SUMMARY Trichosporon spp. are basidiomycetous yeast-like fungi found widely in nature. Clinical isolates are generally related to superficial infections. However, this fungus has been recognized as an opportunistic agent of invasive infections, mostly in cancer patients and those exposed to invasive medical procedures. It is possible that the ability of Trichosporon strains to form biofilms on implanted devices, the presence of glucuronoxylomannan in their cell walls, and the ability to produce proteases and lipases are all factors likely related to the virulence of this genus and therefore may account for the progress of invasive trichosporonosis. Disseminated trichosporonosis has been increasingly reported worldwide and represents a challenge for both diagnosis and species identification. Phenotypic identification methods are useful for Trichosporon sp. screening, but only molecular methods, such as IGS region sequencing, allow the complete identification of Trichosporon isolates at the species level. Methods for the diagnosis of invasive trichosporonosis include PCR-based methods, Luminex xMAP technology, and, more recently, proteomics. Treating patients with trichosporonosis remains a challenge because of limited data on the in vitro and in vivo activities of antifungal drugs against clinically relevant species of the genus. Despite the mentioned limitations, the use of antifungal regimens containing triazoles appears to be the best therapeutic approach.

The reevaluation of the genus Trichosporon has led to the replacement of the old taxon Trichosporon beigelii by six new species. Sequencing of the ribosomal DNA (rDNA) intergenic spacer 1 (IGS1) is currently mandatory for accurate Trichosporon identification, but it is not usually performed in routine laboratories. Here we describe Trichosporon species distribution and prevalence of Trichosporon asahii genotypes based on rDNA IGS1 sequencing as well as antifungal susceptibility profiles of 22 isolates recovered from blood cultures. The clinical isolates were identified as follows: 15 T. asahii isolates, five Trichosporon asteroides isolates, one Trichosporon coremiiforme isolate, and one Trichosporon dermatis isolate. We found a great diversity of different species causing trichosporonemia, including a high frequency of isolation of T. asteroides from blood cultures that is lower than that of T. asahii only. Regarding T. asahii genotyping, we found that the majority of our isolates belonged to genotype 1 (86.7%). We report the first T. asahii isolate belonging to genotype 4 in South America. Almost 50% of all T. asahii isolates exhibited amphotericin B MICs of >2 g/ml. Caspofungin MICs obtained for all the Trichosporon sp. isolates tested were consistently high (MICs > 2 g/ml). Most isolates (87%) had high MICs for 5-flucytosine, but all of them were susceptible to triazoles, markedly to voriconazole (all MICs < 0.06 g/ml).The incidence of invasive mycoses caused by emergent fungal pathogens has risen considerably over the last two decades. This fact is related to several factors, including the increased occurrence of degenerative and malignant diseases in different populations, as well as the higher number of patients exposed to organ transplantation, immunosuppressive therapies, chemotherapy, broad-spectrum antibiotics, and invasive medical procedures. It is important to emphasize that emergent fungal infections are usually difficult to diagnose, refractory to conventional antifungal drugs, and associated with high mortality rates (8,10,26,32,34,47,51).Invasive infections caused by Trichosporon spp. are reported mostly for cancer patients that have central venous catheters (22,(50)(51)(52). Although trichosporonemia represents a small percentage of all fungal invasive infections, Trichosporon spp. have been reported as the second-or third-most-common agents of yeast fungemia (13,21,51).Phenotypic methods for Trichosporon species identification usually generate inconsistent results, and none of the commercial tests available include the whole new taxonomic categories in their databases (1, 36, 37). For instance, it has been mentioned in the literature that an isolate identified by molecular methods as Trichosporon dermatis was mistakenly identified as Trichosporon mucoides when Vitek Systems 1 and 2 (BioMérieux, France) were used (16). Furthermore, Ahmad et al.(1) reported that four isolates previously identified by Vitek 2 as Trichosporon asahii were identified as Trichosporon asteroides by molecular technique...

Candida tropicalis has emerged as one of the most important Candida species. It has been widely considered the second most virulent Candida species, only preceded by C. albicans. Besides, this species has been recognized as a very strong biofilm producer, surpassing C. albicans in most of the studies. In addition, it produces a wide range of other virulence factors, including: adhesion to buccal epithelial and endothelial cells; the secretion of lytic enzymes, such as proteinases, phospholipases, and hemolysins, bud-to-hyphae transition (also called morphogenesis) and the phenomenon called phenotypic switching. This is a species very closely related to C. albicans and has been easily identified with both phenotypic and molecular methods. In addition, no cryptic sibling species were yet described in the literature, what is contradictory to some other medically important Candida species. C. tropicalis is a clinically relevant species and may be the second or third etiological agent of candidemia, specifically in Latin American countries and Asia. Antifungal resistance to the azoles, polyenes, and echinocandins has already been described. Apart from all these characteristics, C. tropicalis has been considered an osmotolerant microorganism and this ability to survive to high salt concentration may be important for fungal persistence in saline environments. This physiological characteristic makes this species suitable for use in biotechnology processes. Here we describe an update of C. tropicalis, focusing on all these previously mentioned subjects.

