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Trichosporonosis corresponds to a systemic fungal disease that leads to high mortality rates and is frequently associated with medical devices. It affects immunosuppressed patients in particular and is strongly linked to acquired human immunodeficiency, organ and tissue transplants, and malignant hematologic diseases such as leukemia and lymphomas. Trichosporon infections have been increasingly reported worldwide; however, little information is available either about their characteristics or the causative microorganism. Thus, the aims of the present study were: to investigate 59 yeasts of the genus Trichosporon by verifying the biofilm formation capacity of isolates; to analyze the susceptibility patterns of planktonic cells against the antifungals fluconazole, itraconazole, amphotericin-B, voriconazole, and caspofungin by comparing European Committee for Antimicrobial Susceptibility Testing (EUCAST) broth microdilution technique with the commercial method Etest; and to assess the susceptibility patterns of biofilm cells (sessile) against the same antifungals through broth microdilution. The ability to form biofilm on the surface of polystyrene plates was noted for all isolates, and 54.3% of samples were considered strong producers. Comparison between the antifungal susceptibility techniques evidenced that Etest showed higher and discordant minimum inhibitory concentrations (MICs) from those obtained by the microdilution method, especially for fluconazole, itraconazole, and caspofungin. Considering the susceptibility of biofilms, most species had high MIC50 and MIC90 against the tested antifungals, showing 4-to-66-fold higher concentrations for amphotericin B and 2-to-33-fold greater concentrations for caspofungin. These results highlight the importance of further studies with Trichosporon spp. for comparison between laboratory findings and in vivo response, considering both the susceptibility tests and the behavior of biofilm cells against drugs.

This study investigated 59 isolates of the medically important yeast Trichosporon in relation to their ability to form biofilms and the susceptibility of biofilms to antifungal agents. All isolates were able to produce biofilms and biofilms showed lower antifungal susceptibility.

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Opportunistic infections are serious complications in critically ill COVID-19 patients, especially co-infections with bacterial and fungal agents. Here we report a rare case of bloodstream co-infection by Trichosporon asahii, an emerging yeast, and Acinetobacterbaumannii, an opportunistic nosocomial pathogen, both multidrug resistant, in a tertiary hospital from southern Brazil. A review of the literature regarding similar cases is also included. Treatment with multiple antimicrobials failed, and the patient progressed to death four days after the diagnosis of bacteremia and fungemia.

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Trichosporon spp. are widely distributed in the nature, comprising species that inhabit different ecological niches and can be found in the water, soil, and body surface of animals and humans. Such microorganisms have been classically associated with superficial infections; however, in the last decades, they have also been related to disseminated infections in immunocompromised patients, behaving as opportunistic agents, which demands rapid and accurate species identification for efficient therapy. Concordance level between the traditional phenotypic method and the molecular technique (gold standard) in the identification of all 59 Trichosporon samples was 59.3%. Identification concordance between MALDI-TOF spectrometry and the molecular technique was 71.2%. No isolate of environmental origin was identifiable by MALDI-TOF mass spectrometry (MS), and 100% of such environmental isolates were discordant for IGS region sequencing and phenotypic characterization. Both comparisons evidenced greatest concordance in the identification of T. asahii. The species T. debeurmannianum, T. dermatis, T. venhuisii and T. insectorum were not properly identified by both MALDI-TOF MS and the phenotypic technique. MALDI-TOF MS, in particular, seems to be appropriate to investigate yeasts of the genus Trichosporon; however, database updates are still necessary, especially for species that are not common in the clinical routine. With the aim of helping understand the aspects involved in early and accurate diagnosis of infections caused by this opportunistic agent, the present study compared the phenotypic, molecular (IGS region) and mass-spectrometry (MALDI-TOF) identification of 59 yeasts of the genus Trichosporon which had clinical and environmental origin and were kept in a mycology collection.

The present study compared the phenotypic, genotypic, and mass-spectrometry (MALDI-TOF) identification of 59 yeasts of the genus Trichosporon. MALDI-TOF MS, in particular, seems to be appropriate to investigate this yeasts when compared to a molecular technique (gold standard).

