Department of Dermatology and Venerology, Peking University First Hospital, Beijing, China.
Research Center for Medical Mycology, Peking University, Beijing, China.
Mycoses. 2021 Oct;64(10):1261-1271. doi: 10.1111/myc.13345. Epub 2021 Jul 5.
Fusarium species are emerging causative agents of superficial and disseminated human infections. Early diagnosis and treatment contribute to better prognosis of severe infection.
To detect the effectiveness of matrix-assisted laser desorption ionisation time of flight mass spectrometry (MALDI-ToF MS) for Fusarium identification, and evaluate the susceptibility profiles to clinical available antifungals.
All 203 clinical Fusarium isolates and 25 environmental isolates were identified by using translation elongation factor 1-alpha (TEF1) and RNA polymerase subunit II (RPB2) sequencing and MALDI-ToF MS. Antifungal susceptibility testing was determined by a microdilution method following the CLSI approved standard M38-A3 document.
Correct identification rates at the species and genus levels were 89.04% (203/228) and 95.18% (217/228), respectively, using Bruker Filamentous Fungi Library 1.0 combined with the novel database. Seven species complexes with 19 Fusarium species were identified, including F. solani (59.21%, n = 135), F. verticillioides (17.54%, n = 40), F. proliferatum (6.58%, n = 15) and F. oxysporum (4.39%, n = 10). Four uncommon species complexes (F. incarnatum-equiseti SC, F. dimerum SC, F. redolens SC and F. sporotrichioides SC) were also identified. A high degree of antifungal resistance was observed. Fusarium isolates exhibited lower MICs to luliconazole and terbinafine compared with amphotericin B and voriconazole, which in turn were significantly more active than amorolfine, fluconazole and itraconazole.
MALDI-ToF MS showed good performance in Fusarium species with an adapted Bruker library and expanded database. Fusarium isolates exhibited lower MICs to luliconazole and terbinafine compared to amphotericin B and voriconazole.
镰刀菌属真菌是一种新兴的人类浅部和播散性感染的病原体。早期诊断和治疗有助于改善严重感染的预后。
检测基质辅助激光解吸电离飞行时间质谱（MALDI-ToF MS）在鉴定镰刀菌方面的有效性，并评估其对临床可用抗真菌药物的敏感性。
采用翻译延伸因子 1-α（TEF1）和 RNA 聚合酶亚基 II（RPB2）测序和 MALDI-ToF MS 对 203 株临床镰刀菌分离株和 25 株环境分离株进行鉴定。采用 CLSI 批准的 M38-A3 文件指导的微量稀释法进行抗真菌药敏试验。
使用 Bruker 丝状真菌库 1.0 结合新数据库，鉴定的种和属水平的正确识别率分别为 89.04%（203/228）和 95.18%（217/228）。鉴定出 7 个种复合体，包含 19 种镰刀菌，其中包括茄病镰刀菌（59.21%，n=135）、弯孢镰刀菌（17.54%，n=40）、层出镰刀菌（6.58%，n=15）和尖孢镰刀菌（4.39%，n=10）。还鉴定出 4 个不常见的种复合体（构巢曲霉/互隔交链孢菌复合体、双极镰刀菌复合体、红色镰刀菌复合体和枝顶孢镰刀菌复合体）。观察到高度的抗真菌耐药性。与两性霉素 B 和伏立康唑相比，镰刀菌分离株对卢立康唑和特比萘芬的 MIC 值较低，而这两种药物的活性显著高于阿莫罗芬、氟康唑和伊曲康唑。
MALDI-ToF MS 在使用改良的 Bruker 库和扩展数据库的情况下，对镰刀菌具有良好的性能。与两性霉素 B 和伏立康唑相比，镰刀菌分离株对卢立康唑和特比萘芬的 MIC 值较低。
