Pseudozyma spp. human infections: A systematic review

Area of Science:

• Medical Mycology
• Infectious Diseases
• Clinical Microbiology

Background:

• Pseudozyma species are environmental yeasts with emerging roles as opportunistic human pathogens.
• These yeasts primarily affect immunocompromised individuals, presenting a diagnostic and therapeutic challenge.

Purpose of the Study:

• To systematically review clinical presentations, diagnostic methods, and antifungal treatments for Pseudozyma species infections.
• To consolidate current knowledge on this rare fungal pathogen.

Main Methods:

• A systematic literature search was conducted across PubMed, LILACS, Scielo, and Web of Science databases (inception to June 2019).
• Inclusion criteria focused on studies reporting Pseudozyma species infections in patients, with classification based on established criteria.
• Species identification was confirmed via sequencing.

Main Results:

• Fifteen cases from eleven articles were reviewed, with oncological/hematological disorders as common risk factors.
• Nontraditional methods accurately identified Pseudozyma, unlike traditional techniques. Sequencing confirmed species identification.
• Most isolates exhibited high minimum inhibitory concentrations (MICs) for fluconazole and echinocandins but remained susceptible to amphotericin B.

Conclusions:

• Pseudozyma infections typically manifest as fever and are diagnosed via blood culture.
• Resistance to fluconazole and echinocandins is common, with amphotericin B being the most utilized and effective treatment.
• Voriconazole and posaconazole showed efficacy against P. aphidis, but further research is needed for other species.