCID: PMC7859090 DOI: 10.3389/fmicb.2020.621605] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 12/30/2020] [Indexed: 12/13/2022] Open
Abstract
The ascomycete yeast Wickerhamomyces anomalus is a mutualistic symbiont of different insects, including diptera vectors of diseases. Although fungal symbioses have been so far poorly characterized, the topic is gaining attention as yeast-insect interactions can provide pivotal information on insect biology, such as their environmental adaptation or vectorial capability. We review the symbiosis between W. anomalus and mosquitoes, which implies nutritional and protective functions. Furthermore, we focus on antiplasmodial effects of W. anomalus in malaria vectors and discuss the yeast potential for the “symbiotic control” (SC) of mosquito-borne diseases (MBDs).
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Affiliation(s)
- Alessia Cappelli
- School of Biosciences and Veterinary Medicine, University of Camerino, CIRM Italian Malaria Network, Camerino, Italy
| | - Guido Favia
- School of Biosciences and Veterinary Medicine, University of Camerino, CIRM Italian Malaria Network, Camerino, Italy
| | - Irene Ricci
- School of Biosciences and Veterinary Medicine, University of Camerino, CIRM Italian Malaria Network, Camerino, Italy
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