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Persister cells are metabolically inactive dormant cells that lie within microbial biofilms. They are phenotypic variants highly tolerant to antimicrobials and, therefore, associated with recalcitrant infections. In the present study, we investigated if Trichosporon asahii and T. inkin are able to produce persister cells. Trichosporon spp. are ubiquitous fungi, commonly found as commensals of the human skin and gut microbiota, and have been increasingly reported as agents of fungemia in immunocompromised patients. Biofilms derived from clinical strains of T asahii (n=5) and T. inkin (n=7) were formed in flat-bottomed microtiter plates and incubated at 35°C for 48 h, treated with 100 µg/ml amphotericin B (AMB) and incubated at 35°C for additional 24 h. Biofilms were scraped from the wells and persister cells were assayed for susceptibility to AMB. Additionally, we investigated if these persister cells were able to generate new biofilms and studied their ultrastructure and AMB susceptibility. Persister cells were detected in both T asahii and T. inkin biofilms and showed tolerance to high doses of AMB (up to 256 times higher than the minimum inhibitory concentration). Persister cells were able to generate biofilms, however they presented reduced biomass and metabolic activity, and reduced tolerance to AMB, in comparison to biofilm growth control. The present study describes the occurrence of persister cells in Trichosporon spp. and suggests their role in the reduced AMB susceptibility of T. asahii and T. inkin biofilms.

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INTRODUCTION: We report here the presence of Cryptococcus neoformans, and other potentially pathogenic yeasts and yeast-like fungi in environmental sources in Bonaire. METHODS: Seventy environmental samples comprising 40 samples of old pigeon droppings, 18 of woody debris from hollows of living trees of Caesalpinia ('Divi Divi'), Ziziphus jujuba (Red Indian date), Tamarindus indica (Tamarind), Terminalia catappa (Tropical almond), Azadirachta indica (Neem) and 3 of other unidentified species of trees, 3 of latex from a rubber tree and 6 of coral dust were processed for isolation of pathogenic Cryptococcus spp. and other potentially pathogenic yeasts and yeast-like fungi. A variety of mycological media were employed. Identification of the isolates was done with conventional techniques and species identification was done by matrix-assisted laser desorption ionization-time of flight mass spectrometry. RESULTS: Three of the 40 samples from old pigeon droppings yielded Cryptococcus neoformans, constituting the first record of environmental occurrence of this important pathogenic yeast in the Dutch Caribbean. Other potentially pathogenic yeasts and yeast-like fungi recovered from these environmental samples included 6 isolates each of Candida albicans, 8 of Candida parapsilosis, 4 each of Candida metapsilosis and Candida orthopsilosis, 2 each of Candida carpophila, Candida famata, Candida fabianii and Candida pelliculosa, 7 of Candida spp., 5 of Trichosporon spp. and 2 of Sporobolomyces spp. CONCLUSIONS: This study has demonstrated for the first time the occurrence of C. neoformans in a natural habitat in the Dutch Caribbean. The recovery of many species of potentially pathogenic yeast-like fungi and yeasts from environmental sources is remarkable.