Trichosporon spp. are widely distributed in nature and can occasionally belong to the human microbiota. For many years, the unique species of the genus, Trichosporon beigelli, was only known as an environmental and saprophytic fungus occasionally found as the etiological agent of white piedra. However, case reports of invasive trichosporonosis have been frequently published and the genus is currently considered the second most common agent of yeasts disseminated infections. Based on molecular analysis, the taxon T. beigelli was replaced by several species and the taxonomy of the genus was progressively modified. Despite the reported increase of Trichosporon infections refractory to conventional antifungal drugs, there are only a few studies investigating in vitro susceptibility of Trichosporon spp. to new compounds. Difficulties on different species identification as well as the lack of standardized sensitivity tests in vitro, contribute to the limited information available on epidemiology, diagnosis and therapeutics of trichosporonosis.

Objectives: To provide species distribution and antifungal susceptibility profiles of 358 Trichosporon clinical isolates collected from 24 tertiary-care hospitals. Methods: Species identification was performed by sequencing the IGS1 region of rDNA. Antifungal susceptibility testing for amphotericin B, fluconazole, voriconazole and posaconazole followed the Clinical and Laboratory Standards Institute reference method. Tentative epidemiologic cutoff values (97.5% ECVs) of antifungals for Trichosporon asahii were also calculated. Results: Isolates were cultured mostly from urine (155/358, 43.3%) and blood (82/358, 23%) samples.Trichosporon asahii was the most common species (273/358, 76.3%), followed by T. inkin (35/358, 9.7%). Isolation of noneT. asahii species increased substantially over the last 11 years [11/77 (14.2%) from 1997 to 2007 vs. 74/281, (26.3%) from 2008 to 2018, p0.03]. Antifungal susceptibility testing showed high amphotericin B minimum inhibitory concentrations against Trichosporon isolates, with higher values for T. faecale. The ECV for amphotericin B and T. asahii was set at 4 mg/mL. Among the triazole derivatives, fluconazole was the least active drug. The ECVs for fluconazole and posaconazole against T. asahii were set at 8 and 0.5 mg/mL, respectively. Voriconazole showed the strongest in vitro activity against the Trichosporon isolates; its ECV for T. asahii was set at 0.25 mg/mL after 48 hours' incubation.Conclusions: Trichosporon species diversity has increased over the years in human samples, and antifungal susceptibility profiles were species specific. Trichosporon asahii antifungal ECVs were proposed, which may be helpful to guide antifungal therapy.

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The aim of this work was to investigate the antimicrobial activity of nanostructured emulsions based on copaiba (Copaifera langsdorffii) resin-oil, copaiba essential oil, and bullfrog (Rana catesbeiana Shaw) oil against fungi and bacteria related to skin diseases. Firstly, the essential oil was extracted from copaiba resin-oil and these oils, along with bullfrog oil, were characterized by gas chromatography combined with mass spectrometry (GC-MS). Secondly, nanostructured emulsion systems were produced and characterized. The antimicrobial susceptibility assay was performed, followed by the Minimum Inhibitory Concentration (MIC) determination, the bioautography assay, and the antibiofilm determination. Strains of the genera Staphylococcus, Pseudomonas, and Candida were used. The CG-MS analysis was able to identify the components of copaiba resin-oil, copaiba essential oil, and bullfrog oil. The MIC assay in association with the bioautography revealed that some esters of palmitic and oleic acids, a-curcumene, a-himachalene, isothujol, and α-fenchene--probably inhibited some strains. The nanostructured emulsions based on copaiba resin-oil and essential oil improved the antimicrobial activity of the pure oils, especially against Staphylococcus and Candida, resistant to azoles. The bullfrog oil nanostructured emulsion showed a lower antimicrobial effect when compared to the copaiba samples. However, bullfrog oil-based nanostructured emulsion showed a significant antibiofilm activity (p < 0.05). Given the significant antimicrobial and antibiofilm activities of the evaluated oils, it may be concluded that nanostructured emulsions based on copaiba and bullfrog oils are promising candidates for the treatment of infections and also may be used to incorporate other antimicrobial drugs.

BackgroundCandida albicans is a diploid yeast that in some circumstances may cause oral or oropharyngeal infections. Yeasts virulence factors contribute for both the maintenance of colonizing strains in addition to damage and cause tissue invasion, thus the establishment of infection occurs. The limited arsenal of antifungal drugs for the treatment of candidiasis turn the investigation of natural products mandatory for the discovery of new targets for antifungal drug development. Therefore, tropical countries emerge as important providers of natural products with potential antimicrobial activity. This study aimed to investigate morphogenesis and secretion of hydrolytic enzymes (phospholipase and proteinase) in the presence of the CE of Eugenia uniflora.MethodsThe isolates were tested for their ability to form hyphae in both solid and liquid media under three different conditions: YPD + 20% FBS, Spider medium and GlcNac and the ability to secrete phospholipase and proteinase in the presence of 2000 μg/mL of E. uniflora.ResultsThe CE of E. uniflora inhibited hypha formation in both liquid and solid media tested. It also impaired hydrolytic enzymes production.ConclusionsThis was the first study to describe the interaction of a natural product with the full expression of three different factors in C. albicans. E. uniflora may be an alternative therapeutic for oral candidiasis in the future.