Cargando…

P490 Fatal secondary fungemia due to Trichosporon asahii onychomycosis in a diabetic patient

POSTER SESSION 1, SEPTEMBER 21, 2022, 12:30 PM - 1:30 PM:   OBJECTIVES: We describe a fatal case of trichosporonosis caused by Trichosporon asahii. The aim was to molecularly characterize the T. asahii strains from blood and foot tissue samples to investigate their genetic relatedness. CASE: An 85-y...

Descripción completa

Detalles Bibliográficos
Autores principales: Taj-Aldeen, Saad, Francisco, Elaine, Al Maslamani, Muna, Theelen, Bart, Vu, Duong, Boekhout, Teun, Hagen, Ferry
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9509946/
http://dx.doi.org/10.1093/mmy/myac072.P490
_version_ 1784797340737994752
author Taj-Aldeen, Saad
Francisco, Elaine
Al Maslamani, Muna
Theelen, Bart
Vu, Duong
Boekhout, Teun
Hagen, Ferry
author_facet Taj-Aldeen, Saad
Francisco, Elaine
Al Maslamani, Muna
Theelen, Bart
Vu, Duong
Boekhout, Teun
Hagen, Ferry
author_sort Taj-Aldeen, Saad
collection PubMed
description POSTER SESSION 1, SEPTEMBER 21, 2022, 12:30 PM - 1:30 PM:   OBJECTIVES: We describe a fatal case of trichosporonosis caused by Trichosporon asahii. The aim was to molecularly characterize the T. asahii strains from blood and foot tissue samples to investigate their genetic relatedness. CASE: An 85-year-old morbidly obese female with a prior cerebrovascular accident, hypertension, and diabetes mellitus was admitted to a peripheral hospital with type II respiratory failure, metabolic acidosis, and chronic anemia. Three weeks post-hospitalization the patient remained febrile, physical examination showed that the patient had paronychia, nail pigmentation, subungual onychomycosis, and a diabetic foot ulcer. Blood culture, as well as nail and ulcer samples, became positive for Trichosporon yeasts. METHODS: Trichosporon yeasts were subjected to molecular identification by sequencing the intergenic spacer (IGS1) region. Minimal inhibitory concentrations (MICs) were determined by the EUCAST microdilution method. Long-read nanopore sequencing was performed for the three clinical strains, the type-strain of T. asahii (CBS2479), and two IGS-genotype 7 strains (CBS2936, CBS7632) using the native barcoding kit v12 (SQK-LSK112; Oxford Nanopore Technologies). Raw data were basecalled with Guppy v6, Flye v2.9 was used to de novo assemble the genome of CBS2479, this was used as a reference for variant calling using the genomic reads of all strains. RESULTS: The three clinical strains were found to belong to the rare IGS-genotype 7 and had similar MICs for amphotericin B (4 µg/ml), 5-fluorocytosine and fluconazole (2 µg/ml), voriconazole (≤ 0.015 µg/ml), posaconazole (0.0625 µg/ml), itraconazole (0.125 µg/ml), caspofungin (8 µg/ml), anidulafungin and micafungin (> 16 µg/ml). Strains from the ulcer and nail were genetically very closely related with 10 836 SNPs differences, the blood-derived strain differed more from these two strains with 94 729 SNPs and 94 913 SNPs, respectively. Strains CBS2936 and CBS7632 were only distantly related to CBS2479 with 328 221, and 436 060 SNPs, respectively. CONCLUSION: The T. Asahii IGS-genotype 7 strain causing fatal fungemia was genetically nearly identical to that obtained from nail and foot ulcers, making it highly likely that this was the port d'entrée for T. asahii.
format Online
Article
Text
id pubmed-9509946
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Oxford University Press
record_format MEDLINE/PubMed