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O gênero Trichosporon é composto por leveduras artrosporadas do Filo Basidiomycota e é conhecido agente de infecção fúngica invasiva (IFI) em pacientes imunodeprimidos ou com outros fatores de risco. Em pacientes onco-hematológicos é a principal levedura responsável por IFI depois do gênero Candida. Entre as espécies responsáveis por infecções no homem encontram-se: T. asahii, T. inkin, T. mucoides, T. dermatis, T. jirovecii, T. ovoides, T. cutaneum, T. montevideense, T. domesticum, T. asteroides, T. coremiiforme, T. faecale, T. dohaense, T. lactis, T. japonicum. A tecnologia de identificação de fungos por espectrometria de massa (SM) MALDI-TOF ainda carece de padronização para identificação de fungos do gênero Trichosporon, mas a literatura mostra resultados encorajadores. O objetivo deste estudo é padronizar a técnica de espectrometria de massa MALDI-TOF para a identificação das espécies do gênero Trichosporon de importância médica. O estudo foi realizado em cooperação entre a Divisão de Laboratório Central do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (DLC, HC-FMUSP), Instituto de Medicina Tropical da USP (IMT-USP), Instituto Adolfo Lutz (IAL) e Laboratoire de Parasitologie-Mycologie do Hospital Saint Antoine de Paris, vinculado ao grupo de pesquisa INSERM/UPMC UMR S945 "Immunité et Infection" Faculté de Medecine et Université Pierre et Marie Curie de Paris. Noventa e três cepas/isolados foram analisado(a)s, sendo dezenove cepas de referência adquiridas junto à coleção holandesa Centraalbureau Schimmelcultures (CBS), 19 isolados do HC-FMUSP e IAL, e 55 isolados de diferentes hospitais franceses. A identificação molecular foi realizada através do sequenciamento da região IGS1 do rDNA e foi considerada como método de referência. O protocolo de extração de proteínas foi estabelecido através da comparação do desempenho de três metodologias (Bruker®, Cassagne et al., Sendid et al.). Os espectros de massa foram obtidos no...

Trichosporon spp. are arthrospored yeasts from the Filum Basidiomycota that are known to produce invasive fungal infection (IFI) in patients with immunosupression or other risk factors. After Candida, Trichosporon is the second genus of yeasts responsible for IFI in patients with onco-hematological diseases. The most important species related to human infection are: T. asahii, T. inkin, T. mucoides, T. dermatis, T. jirovecii, T. ovoides, T. cutaneum, T. montevideense, T. domesticum, T. asteroides, T. coremiiforme, T. faecale, T. dohaense, T. lactis, T. japonicum. The technology of mass spectrometry (MS) for identification of Trichosporon species has not yet been standardized. However, preliminary promising results can be found in the literature. The objective of this study is to analyse and validate MS MALDI-TOF for the identification of Trichosporon species of medical relevance. This was a multicentric study with collaboration from the Central Laboratory Section from Clinics Hospital of the Medical School from the University of São Paulo (DLC-HCFMUSP), Tropical Medicine Institute from the University of São Paulo (IMT-USP), Instituto Adolfo Lutz (IAL) and Laboratoire de Parasitologie-Mycologie from the Hospital Saint Antoine of Paris and INSERM/UPMC UMR S945 "Immunité et Infection", Faculté de Medecine et Université Pierre et Marie Curie of Paris. Ninety three strains/isolates belonging to sixteen Trichosporon species were analysed. Nineteen were purchased from Centraalbureau Schimmelcultures (CBS) yeast collection, 19 belonged to HC-FMUSP and IAL collections, 55 belonged to different French collections. The reference identification method was the IGS1 rDNA sequencing. A protein extraction protocol was first established after comparing the performance of three different methodologies (Bruker(TM),...

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The present study aimed to 1) determine the colonization rates of medically important Trichosporon species on normal perigenital skin and 2) determine the isolation rates of Trichosporon spp. isolated from the urine and catheters of Brazilian patients hospitalized in the Intensive Care Unit (ICU). The overall colonization rate of Trichosporon spp. was 11.15 percent (112 isolates). The most common species isolated from normal perigenital skin was T. cutaneum (29.46 percent), followed by T. asteroides (20.53 percent), T. ovoides (15.17 percent), T. inkin (10.71 percent), T. mucoides (8.92 percent), and T. asahii (6.25 percent). From urine and catheters, T. asahii was the species most commonly isolated (76.5 percent; n =23), followed by T. inkin (16.6 percent; n = 5) and T. asteroides (6.6 percent; n = 2). In addition, the highest isolation rate occurred in subjects in the 71- to 80-year-old age range (36.7 percent; n= 11), followed by 61 to 70 (26.7 percent; n = 8), 51 to 60 (13.3 percent; n = 4), 31 to 40 (13.33 percent; n = 4), and 41 to 50 (10 percent; n =3). We concluded that 6 medically important species of the genus Trichosporon colonize the perigenital region in a normal population. The identification of these species is possible by means of classical methods but often requires repeated analyses repetitions due to difficulties in the assimilation process. In contrast, only 3 species of Trichosporon were isolated from urine and catheters.

