Multidrug-resistant Trichosporon species: underestimated fungal pathogens posing imminent threats in clinical settings

Autor(es)

Arastehfar, Amir ^[1] ; de Almeida Junior, Joao N. ^{[2, 3]} ; Perlin, David S. ^[1] ; Ilkit, Macit ^[4] ; Boekhout, Teun ^{[5, 6]} ; Colombo, Arnaldo Lopes ^[7]

Afiliação do(s) autor(es)

^[1] Hackensack Meridian Hlth, Ctr Discovery & Innovat, Nutley, NJ 07110 - USA

^[2] Univ Sao Paulo, Inst Med Trop, Lab Micol Med LIM 53, Sao Paulo - Brazil

^[3] Univ Sao Paulo, Hosp Clin, Fac Med, Lab Cent LIM 03, Sao Paulo - Brazil

^[4] Univ Cukurova, Div Mycol, Adana - Turkey

^[5] Westerdijk Fungal Biodivers Inst, Utrecht - Netherlands

^[6] Univ Amsterdam, Inst Biodivers & Ecosyst Dynam IBED, Amsterdam - Netherlands

^[7] Univ Fed Sao Paulo, Escola Paulista Med, Div Infect Dis, Dept Med, Sao Paulo - Brazil

• Tipo de documento: Artigo de Revisão
• Fonte: CRITICAL REVIEWS IN MICROBIOLOGY; v. 47, n. 6, p. 679-698, NOV 2 2021.
• Citações Web of Science: 2

Resumo

Species of Trichosporon and related genera are widely used in biotechnology and, hence, many species have their genome sequenced. Importantly, yeasts of the genus Trichosporon have been increasingly identified as a cause of life-threatening invasive trichosporonosis (IT) in humans and are associated with an exceptionally high mortality rate. Trichosporon spp. are intrinsically resistant to frontline antifungal agents, which accounts for numerous reports of therapeutic failure when echinocandins are used to treat IT. Moreover, these fungi have low sensitivity to polyenes and azoles and, therefore, are potentially regarded as multidrug-resistant pathogens. However, despite the clinical importance of Trichosporon spp., our understanding of their antifungal resistance mechanisms is quite limited. Furthermore, antifungal susceptibility testing is not standardized, and there is a lack of interpretive epidemiological cut-off values for minimal inhibitory concentrations to distinguish non-wild type Trichosporon isolates. The route of infection remains obscure and detailed clinical and environmental studies are required to determine whether the Trichosporon infections are endogenous or exogenous in nature. Although our knowledge on effective IT treatments is rather limited and future randomized clinical trials are required to identify the best antifungal agent, the current paradigm advocates the use of voriconazole, removal of central venous catheters and recovery from neutropenia. (AU)

• Processo FAPESP: 18/19347-4 - Caracterização de mecanismos moleculares associados à resistência aos derivados azólicos em cepas clínicas de Trichosporon asahii
• Beneficiário: João Nóbrega de Almeida Júnior
• Modalidade de apoio: Bolsas no Exterior - Pesquisa