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Unveiling Lodderomyces elongisporus as an Emerging Yeast Pathogen: A Holistic Approach to Microbiological Diagnostic
Watcharamat Muangkaew1, Natthapaninee Thanomsridetchai2, Marut Tangwattanachuleeporn2
1Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Abstract:
Lodderomyces elongisporus, first isolated in 1952, has increasingly been recognized as a significant pathogen, with a notable rise in human infections since the 1970s. Initially misidentified as Candida parapsilosis due to morphological similarities, L. elongisporus has now been conclusively established as a distinct species, largely due to advancements in molecular biology, particularly DNA sequencing. This review traces the detection history of L. elongisporus, from the earliest documented cases to the most recent reports, underscoring its role as a causative agent in human infections. It also explores therapeutic strategies that have demonstrated efficacy, alongside instances of environmental contamination reported in international literature. A critical evaluation of diagnostic methodologies essential for precise identification is provided, including culture-based techniques such as colony morphology on Sabouraud Dextrose Agar (SDA) and chromogenic media, coupled with microscopic assessments using Lactophenol Cotton Blue (LPCB) and Gram staining. The ultrastructure of L. elongisporus, as observed under Scanning Electron Microscopy (SEM), is also discussed. Furthermore, non-culture-based diagnostics, such as sugar utilization tests (API 20C AUX and the innovative in-house arabinose-based "Loddy" test) and antifungal susceptibility profiling, are reviewed, with a particular focus on molecular tools like ITS-DNA sequencing and MALDI-TOF MS, which, despite their higher costs, offer unparalleled specificity. The accurate distinction and characterization of L. elongisporus are paramount, particularly in vulnerable and immunocompromised patients, where misdiagnosis can lead to severe consequences. This review advocates for intensified research efforts to develop more accessible diagnostic tools and deepen our understanding of this emerging pathogen, ultimately aiming to improve patient outcomes.
Insights
Lodderomyces elongisporus is an emerging fungal pathogen causing human infections. Accurate diagnostics, including molecular methods, are crucial for timely treatment and improved patient outcomes.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Molecular Diagnostics
Background:
- Lodderomyces elongisporus, identified in 1952, is increasingly recognized as a human pathogen.
- Previously misidentified as Candida parapsilosis, molecular advancements confirm it as a distinct species.
- Human infections by L. elongisporus have notably increased since the 1970s.
Purpose of the Study:
- To review the detection history and clinical significance of Lodderomyces elongisporus.
- To evaluate current and emerging diagnostic methodologies for accurate identification.
- To discuss therapeutic strategies and environmental occurrences of L. elongisporus.
Main Methods:
- Review of historical and current literature on L. elongisporus detection and infections.
- Analysis of culture-based diagnostics: colony morphology, microscopy (LPCB, Gram stain), and chromogenic media.
- Evaluation of non-culture-based diagnostics: sugar utilization tests (API 20C AUX, "Loddy" test), antifungal susceptibility, ITS-DNA sequencing, and MALDI-TOF MS.
Main Results:
- L. elongisporus has a documented history of human infections, often requiring differentiation from Candida species.
- Culture-based methods provide initial identification, while molecular techniques like ITS-DNA sequencing and MALDI-TOF MS offer high specificity.
- Antifungal susceptibility data guides therapeutic choices, though resistance patterns require further study.
Conclusions:
- Accurate and timely diagnosis of L. elongisporus is critical, especially in immunocompromised patients.
- Molecular diagnostic tools, despite cost, are essential for definitive identification.
- Further research is needed to develop accessible diagnostics and enhance understanding of this emerging pathogen to improve patient care.
