Ağirbasli Handan, Bilgen Hulya, Ozcan Sema Keceli, Otlu Baris, Sinik Gulce, Cerikçioğlu Nilgün, Durmaz Riza, Can Emine, Yalman Nevin, Gedikoğlu Gunduz, Sugita Takashi
Our-Children Leukemia Foundation, Istanbul, Turkey.
Jpn J Infect Dis. 2008 Mar;61(2):130-2.
Trichosporon spp. are emerging as opportunistic agents that cause systemic diseases in immunocompromised hosts. Trichosporonosis carries a poor prognosis in neutropenic patients. Trichosporon japonicum was isolated from the air and named by Sugita et al. Here we present the first case of T. japonicum isolated from a clinical specimen. Two cases of acute myeloid leukemia who had Trichosporon isolates are discussed because of their rarity and growing importance. T. asahii was isolated from the throat, feces and urine of the first patient. T. japonicum was isolated from the sputum of the second patient. Both cases produced high MICs to itraconazole, and low MICs to fluconazole and voriconazole. In virulance factor investigations there was (++) biofilm formation in T. japonicum but not in T. asahii. Conventional mycological studies were not adequate for the identification of the isolate at the species level. In our second case as in the first one, the isolate was identified as T. asahii with 99.9% accuracy by API 20C AUX. Although two T. asahii isolates from the same patient yielded identical typing profiles by arbitrary primed-PCR, the isolates of the two different patients showed different arbitrary primed-PCR typing profiles. However, the genetic identification of the other patient's strain gave the result of T. japonicum.
毛孢子菌属正逐渐成为在免疫功能低下宿主中引起系统性疾病的机会致病菌。毛孢子菌病在中性粒细胞减少患者中的预后较差。日本毛孢子菌是从空气中分离出来的，由杉田等人命名。在此，我们报告首例从临床标本中分离出的日本毛孢子菌病例。讨论了两例患有毛孢子菌分离株的急性髓系白血病病例，因其罕见性及日益增加的重要性。第一例患者的咽喉、粪便和尿液中分离出了阿萨希毛孢子菌。第二例患者的痰液中分离出了日本毛孢子菌。两例病例对伊曲康唑的最低抑菌浓度（MIC）均较高，而对氟康唑和伏立康唑的MIC较低。在毒力因子研究中，日本毛孢子菌有（++）生物膜形成，而阿萨希毛孢子菌没有。传统的真菌学研究不足以在种水平鉴定分离株。在我们的第二例病例中，如同第一例一样，通过API 20C AUX以99.9%的准确率将分离株鉴定为阿萨希毛孢子菌。尽管来自同一患者的两株阿萨希毛孢子菌通过任意引物PCR产生相同的分型图谱，但两名不同患者的分离株显示出不同的任意引物PCR分型图谱。然而，另一患者菌株的基因鉴定结果为日本毛孢子菌。
