Abstract
Fusarium is widely distributed in the environment and is involved with plant and animal diseases. In humans, several species and species complexes (SC) are related to fusariosis, i.e., F. solani SC, F. oxysporum SC, F. fujikuroi SC, F. dimerum, F. chlamydosporum, F. incarnatum-equiseti, and F. sporotrichoides. We aimed to investigate the susceptibility of Fusarium clinical isolates to antifungals and azole fungicides and identify the species. Forty-three clinical Fusarium isolates were identified by sequencing translation elongation factor 1-alpha (TEF1α) gene. Antifungal susceptibility testing was performed to the antifungals amphotericin B, itraconazole, voriconazole, posaconazole, and isavuconazole, and the azole fungicides difenoconazole, tebuconazole, and propiconazole. The isolates were recovered from patients with median age of 36 years (range 2–78 years) of which 21 were female. Disseminated fusariosis was the most frequent clinical form (n = 16, 37.2%) and acute lymphoblastic leukemia (n = 7; 16.3%) was the most commonly underlying condition. A few species described in Fusarium solani SC have recently been renamed in the genus Neocosmospora, but consistent naming is yet not possible. Fusarium keratoplasticum FSSC 2 (n = 12) was the prevalent species, followed by F. petroliphilum FSSC 1 (n = 10), N. gamsii FSSC 7 (n = 5), N. suttoniana FSSC 20 (n = 3), F. solani sensu stricto FSSC 5 (n = 2), Fusarium sp. FSSC 25 (n = 2), Fusarium sp. FSSC 35 (n = 1), Fusarium sp. FSSC18 (n = 1), F. falciforme FSSC 3+4 (n = 1), F. pseudensiforme (n = 1), and F. solani f. xanthoxyli (n = 1). Amphotericin B had activity against most isolates although MICs ranged from 0.5 to 32 μg mL-1. Fusarium keratoplasticum showed high MIC values (8–>32 μg mL-1) for itraconazole, voriconazole, posaconazole, and isavuconazole. Among agricultural fungicides, difenoconazole had the lowest activity against FSSC with MICs of >32 μg mL-1 for all isolates.
Highlights
The fungal genus Fusarium is widely distributed as saprobes in the environment but is able to cause cross-kingdom disease in both plants and mammals (Gauthier and Keller, 2013; van Diepeningen and de Hoog, 2016)
Species belonging to Fusarium are distributed into several species complexes (SC), some of which are important in human and veterinary mycology, F. solani SC, F. oxysporum SC, F. fujikuroi SC, F. dimerum, F. chlamydosporum, F. incarnatum-equiseti, and F. sporotrichoides
F. culmorum, F. fujikuroi SC, F. solani SC, and F. oxysporum SC may be found as plant pathogens in maize, wheat, rice, soybean, and tomato crops (Basler, 2016; Costa et al, 2016; Kim et al, 2016; Manzo et al, 2016)
Summary
The fungal genus Fusarium is widely distributed as saprobes in the environment but is able to cause cross-kingdom disease in both plants and mammals (Gauthier and Keller, 2013; van Diepeningen and de Hoog, 2016). The most frequent fungal diseases caused by Fusarium species are onychomycosis and keratitis, other clinical presentations are observed, such as fungemia, mycetoma, skin infection, lung disease (including allergic disease, hypersensitivity pneumonitis, colonization of a pre-existing cavity, pneumonia in severely immunocompromised patients), and other rare infections (endocarditis, urinary tract infection, osteomyelitis, etc.) (Sierra-Hoffman et al, 2005; Su et al, 2007; Nucci et al, 2015; Kassar et al, 2016). Species belonging to Fusarium are distributed into several species complexes (SC), some of which are important in human and veterinary mycology, F. solani SC, F. oxysporum SC, F. fujikuroi SC, F. dimerum, F. chlamydosporum, F. incarnatum-equiseti, and F. sporotrichoides (van Diepeningen et al, 2014; Salah et al, 2015; Al-Hatmi et al, 2016a; Hassan et al, 2016). Some Fusarium species produce mycotoxins during growth in plant tissue, which may contaminate cereal grains and derivatives, making them unsuitable for consumption and causing great agricultural losses (Milicevic et al, 2010; Sobrova et al, 2010)
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