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Coelomycetous Fungi in the Clinical Setting: Morphological Convergence and Cryptic Diversity

Nicomedes Valenzuela-Lopez1,2, Deanna A Sutton3, José F Cano-Lira4

  • 1Unitat de Micologia, Facultat de Medicina i Ciències de la Salut and IISPV, Universitat Rovira i Virgili, Reus, Spain.

Journal of Clinical Microbiology
|December 9, 2016
PubMed

Insights

Coelomycetous fungi are increasingly causing human infections, primarily through plant material. This study identified fungal distribution in clinical samples and their antifungal susceptibility, finding most isolates susceptible to common antifungals.

Area of Science:

  • Medical Mycology
  • Clinical Microbiology
  • Fungal Pathogenesis

Background:

  • Human infections caused by coelomycetous fungi are rising, often resulting from traumatic implantation of contaminated plant material.
  • Coelomycetes are characterized by asexual spore (conidia) production within conidiomata.

Purpose of the Study:

  • To determine the distribution of coelomycetous fungi in clinical samples.
  • To perform phenotypic and molecular identification of fungal isolates.
  • To evaluate the in vitro antifungal susceptibility patterns of selected isolates.

Main Methods:

  • Phenotypic characterization and molecular identification using sequencing of the D1 and D2 domains of the large subunit (LSU) nuclear ribosomal RNA (nrRNA) gene.
  • Analysis of 230 clinical isolates from a U.S. reference mycological institution.
  • In vitro antifungal susceptibility testing against nine antifungals.

Main Results:

  • Eleven orders of Ascomycota were identified, with Pleosporales (66.1%) and Botryosphaeriales (19.57%) being the most prevalent.
  • The most common species included Neoscytalidium dimidiatum, Paraconiothyrium spp., Phoma herbarum, Didymella heteroderae, and Epicoccum sorghinum.
  • Superficial tissue (66.5%) and the respiratory tract (17.4%) were the most frequent isolation sites. Most isolates showed susceptibility to antifungals, except for flucytosine.

Conclusions:

  • Coelomycetous fungi represent a growing group of human pathogens with diverse clinical presentations.
  • Molecular and phenotypic methods are crucial for accurate identification and understanding the epidemiology of these infections.
  • Susceptibility patterns suggest that most coelomycetes are treatable with standard antifungal agents, with flucytosine demonstrating limited efficacy.
Keywords:
ColletotrichumNeoscytalidiumPhomaPyrenochaetaantifungal susceptibilitycoelomycetescoelomycetous fungimycosis

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