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The aim of the present study was to evaluate the antifungal susceptibility profile of Trichosporon species isolated from different sources employing the Clinical and Laboratory Standards Institute (CLSI) method and E-test method. Thirty-four isolates of Trichosporon spp. and six CBS reference samples were tested for their susceptibility to Amphotericin B, 5-flucytosine, Fluconazole, Itraconazole, Voriconazole and Terbinafine. All species showed high Minimun Inhibitory Concentrations (MIC) for Itraconazole and susceptibility to Fluconazole, The comparison among the results obtained by the CLSI method and E-test revealed larger discrepancies among 5-flucytosine and Itraconazole. The present work provides epidemiological data that could influence therapeutic choices. Furthermore, the comparison between different methodologies could help to analyze results obtained by different laboratories.

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The aim of the present study was to evaluate the antifungal susceptibility profile of Trichosporon species isolated from different sources employing the Clinical and Laboratory Standards Institute (CLSI) method and E-test method. Thirty-four isolates of Trichosporon spp. and six CBS reference samples were tested for their susceptibility to Amphotericin B, 5-flucytosine, Fluconazole, Itraconazole, Voriconazole and Terbinafine. All species showed high Minimun Inhibitory Concentrations (MIC) for Itraconazole and susceptibility to Fluconazole, The comparison among the results obtained by the CLSI method and E-test revealed larger discrepancies among 5-flucytosine and Itraconazole. The present work provides epidemiological data that could influence therapeutic choices. Furthermore, the comparison between different methodologies could help to analyze results obtained by different laboratories.

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The present study aimed to 1) determine the colonization rates of medically important Trichosporon species on normal perigenital skin and 2) determine the isolation rates of Trichosporon spp. isolated from the urine and catheters of Brazilian patients hospitalized in the Intensive Care Unit (ICU). The overall colonization rate of Trichosporon spp. was 11.15% (112 isolates). The most common species isolated from normal perigenital skin was T. cutaneum (29.46%), followed by T. asteroides (20.53%), T. ovoides (15.17%), T. inkin (10.71%), T. mucoides (8.92%), and T. asahii (6.25%). From urine and catheters, T. asahii was the species most commonly isolated (76.5%; n =23), followed by T. inkin (16.6%; n = 5) and T. asteroides (6.6%; n = 2). In addition, the highest isolation rate occurred in subjects in the 71- to 80-year-old age range (36.7%; n= 11), followed by 61 to 70 (26.7%; n = 8), 51 to 60 (13.3%; n = 4), 31 to 40 (13.33%; n = 4), and 41 to 50 (10%; n =3). We concluded that 6 medically important species of the genus Trichosporon colonize the perigenital region in a normal population. The identification of these species is possible by means of classical methods but often requires repeated analyses repetitions due to difficulties in the assimilation process. In contrast, only 3 species of Trichosporon were isolated from urine and catheters.

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The present study aimed to 1) determine the colonization rates of medically important Trichosporon species on normal perigenital skin and 2) determine the isolation rates of Trichosporon spp. isolated from the urine and catheters of Brazilian patients hospitalized in the Intensive Care Unit (ICU). The overall colonization rate of Trichosporon spp. was 11.15% (112 isolates). The most common species isolated from normal perigenital skin was T. cutaneum (29.46%), followed by T. asteroides (20.53%), T. ovoides (15.17%), T. inkin (10.71%), T. mucoides (8.92%), and T. asahii (6.25%). From urine and catheters, T. asahii was the species most commonly isolated (76.5%; n =23), followed by T. inkin (16.6%; n = 5) and T. asteroides (6.6%; n = 2). In addition, the highest isolation rate occurred in subjects in the 71- to 80-year-old age range (36.7%; n= 11), followed by 61 to 70 (26.7%; n = 8), 51 to 60 (13.3%; n = 4), 31 to 40 (13.33%; n = 4), and 41 to 50 (10%; n =3). We concluded that 6 medically important species of the genus Trichosporon colonize the perigenital region in a normal population. The identification of these species is possible by means of classical methods but often requires repeated analyses repetitions due to difficulties in the assimilation process. In contrast, only 3 species of Trichosporon were isolated from urine and catheters.

