Antifungal susceptibility profile of clinical Fusarium spp. isolates identified by molecular methods

Alastruey‐Izquierdo, Ana; Cuenca‐Estrella, Manuel; Monzón, Araceli; Mellado, Emilia; Rodríguez-Tudela, Juan Luis

doi:10.1093/jac/dkn022

Cited by 200 publications

(141 citation statements)

References 28 publications

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“…Consistent with the findings of others (1,2,24), the six antifungal agents tested in the present study showed poor overall in vitro activities against 20 phylogenetically diverse species. The most significant finding is that AMB was the most active drug against all Fusarium species, including the FSSC, as has been reported by others (2,24); however, AMB MICs varied with species, and MICs against the FIESC were Ͼ8 g/ml (Table 1).…”

Section: Vol 49 2011 Seven-locus Sequence Analysis Of Fusarium 1895supporting

confidence: 90%

“…In humans, they cause infections ranging from superficial disease (e.g., keratitis and onychomycosis) to life-threatening disseminated infections; the latter occur predominantly in severely immunocompromised patients (7,18,19) in whom mortality approaches 100% (10). This high mortality is due in part to frequent delays in diagnosis and to the fact that most Fusarium species, particularly those nested within the Fusarium solani species complex (FSSC), are typically resistant to most antifungal agents (1,2,28).…”

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Accurate and Practical Identification of 20 Fusarium Species by Seven-Locus Sequence Analysis and Reverse Line Blot Hybridization, and an In Vitro Antifungal Susceptibility Study

Xiao

Kong

et al. 2011

J Clin Microbiol

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Eleven reference and 25 clinical isolates of Fusarium were subject to multilocus DNA sequence analysis to determine the species and haplotypes of the fusarial isolates from Beijing and Shandong, China. Seven loci were analyzed: the translation elongation factor 1 alpha gene (EF-1␣); the nuclear rRNA internal transcribed spacer (ITS), large subunit (LSU), and intergenic spacer (IGS) regions; the second largest subunit of the RNA polymerase gene (RPB2); the calmodulin gene (CAM); and the mitochondrial small subunit (mtSSU) rRNA gene. We also evaluated an IGS-targeted PCR/reverse line blot (RLB) assay for species/haplotype identification of Fusarium. Twenty Fusarium species and seven species complexes were identified. Of 25 clinical isolates (10 species), the Gibberella (Fusarium) fujikuroi species complex was the commonest (40%) and was followed by the Fusarium solani species complex (FSSC) (36%) and the F. incarnatum-F. equiseti species complex (12%). Six FSSC isolates were identified to the species level as FSSC-3؉4, and three as FSSC-5. Twenty-nine IGS, 27 EF-1␣, 26 RPB2, 24 CAM, 18 ITS, 19 LSU, and 18 mtSSU haplotypes were identified; 29 were unique, and haplotypes for 24 clinical strains were novel. By parsimony informative character analysis, the IGS locus was the most phylogenetically informative, and the rRNA gene regions were the least. Results by RLB were concordant with multilocus sequence analysis for all isolates. Amphotericin B was the most active drug against all species. Voriconazole MICs were high (>8 g/ml) for 15 (42%) isolates, including FSSC. Analysis of larger numbers of isolates is required to determine the clinical utility of the seven-locus sequence analysis and RLB assay in species classification of fusaria.

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Section: Vol 49 2011 Seven-locus Sequence Analysis Of Fusarium 1895supporting

confidence: 90%

mentioning

confidence: 99%

Accurate and Practical Identification of 20 Fusarium Species by Seven-Locus Sequence Analysis and Reverse Line Blot Hybridization, and an In Vitro Antifungal Susceptibility Study

Xiao

Kong

et al. 2011

J Clin Microbiol

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“…are of relative resistance to most antifungal agents (54). Among the small number of isolates in the present study, MICs were generally Յ4 g/ml for both posaconazole and voriconazole against the 10 Fusarium isolates tested: G. fujikuroi (80% Յ4 g/ml) (Table 6), F. solani (67%) (see the supplemental material), and Fusarium spp.…”

Section: Different Laboratories (2003 To 2007 At the University Of Iomentioning

confidence: 64%

Echinocandin and Triazole Antifungal Susceptibility Profiles for Clinical Opportunistic Yeast and Mold Isolates Collected from 2010 to 2011: Application of New CLSI Clinical Breakpoints and Epidemiological Cutoff Values for Characterization of Geographic and Temporal Trends of Antifungal Resistance

