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Published on: July 19, 2021
Physiological characterization and molecular identification of some rare yeast species causing onychomycosis
Alexandra M Montoya1, Carolina E Luna-Rodríguez1, Alexandro Bonifaz2
1Departamento de Microbiología, Facultad de Medicina, Universidad Autónoma de Nuevo León, avenue Francisco I. Madero s/n, 64460 Monterrey, México.
Introduction:
Onychomycosis are infections with a variety of etiological agents. Although dermatophytes are responsible for most infections, yeasts are gaining importance as agents of these pathologies. The use of antifungals has increased the incidence of what had been considered rare or novel pathogens. We reidentify three rare yeasts from a culture collection of onychomycosis agents by matrix-assisted laser desorption/ionization time of flight/mass spectrometry (MALDI-TOF/MS) and sequencing the internal transcribed spacer (ITS) regions or the intergenic spacer (IGS) 1 region of ribosomal DNA (rDNA), and present their enzymatic and antifungal susceptibility profiles.
Material And Methods:
We performed a phenotypical characterization and molecular identification of five yeast isolates. We tested the urease, gelatinase, DNase, phospholipase, protease, and esterase activities, as well as the hemolytic activity. We evaluated the antifungal susceptibility to amphotericin B, fluconazole, anidulafungin and caspofungin.
Results:
Phenotypic methods could not identify the isolates. MALDI-TOF/MS was able to properly identify Candida duobushameulonii. The five isolates were successfully identified by sequence analysis as Candida duobushaemulonii, Meyerozyma caribbica and Cutaneotrichosporon dermatis. Candida duobushameulonii showed hemolytic, phospholipase, and protease activities. Meyerozyma caribbica was positive for gelatinase and protease activities. All antifungals exhibited minimum inhibitory concentrations (MICs) ≤2μg/mL against both species. The three isolates of Cutaneotrichosporon dermatis showed urease, DNase, and esterase activities, and resistance to echinocandins (MICs ≥8μg/mL), while amphotericin B and fluconazole exhibited low MICs against these isolates (0.50-2μg/mL).
Discussion:
Sequencing of the ITS or IGS1 regions of rDNA remains the best method for identifying cryptic species over other commercially available systems. More reports are needed to define the enzymatic and antifungal profiles for these species. This is the first report of Meyerozyma caribbica and Cutaneotrichosporon dermatis as etiological agents of onychomycosis.
Insights
Rare yeasts are emerging as onychomycosis agents. Molecular identification confirmed Candida duobushaemulonii, Meyerozyma caribbica, and Cutaneotrichosporon dermatis, revealing distinct enzymatic profiles and antifungal susceptibilities.
Area of Science:
- Medical Mycology
- Clinical Microbiology
- Yeast Pathogenesis
Background:
- Onychomycosis is increasingly caused by yeasts beyond common dermatophytes.
- Antifungal use has led to the emergence of rare or novel yeast pathogens.
- Accurate identification of yeast species is crucial for effective treatment.
Purpose of the Study:
- To re-identify rare yeast isolates from onychomycosis using advanced molecular techniques.
- To characterize the enzymatic activities and antifungal susceptibility profiles of these yeasts.
- To report novel etiological agents of onychomycosis.
Main Methods:
- Phenotypic characterization including enzymatic activity testing (urease, gelatinase, DNase, phospholipase, protease, esterase, hemolysis).
- Molecular identification using matrix-assisted laser desorption/ionization time of flight/mass spectrometry (MALDI-TOF/MS).
- Sequencing of ribosomal DNA (rDNA) internal transcribed spacer (ITS) or intergenic spacer (IGS) 1 regions.
- Antifungal susceptibility testing against amphotericin B, fluconazole, anidulafungin, and caspofungin.
Main Results:
- Phenotypic methods were insufficient for isolate identification.
- MALDI-TOF/MS identified Candida duobushameulonii.
- Sequence analysis identified Candida duobushaemulonii, Meyerozyma caribbica, and Cutaneotrichosporon dermatis.
- Specific enzymatic activities were noted for each species.
- Cutaneotrichosporon dermatis showed resistance to echinocandins but susceptibility to amphotericin B and fluconazole.
Conclusions:
- Ribosomal DNA sequencing (ITS/IGS1) is superior for identifying cryptic yeast species.
- Further research is needed to fully define enzymatic and antifungal profiles of these species.
- This study reports Meyerozyma caribbica and Cutaneotrichosporon dermatis as new etiological agents of onychomycosis.
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