Species diversity, antifungal susceptibility and phenotypic and genotypic characterisation of Exophiala spp. infecting patients in different medical centres in Brazil

Summary The Exophiala genus is responsible for many superficial and invasive infections resulting from black fungi. Identification of Exophiala at the species level is based on morphological observations complemented by molecular tests. The aim of this study was to identify 23 clinical isolates of E...

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Published in:	Mycoses Vol. 60; no. 5; pp. 328 - 337
Main Authors:	Silva, Wendy C., Gonçalves, Sarah S., Santos, Daniel W. C. L., Padovan, Ana Carolina B., Bizerra, Fernando C., Melo, Analy S. A.
Format:	Journal Article
Language:	English
Published:	Germany Wiley Subscription Services, Inc 01-05-2017
Subjects:	Adolescent Adult Aged Amphotericin B Amphotericin B - pharmacology Antifungal agents Antifungal Agents - pharmacology antifungal susceptibility Brazil - epidemiology Caspofungin Child Child, Preschool Clinical isolates DNA, Ribosomal Spacer - genetics Echinocandins - pharmacology Electron microscopy Exophiala Exophiala - classification Exophiala - drug effects Exophiala - genetics Exophiala - ultrastructure Exophiala spp Female Fungi Genetic Variation Genotype Humans Itraconazole Itraconazole - pharmacology Lipopeptides - pharmacology Male Microbial Sensitivity Tests Microscopy, Electron, Scanning Middle Aged Minimum inhibitory concentration Phaeohyphomycosis - blood Phaeohyphomycosis - epidemiology Phaeohyphomycosis - microbiology Phenotype Posaconazole Scanning electron microscopy Species diversity species identification Terbinafine Triazoles Voriconazole Brazil Exophiala spp species identification antifungal susceptibility
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Summary:	Summary The Exophiala genus is responsible for many superficial and invasive infections resulting from black fungi. Identification of Exophiala at the species level is based on morphological observations complemented by molecular tests. The aim of this study was to identify 23 clinical isolates of Exophiala spp. and evaluate the antifungal susceptibility to seven different agents. Molecular identification was based on an analysis of ITS region of rDNA using genomic databases. The micromorphology was evaluated by microculture and scanning electron microscopy. The susceptibility tests were performed using the antifungal agents 5‐fluorocytosine (5‐FC), amphotericin B (AMB), itraconazole (ITC), voriconazole (VRC), posaconazole (PSC), caspofungin (CFG) and terbinafine (TRB). The ITS analysis identified 100% of the following isolates as: E. dermatitidis (8), E. xenobiotica (6), E. bergeri (4), E. oligosperma (3), E. spinifera (1) and E. mesophila (1). The antifungal susceptibility tests showed that the triazoles compounds were in vitro the most active agents against Exophiala. ITS sequencing enabled the accurate identification of the 23 tested isolates. The triazoles, particularly itraconazole and posaconazole, exhibited MIC values lower than AMB, CAS and 5‐FC. Although the guidelines do not indicate AMB for treatment against Exophiala spp., this study showed activity for all of the tested species, except E. mesophila.
Bibliography:	ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Feature-4 content type line 23 ObjectType-Report-1 ObjectType-Article-3 ObjectType-Article-1 ObjectType-Feature-2
ISSN:	0933-7407 1439-0507
DOI:	10.1111/myc.12597