et al. 2013

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The SENTRY Antimicrobial Surveillance Program monitors global susceptibility and resistance rates of newer and established antifungal agents. We report the echinocandin and triazole antifungal susceptibility patterns for 3,418 contemporary clinical isolates of yeasts and molds. The isolates were obtained from 98 laboratories in 34 countries during 2010 and 2011. Yeasts not presumptively identified by CHROMagar, the trehalose test, or growth at 42°C and all molds were sequence identified using internal transcribed spacer (ITS) and 28S (yeasts) or ITS, translation elongation factor (TEF), and 28S (molds) genes. Susceptibility testing was performed against 7 antifungals (anidulafungin, caspofungin, micafungin, fluconazole, itraconazole, posaconazole, and voriconazole) using CLSI methods. Rates of resistance to all agents were determined using the new CLSI clinical breakpoints and epidemiological cutoff value criteria, as appropriate. Sequencing of fks hot spots was performed for echinocandin non-wildtype (WT) strains. Isolates included 3,107 from 21 Candida spp., 146 from 9 Aspergillus spp., 84 from Cryptococcus neoformans, 40 from 23 other mold species, and 41 from 9 other yeast species. Among Candida spp., resistance to the echinocandins was low (0.0 to 1.7%). Candida albicans and Candida glabrata that were resistant to anidulafungin, caspofungin, or micafungin were shown to have fks mutations. Resistance to fluconazole was low among the isolates of C. albicans (0.4%), Candida tropicalis (1.3%), and Candida parapsilosis (2.1%); however, 8.8% of C. glabrata isolates were resistant to fluconazole. Among echinocandin-resistant C. glabrata isolates from 2011, 38% were fluconazole resistant. Voriconazole was active against all Candida spp. except C. glabrata (10.5% non-WT), whereas posaconazole showed decreased activity against C. albicans (4.4%) and Candida krusei (15.2% non-WT). All agents except for the echinocandins were active against C. neoformans, and the triazoles were active against other yeasts (MIC 90 , 2 g/ml). The echinocandins and triazoles were active against Aspergillus spp. (MIC 90 /minimum effective concentration [MEC 90 ] range, 0.015 to 2 g/ml), but the echinocandins were not active against other molds (MEC 90 range, 4 to >16 g/ml). Overall, echinocandin and triazole resistance rates were low; however, the fluconazole and echinocandin coresistance among C. glabrata strains warrants continued close surveillance.

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“…While refractory onychomycoses are not life-threatening, timely and effective treatment for deep and disseminated fusariosis is very important. Joint guidelines on the treatment of hyalohyphomycoses recommend amphotericin B and voriconazole for the treatment of systemic fusariosis [18], despite variable minimum inhibitory concentration (MIC) test results for both drugs [2,16,17,19]. Hence, accurate identification of the species involved is of importance for epidemiological studies and for guiding clinical follow-up of the patients [2,13].…”

Section: Introductionmentioning

confidence: 99%

Emergence of fusarioses in a university hospital in Turkey during a 20-year period

Cilo

Al‐Hatmi

Seyedmousavi

et al. 2015

Eur J Clin Microbiol Infect Dis

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Fusarium species have started appearing increasingly as the main cause of infections, particularly in immunocompromised patients. In this study, we aimed to present the first epidemiological data from Turkey, analyze fusariosis cases that have been monitored in a university hospital during the past 20 years, identify the responsible Fusarium species, and determine antifungal susceptibilities. A total of 47 cases of fusariosis was included in the study. Fusarium isolates were identified by multilocus sequence typing (MLST). Antifungal susceptibility was tested by the broth microdilution method according to the Clinical and Laboratory Standards Institute (CLSI) methodology. Of the Fusarium infections, 23.4 % were superficial, 44.7 % were locally invasive, and 31.9 % were disseminated. A significant increase was observed over the years. The Fusarium fujikuroi species complex (FFSC) proved to be the most frequent agent group (17 cases; 51.5 %), followed by the Fusarium solani species complex (FSSC) (14 cases; 42.4 %), the Fusarium dimerum species complex (FDSC), and the Fusarium oxysporum species complexes (FOSC) (one case each). Amphotericin B had the highest in vitro activity against all species. Voriconazole and posaconazole showed interspecies variability across and within Fusarium species complexes. In conclusion, our data support the fact that regional differences exist in the distribution of the Fusarium species and that species-specific differences are observed in antifungal susceptibility patterns. The monitoring of local epidemiological data by determining fungal identity and susceptibility are of importance in guiding the clinical followup of patients.Electronic supplementary material The online version of this article

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Antifungal susceptibility profile of clinical Fusarium spp. isolates identified by molecular methods

Cited by 200 publications

References 28 publications

Accurate and Practical Identification of 20 Fusarium Species by Seven-Locus Sequence Analysis and Reverse Line Blot Hybridization, and an In Vitro Antifungal Susceptibility Study

Accurate and Practical Identification of 20 Fusarium Species by Seven-Locus Sequence Analysis and Reverse Line Blot Hybridization, and an In Vitro Antifungal Susceptibility Study

Echinocandin and Triazole Antifungal Susceptibility Profiles for Clinical Opportunistic Yeast and Mold Isolates Collected from 2010 to 2011: Application of New CLSI Clinical Breakpoints and Epidemiological Cutoff Values for Characterization of Geographic and Temporal Trends of Antifungal Resistance

Emergence of fusarioses in a university hospital in Turkey during a 20-year period

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