Molecular epidemiology of clinical filamentous fungi in Qatar beyond Aspergillus and Fusarium with notes on the rare species

Abstract

Due to an increasing number of patients at risk, (i.e., those with a highly compromised immune system and/or receiving aggressive chemotherapy treatment), invasive fungal infections (IFI) are increasingly being reported and associated with high mortality rates. Aspergillus spp., particularly A. fumigatus, is the major cause of IFI caused by filamentous fungi around the world followed by Fusarium spp., however, other fungi are emerging as human pathogens. The aim of this study was to explore the epidemiology and prevalence of the non-Aspergillus and non-Fusarium filamentous fungi in human clinical samples over an 11-years period in Qatar using molecular techniques. We recovered 53 filamentous fungal isolates from patients with various clinical conditions. Most patients were males (75.5%), 9.4% were immunocompromised, 20.7% had IFI, and 11.3% died within 30 days of diagnosis. The fungal isolates were recovered from a variety of clinical samples, including nasal cavity, wounds, respiratory samples, body fluids, eye, ear, tissue, abscess, and blood specimens. Among the fungi isolated, 49% were dematiaceous fungi, followed by Mucorales (30%), with the latter group Mucorales being the major cause of IFI (5/11, 45.5%). The current study highlights the epidemiology and spectrum of filamentous fungal genera, other than Aspergillus and Fusarium, recovered from human clinical samples in Qatar, excluding superficial infections, which can aid in surveillance of uncommon and emerging mycoses.

Invasive Fusarium rhinosinusitis in COVID-19 patients: report of three cases with successful management

“…This can be attributed partly to the rising prevalence of immunodeficiency, the emergence of COVID-19, and advancements in the diagnosis of pathogenic fungi. While Aspergillus and Mucorales are the primary agents of IFRS, other fungi such as Fusarium , Lomentospora, Curvularia, Alternaria, Cladosporium, Bipolaris, Exherosilum, Trichoderma, Schizophyllum, Candida , and Trichosporon are occasionally reported as well ( Ardeshirpour et al., 2014 ; Vinh et al., 2017 ; Shamsaei et al., 2021 ; Erami et al., 2023a ; Erami et al., 2023b ; Salah et al., 2023 ). However, the limited availability of diagnostic tools often results in delays in accurate detection and identification of invasive fungal pathogens, leading to delayed treatment.…”

“…DalléRosa et al ( 2018) described a case of IFRS resulting from F. riograndense (a newly identified species within the F. solani complex) infection in an 11-year-old boy with acute lymphoblastic leukemia, who was treated with voriconazole (DalléRosa et al, 2018). Additionally, there are only two reported cases of IFRS caused by F. oxysporum, and no clinical details are available for these cases (Shamsaei et al, 2021). Furthermore, there have been just four cases, including our current case 1, of IFRS caused by F. proliferatum with a presentation of rhinosinusitis.…”