Epidemiological profile and antifungal susceptibility pattern of Trichosporon species in a tertiary care hospital in Chandigarh, India

Document Type : Original Articles

Authors

1 Department of Microbiology, Government Medical College Hospital, Chandigarh, India

2 Department of Microbiology, Indraprastha Apollo Hospitals, New Delhi, India

3 Department of Radiotherapy, Government Medical College Hospital, Chandigarh, India

10.18502/cmm.7.1.6179

Abstract

Background and Purpose: Trichosporon species are ubiquitous in nature which are associated with fatal opportunistic invasive infections, especially in immunocompromised patients. The present study aimed to evaluate the epidemiological and clinical details, as well as the antifungal susceptibility pattern of the patients with Trichosporon infections.
Materials and Methods: In total, 50 clinical isolates of Trichosporon species from various samples were included in this study. The samples were isolated over a period of 18 months from patients in a tertiary hospital in North India. The isolates were characterised phenotypically with Vitek MS (bioMérieux, France). Trichosporon spp. were isolated from urine (30%), nail (30%), tissue (16%), pleural fluid (14%), and sputum (5%). In total, majority of the isolates were of Trichosporon asahii (92%),followed by Trichosporon mucoides (6%), and Trichosporon ovoides (2%). It is noteworthy that most of the reported cases were from intensive care unit (34%).
Results: Intravenous catheters, antibiotics, and antifungal uptake were significantly associated risk factors with Trichosporon infection. All invasive isolates were observed to be resistant in vitro to caspofungin and exhibited high minimum inhibitory concentration (MIC) values against amphotericin B, fluconazole, and 5-flucytosine. The MICs for voriconazole and posaconazole were low.
Conclusion: Trichosporonosis is being increasingly reported all around the world,
including India. The results of this study highlighted the importance of early detection and treatment for this emerging yeast and also added to the ongoing surveillance for the antifungal susuceptibility pattern for this fungus.

