Trichosporon asahii as a prospective pathogen in solid organ transplant recipients

Abstract

Trichosporon spp. is not an important factor of mycotic infections in immunocompetent patients. It may be a cause of invasive mycoses with a high mortality rate in patients undergoing solid organ transplantation. We have analysed the antifungal agents' susceptibility of Trichosporon asahii and its frequency of occurrence as a prospective etiological agent of infections in liver, kidney and simultaneous pancreas-kidney transplant recipients. Clinical specimens (urine, blood, peritoneal fluid and swabs) were obtained from patients hospitalised in the A total of 475 strains of yeast-like fungi were isolated from clinical specimens taken from 263 liver, kidney and simultaneous pancreas-kidney transplant recipients and from 26 organ donors. Trichosporon asahii was found in 26 clinical samples taken from 18 patients and one organ donor. Positive cultures were obtained from 22 urine samples, one stoma fluid, one wound swab, one tracheal aspirate and one ejaculate. Isolates of Trichosporon asahii were found in 6% of total positive mycological cultures in the solid organ transplant recipients. Among cultured strains, 11 isolates were resistant to fluconazole, four to itraconazole and three of them demonstrated resistance to amphotericin B.

Molecular Identification and Susceptibility ofTrichosporonSpecies Isolated from Clinical Specimens in Qatar: Isolation ofTrichosporon dohaenseTaj-Aldeen, Meis & Boekhout sp. nov

“…Disseminated Trichosporon infections are potentially lifethreatening and are often fatal in neutropenic patients (7,22). Although uncommon, pathogenic species of this genus have been reported increasingly, mostly in patients with malignant diseases (3,6,9,10,11,20,32,44,47,48,63,77), neonates (18,56,84), a bone marrow transplant recipient (22), a solid organ transplant recipient (50), and patients with human immunodeficiency virus (34,35,46). Trichosporon has also been reported to cause fungemia (5,9,25,29,30,33,53,62).…”

“…The MIC of amphotericin B was taken from the well with the lowest concentration with 100% inhibition of growth (compared to the growth control well), while the MICs of fluconazole, itraconazole, voriconazole, posaconazole, isavuconazole, caspofungin, and anidulafungin were taken from the wells with prominent decreases in turbidity (approximately Յ50% growth inhibition) from that of the growth control well. Ranges for MICs and for MICs at which 50 and 90% of the isolates of T. asahii tested were inhibited (MIC 50 and MIC 90 ) were calculated. The MICs for the quality control strains Candida parapsilosis ATCC 22019 and Candida krusei ATCC 6258 were all within the reference ranges (data not shown).…”

Isolation and antifungal susceptibility testing of Trichosporon asahii in Ceará, Brazil

“…In a study of 101 strains of T. asahii isolated in Thailand, a low susceptibility to fluconazole and amphotericin B was observed, and voriconazole represented the best alternative 8 . In a study of 26 strains of T. asahii, high resistance to fluconazole was observed 10 . There is little data available regarding T. asahii's susceptibility to antifungal drugs in Brazil.…”

Trichosporon Mucoides Peritonitis in a Continuous Ambulatory Peritoneal Dialysis Patient

“…Some may be part of the normal flora of human mucosal surfaces, skin, throat, stools, lower urinary tract, sputum, nails, and hair, and can act as opportunistic pathogens. These opportunistic infections have been reported in immunocompromised individuals such as those with hematologic malignancies (3), acquired immunodeficiency syndrome, and uremia per se, and in patients undergoing transplantation (4,5).…”