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The aim of the present study was to evaluate the antifungal susceptibility profile of Trichosporon species isolated from different sources employing the Clinical and Laboratory Standards Institute (CLSI) method and E-test method. Thirty-four isolates of Trichosporon spp. and six CBS reference samples were tested for their susceptibility to Amphotericin B, 5-flucytosine, Fluconazole, Itraconazole, Voriconazole and Terbinafine. All species showed high Minimun Inhibitory Concentrations (MIC) for Itraconazole and susceptibility to Fluconazole, The comparison among the results obtained by the CLSI method and E-test revealed larger discrepancies among 5-flucytosine and Itraconazole. The present work provides epidemiological data that could influence therapeutic choices. Furthermore, the comparison between different methodologies could help to analyze results obtained by different laboratories.

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White piedra is a superficial mycosis caused by Trichosporon spp. that affects the hair shaft of any part of the body. It is presented an outbreak of scalp white piedra seen in 5.8 percent of the children frequenting a day care in Northeastern of São Paulo State, Brazil. Mycological exam and culture identified T. cutaneum in all five cases, and scanning electron microscopy of nodules around hair shaft infected by Trichosporon spp. is demonstrated comparing them with those of black piedra and with nits of Pediculous capitis.

Piedra branca caracteriza-se por ser micose superficial, causada por Trichosporon spp., que compromete a haste dos pelos de qualquer região do corpo. Um surto de piedra branca, afetando os cabelos do couro cabeludo, foi registrado em 5,8 por cento das crianças que freqüentavam uma creche na região nordeste do estado de São Paulo. Exame micológico direto e cultura identificaram T. cutaneum nas cinco crianças afetadas. Enfatiza-se a utilização da microscopia eletrônica de varredura, que mostrou nódulos circundando a haste dos cabelos infectada por Trichosporon spp., comparando-os com nódulos de Piedra nigra e com lêndeas de Pediculus capitis.

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Mujer de 40 a±os, con historia de un mes de evolución de necrosis progresiva del lecho ungueal del cuarto dedo de la mano derecha, con dolor intenso y destrucción de la placa ungueal. Sin antecedentes patológicos, ni traumßticos. En la biopsia se observaron estructuras micóticas y en los cultivos para hongos se obtuvo crecimiento de Trichosporon mucoides, confirmado mediante pruebas bioquímicas. Se inició fluconazol y se obtuvo resolución del cuadro. Estos hongos son habitantes normales del suelo y se caracterizan por la presencia de hifas verdaderas, pseudohifas, artroconidias y blastoconidas. T. mucoides puede comportarse como un patógeno oportunista que produce infecciones graves en huéspedes inmunocomprometidos. Se conocen casos aislados de T. mucoides como agente causal de onicomicosis pero ninguno con la severidad del caso que aquí se presenta.

A forty-year-old woman, hairdresser, presented a month history of progressive necrosis of the left fourth finger nailbed, accompanied by intense pain, without pathological antecedents and no trauma. Histologic examination showed extensive surface necrosis with abundant cell detritus and erythrocytes, within the necrotic tissue displacing the collagen. There were hyaline, birrefringent structures compatible with arthroconidia Tissue culture for aerobic as well as anaerobic bacteria and mycobacteria were negative. In tissue culture for fungus grew Trichosporon mucoides. A fluconazole therapy was initiated with 400 mg per week dosage, with clinical improvement. This fungus also normal soil inhabitant, is characterized by the presence of true hyphae, other members of the genus have pseudohyphae, arthroconidia y blastoconidia. T. mucoides can also be an opportunistic pathogen producing potentially fatal systemic infections in immunocompromised hosts. Cases of onychomycoses with this fungus as causative organism have been reported, but their symptomatology has not been as severe as in this case.

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