spelling pubmed-95099462022-09-26 P490 Fatal secondary fungemia due to Trichosporon asahii onychomycosis in a diabetic patient Taj-Aldeen, Saad Francisco, Elaine Al Maslamani, Muna Theelen, Bart Vu, Duong Boekhout, Teun Hagen, Ferry Med Mycol Oral Presentations POSTER SESSION 1, SEPTEMBER 21, 2022, 12:30 PM - 1:30 PM:   OBJECTIVES: We describe a fatal case of trichosporonosis caused by Trichosporon asahii. The aim was to molecularly characterize the T. asahii strains from blood and foot tissue samples to investigate their genetic relatedness. CASE: An 85-year-old morbidly obese female with a prior cerebrovascular accident, hypertension, and diabetes mellitus was admitted to a peripheral hospital with type II respiratory failure, metabolic acidosis, and chronic anemia. Three weeks post-hospitalization the patient remained febrile, physical examination showed that the patient had paronychia, nail pigmentation, subungual onychomycosis, and a diabetic foot ulcer. Blood culture, as well as nail and ulcer samples, became positive for Trichosporon yeasts. METHODS: Trichosporon yeasts were subjected to molecular identification by sequencing the intergenic spacer (IGS1) region. Minimal inhibitory concentrations (MICs) were determined by the EUCAST microdilution method. Long-read nanopore sequencing was performed for the three clinical strains, the type-strain of T. asahii (CBS2479), and two IGS-genotype 7 strains (CBS2936, CBS7632) using the native barcoding kit v12 (SQK-LSK112; Oxford Nanopore Technologies). Raw data were basecalled with Guppy v6, Flye v2.9 was used to de novo assemble the genome of CBS2479, this was used as a reference for variant calling using the genomic reads of all strains. RESULTS: The three clinical strains were found to belong to the rare IGS-genotype 7 and had similar MICs for amphotericin B (4 µg/ml), 5-fluorocytosine and fluconazole (2 µg/ml), voriconazole (≤ 0.015 µg/ml), posaconazole (0.0625 µg/ml), itraconazole (0.125 µg/ml), caspofungin (8 µg/ml), anidulafungin and micafungin (> 16 µg/ml). Strains from the ulcer and nail were genetically very closely related with 10 836 SNPs differences, the blood-derived strain differed more from these two strains with 94 729 SNPs and 94 913 SNPs, respectively. Strains CBS2936 and CBS7632 were only distantly related to CBS2479 with 328 221, and 436 060 SNPs, respectively. CONCLUSION: The T. Asahii IGS-genotype 7 strain causing fatal fungemia was genetically nearly identical to that obtained from nail and foot ulcers, making it highly likely that this was the port d'entrée for T. asahii. Oxford University Press 2022-09-20 /pmc/articles/PMC9509946/ http://dx.doi.org/10.1093/mmy/myac072.P490 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Oral Presentations
Taj-Aldeen, Saad
Francisco, Elaine
Al Maslamani, Muna
Theelen, Bart
Vu, Duong
Boekhout, Teun
Hagen, Ferry
P490 Fatal secondary fungemia due to Trichosporon asahii onychomycosis in a diabetic patient
title P490 Fatal secondary fungemia due to Trichosporon asahii onychomycosis in a diabetic patient
title_full P490 Fatal secondary fungemia due to Trichosporon asahii onychomycosis in a diabetic patient
title_fullStr P490 Fatal secondary fungemia due to Trichosporon asahii onychomycosis in a diabetic patient
title_full_unstemmed P490 Fatal secondary fungemia due to Trichosporon asahii onychomycosis in a diabetic patient
title_short P490 Fatal secondary fungemia due to Trichosporon asahii onychomycosis in a diabetic patient
title_sort p490 fatal secondary fungemia due to trichosporon asahii onychomycosis in a diabetic patient
topic Oral Presentations
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9509946/
http://dx.doi.org/10.1093/mmy/myac072.P490
work_keys_str_mv AT tajaldeensaad p490fatalsecondaryfungemiaduetotrichosporonasahiionychomycosisinadiabeticpatient
AT franciscoelaine p490fatalsecondaryfungemiaduetotrichosporonasahiionychomycosisinadiabeticpatient
AT almaslamanimuna p490fatalsecondaryfungemiaduetotrichosporonasahiionychomycosisinadiabeticpatient
AT theelenbart p490fatalsecondaryfungemiaduetotrichosporonasahiionychomycosisinadiabeticpatient
AT vuduong p490fatalsecondaryfungemiaduetotrichosporonasahiionychomycosisinadiabeticpatient
AT boekhoutteun p490fatalsecondaryfungemiaduetotrichosporonasahiionychomycosisinadiabeticpatient
AT hagenferry p490fatalsecondaryfungemiaduetotrichosporonasahiionychomycosisinadiabeticpatient