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Emerging Trichosporon asahii in elderly patients: epidemiological and molecular analysis by the DiversiLab system

M Treviño1, C García-Riestra, P Areses

  • 1Servicio de Microbiología, Complejo Hospitalario Universitario de Santiago de Compostela, c/ Travesía Choupana s/n, 15706, Santiago de Compostela, Spain, Maria.Mercedes.Trevino.Castellano@sergas.es.

European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology
|April 11, 2014
PubMed

Insights

Trichosporon asahii is an emerging cause of urinary tract infections, particularly in elderly patients with drainage devices. Triazoles, especially voriconazole, are effective treatments, and molecular typing aids in managing outbreaks.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Clinical Microbiology

Background:

  • Trichosporon asahii is an opportunistic pathogen causing invasive infections, especially in immunocompromised individuals.
  • Urinary tract infections (UTIs) due to T. asahii can occur in patients with urinary obstruction, catheterization, or antibiotic use.
  • Nosocomial outbreaks of Trichosporon species have been linked to urinary catheter manipulations.

Purpose of the Study:

  • To perform molecular-epidemiological characterization of T. asahii strains within an institution.
  • To compare the efficacy of three different antifungal susceptibility testing methods for T. asahii.
  • To evaluate the utility of the DiversiLab system for molecular strain typing in managing T. asahii infections.

Main Methods:

  • Molecular strain typing was conducted using the DiversiLab system.
  • Antifungal susceptibility testing was performed using broth dilution, Vitek 2, and Etest methods.
  • Epidemiological data from an institutional setting were analyzed.

Main Results:

  • T. asahii was identified as an emergent pathogen in elderly patients with urinary drainage devices.
  • Voriconazole demonstrated the highest in vitro activity against the T. asahii isolates.
  • Broth dilution and Vitek 2 methods showed good concordance in susceptibility testing, while Etest had more discrepancies.
  • The DiversiLab system proved effective for rapid and accurate molecular typing of T. asahii strains.

Conclusions:

  • T. asahii represents a significant emerging threat in healthcare settings, particularly affecting elderly patients with urinary devices.
  • Triazole antifungals, with voriconazole as a primary option, are effective for treating T. asahii UTIs.
  • Molecular typing tools like DiversiLab are valuable for controlling nosocomial outbreaks caused by T. asahii.

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