Keywords


1. Darier J, Sabouraud R, Cougerot H. Nouvelle pratique
dermatologique. Lancet. 1936; 1:1414.
2. Gueho E, Smith MT, De Hoog GS, Billon-Grand G, Christen R,
Ballenburg-Vander Vegte WH. Contributions to a revision of
the genus
Trichosporon. Antonie Van Leeuwenhoek. 1992;
61(4):289-316.
3. Pagnocca FC, Bacci M, Legapspe MF, Rodrigues A, Ruivo CC,
Nagamoto N, et al. Yeasts isolated from a fungus-growing ant
nest, including the description of
Trichosporon chiarellii sp.
nov., an anamorphic basidiomycetous yeast. Int J Syst Evol
Microbiol. 2010; 60(Pt 6):1454-9.
4. Colombo AL, Padovan ACB, Chaves GM. Current knowledge
of
Trichosporon species and trichosporonosis. Clin Microbiol
Rev. 2011; 24(4):682-700.
5. Lemes RM, Lyon JP, Moreira LM, de Resende MA. Antifungal
susceptibility profile of
Trichosporon isolates: correlation
between CLSI and E-test methodologies. Braz J Microbiol.
2010; 41(2):310-5.
6. Goodman D, Pamer E, Jakubowski A, Morris C, Sepkowitz K.
Breakthrough trichosporonosis in a bone marrow transplant
recipient receiving caspofungin acetate. Clin Infect Dis. 2002;
35(3):E35-6.
7. Girmenia C, Pagano L, Martino B, D'Antonio D, Fanci R,
Specchia G, et al. Invasive infections caused by
Trichosporon
species and Geotrichum capitatum in patients with
hematological malignancies: a retrospective multicenter study
from Italy and review of the literature. J Clin Microbiol. 2005;
43(4):1818-28.
8. Chander J. Textbook of medical mycology. 4
th ed. New Delhi:
JP Medical Ltd; 2018.
9. De Hoog GS, Guarro J, Gené J, Figueras MJ. Atlas of clinical
fungi. 2
nd ed. Utrecht, Netherlands: Centraalbureau Voor
Schimmelcultures; 2000.
10. Biswas SK, Wang L, Yokoyama K, Nishimura K. Molecular
phylogenetics of the genus
Trichosporon inferred from
mitochondrial cytochrome B gene sequences. J Clin Microbiol.
2005; 43(10):5171-8.
11. de Almeida JN Jr, Favero Gimenes VM, Francisco EC, Machado
Siqueira LP, Gonçalves de Almeida RK, Guitard J, et al.
Evaluating and improving Vitek MS for identification of
clinically relevant species of
Trichosporon and the closely
related genera cutaneotrichosporon and apiotrichum. J Clin
Microbiol. 2017; 55(8):2439-44.
12. Clinical and Laboratory Standards Institute. Reference method
for broth dilution antifungal susceptibility testing of yeasts M27-
A3; Approved standard. 3
rd ed. Wayne, PA: Clinical and
Laboratory Standards Institute; 2012.
13. Shah N. Ethical guidelines for biomedical research on human
subjects. Trends Biomater Artif Organs. 2005; 18:174-7.
14. World Medical Association Declaration of Helsinki. Ethical 59th
principles for medical research involving human subjects. Seoul:
WMA General Assembly; 2008.
15. Montoya AM, Sánchez González A, Palma-Nicolás JP, GómezTreviño A, González JG, González GM. Genotyping,
extracellular compounds, and antifungal susceptibility testing of
Trichosporon asahii isolated from Mexican patients. Med
Mycol. 2015; 53(5):505-11.
16. Yang YL, Liu YW, Chen HT, Tsai MS, Chu WL, Lo HJ.
Genotype analysis based on intergenic spacer 1 sequences of
Trichosporon asahii collected in Taiwan. Med Mycol. 2013;
51(8):880-3.
17. Kalkanci A, Sugita T, Arikan S, Yucesoy M, Ener B, Otag F, et
al. Molecular identification, genotyping, and drug susceptibility
of the basidiomycetous yeast pathogen
Trichosporon isolated
from Turkish patients. Med Mycol. 2010; 48(1):141-6.
18. de Almeida Júnior JN, Hennequin C. Invasive
Trichosporon
infection: a systematic review on a re-emerging fungal pathogen.
Front Microbiol. 2016; 7:1629.
19. Sun W, Su J, Xu S, Yan D.
Trichosporon asahii causing
nosocomial urinary tract infections in intensive care unit
patients: genotypes, virulence factors and antifungal
susceptibility testing. J Med Microbiol. 2012; 61(Pt 12):1750-7.
20. Kontoyiannis DP, Torres HA, Chagua M. Trichosporonosis in a
tertiary care cancer center: risk factors, changing spectrum and
determinants of outcome. Scand J Infect Dis. 2004; 36(8):564-9.
21. Gueho E, Improvisi L, De Hoog GS, Dupont B.
Trichosporon on
humans: a practical account. Mycoses. 1994; 37(1-2):3-10.
22. Taverna CG, Córdoba S, Murisengo OA, Vivot W, Davel G,
Bosco-Borgeat ME. Molecular identification, genotyping,
and antifungal susceptibility testing of clinically relevant
Trichosporon species from Argentina. Med Mycol. 2014;
52(4):356-66.
23. Arabatzis M, Abel P, Kanellopoulou M, Adamou D,
Alexandrou-Athanasoulis H, Stathi A, et al. Sequencebased identification, genotyping and EUCAST antifungal
susceptibilities of
Trichosporon clinical isolates from Greece.
Clin Microbiol Infect. 2014; 20(8):777-83.
24. Rastogi V, Honnava P, Rudramurthy SM, Pamidi U, Ghosh A,
Chakrabarti A. Molecular characterisation and antifungal
susceptibility of clinical
Trichosporon isolates in India.
Mycoses. 2016; 59(8):528-34.
25. Singh S, Capoor MR, Varshney S, Gupta DK, Verma PK,
Ramesh V. Epidemiology and antifungal susceptibility of
infections caused by
Trichosporon species: an emerging nonCandida and non-Cryptococcus Yeast Worldwide. Indian J Med
Microbiol. 2019; 37(4):536-41.
 
Volume 7, Issue 1
March 2021
Pages 19-24
  • Receive Date: 22 October 2020
  • Revise Date: 26 January 2021
  • Accept Date: 06 February 2021
  • Publish Date: 01 March 2021