Laboratório Especial de Micologia, Disciplina de Infectologia, Universidade Federal de São Paulo, Brazil.
Clin Microbiol Rev. 2011 Oct;24(4):682-700. doi: 10.1128/CMR.00003-11.
Trichosporon spp. are basidiomycetous yeast-like fungi found widely in nature. Clinical isolates are generally related to superficial infections. However, this fungus has been recognized as an opportunistic agent of invasive infections, mostly in cancer patients and those exposed to invasive medical procedures. It is possible that the ability of Trichosporon strains to form biofilms on implanted devices, the presence of glucuronoxylomannan in their cell walls, and the ability to produce proteases and lipases are all factors likely related to the virulence of this genus and therefore may account for the progress of invasive trichosporonosis. Disseminated trichosporonosis has been increasingly reported worldwide and represents a challenge for both diagnosis and species identification. Phenotypic identification methods are useful for Trichosporon sp. screening, but only molecular methods, such as IGS region sequencing, allow the complete identification of Trichosporon isolates at the species level. Methods for the diagnosis of invasive trichosporonosis include PCR-based methods, Luminex xMAP technology, and, more recently, proteomics. Treating patients with trichosporonosis remains a challenge because of limited data on the in vitro and in vivo activities of antifungal drugs against clinically relevant species of the genus. Despite the mentioned limitations, the use of antifungal regimens containing triazoles appears to be the best therapeutic approach.
新生隐球菌是一种广泛存在于自然界中的担子菌酵母样真菌。临床分离株通常与浅部感染有关。然而，这种真菌已被认为是侵袭性感染的机会性病原体，主要发生于癌症患者和接受有创医疗操作的患者中。新生隐球菌菌株在植入设备上形成生物膜的能力、细胞壁中存在的葡聚糖醛酸甘露聚糖、以及产生蛋白酶和脂肪酶的能力，这些都可能与该属的毒力有关，因此可能是侵袭性新生隐球菌病进展的原因。世界各地越来越多地报道了播散性新生隐球菌病，这对诊断和种鉴定都构成了挑战。表型鉴定方法可用于新生隐球菌的筛选，但只有 IGS 区测序等分子方法才能在种水平上对新生隐球菌分离株进行完全鉴定。侵袭性新生隐球菌病的诊断方法包括基于 PCR 的方法、Luminex xMAP 技术，以及最近的蛋白质组学方法。由于缺乏抗真菌药物对临床相关种属的体外和体内活性的相关数据，治疗新生隐球菌病仍然是一个挑战。尽管存在上述局限性，使用含唑类药物的抗真菌方案似乎是最佳的治疗方法。
