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Clinically Relevant Fusarium Species
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Clinically Relevant Fusarium Species

A special issue of Journal of Fungi (ISSN 2309-608X). This special issue belongs to the section "Fungal Pathogenesis and Disease Control".

Deadline for manuscript submissions: closed (30 April 2022) | Viewed by 24413

Special Issue Editor

Dr. Abdullah M.S. Al-Hatmi

E-Mail Website
Guest Editor
Ministry of Health, Directorate General of Health Services, Ibri, Oman
Interests: infections caused by human pathogenic fungi (yeasts and molds); fungal biology; fungal taxonomy and barcoding; diagnosis; fungal pathogenicity; fungal genetics; fungal immunology; antimicrobial PK/PD and treatment

Special Issue Information

Dear Colleagues,

This Special Issue will focus on human infections caused by Fusarium spp. treatment and outcomes, and methods for accurately identifying isolates recovered from clinical specimens. Fusarium is one of the very few fungi that infect plants as easily as humans, and the genus and its relatives of the order Hypocreales are intrinsically multiresistant to most currently used antifungals. For several decades, Fusarium species have been well known as important plant pathogens, and over the last 25 years, they have, in addition, emerged as a significant group of clinically important fungi and acquired the status of being notorious human opportunistic pathogens, next only to Candida and Aspergillus species. Fusarium species are significant causes of invasive infections in highly immunocompromised hosts. However, in immunocompetent individuals, Fusarium spp. infections primarily include keratitis, onychomycosis, and localized infections due to trauma. The changing epidemiology of fungal infections in immunocompromised hosts with the advent of antifungal prophylaxis has further led to an increase in the incidence of mold infections like Fusarium. In addition, Fusarium species are among the most important phytopathogenic and toxigenic fungi.

Given the recent developments in this field, the purpose of this Special Issue is to highlight aspects related to the challenges in the diagnosis, treatment, and prevention of the cases caused by Fusarium species. Comprehensive reviews, original studies, and novel perspectives are all welcome. Finally, any new developments occurring in this field will also be included.

Dr. Abdullah M.S. Al-Hatmi
Guest Editor

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Keywords

  • Fusarium
  • human infections
  • keratitis
  • onychomycosis
  • invasive
  • diagnosis
  • novel molecular tests
  • antifungal susceptibility and treatment
  • mycotoxins
  • taxonomy
  • phylogeny

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Published Papers (7 papers)

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Research

Jump to: Review

9 pages, 278 KiB  
Article
In Vitro Antifungal Susceptibility Profile of Miltefosine against a Collection of Azole and Echinocandins Resistant Fusarium Strains
by Mohsen Nosratabadi, Javad Akhtari, Leila Faeli, Iman Haghani, Seyed Reza Aghili, Tahereh Shokohi, Mohammad Taghi Hedayati, Hossein Zarrinfar, Rasoul Mohammadi, Mohammad Javad Najafzadeh, Sadegh Khodavaisy, Ahmed Al-Harrasi, Mohammad Javan-Nikkhah, Reza Kachuei, Maryam Salimi, Mahsa Fattahi, Hamid Badali, Abdullah M. S. Al Hatmi and Mahdi Abastabar
J. Fungi 2022, 8(7), 709; https://doi.org/10.3390/jof8070709 - 4 Jul 2022
Cited by 6 | Viewed by 2808
Abstract
Fusarium species are filamentous fungi that cause a variety of infections in humans. Because they are commonly resistant to many antifungal drugs currently available in clinical settings, research into alternative targets in fungal cells and therapeutic approaches is required. The antifungal activity of [...] Read more.
Fusarium species are filamentous fungi that cause a variety of infections in humans. Because they are commonly resistant to many antifungal drugs currently available in clinical settings, research into alternative targets in fungal cells and therapeutic approaches is required. The antifungal activity of miltefosine and four comparators, amphotericin B, voriconazole, itraconazole, and caspofungin, were tested in vitro against a collection of susceptible and resistant clinical (n = 68) and environmental (n = 42) Fusarium isolates. Amphotericin B (0.8 μg/mL) had the lowest geometric mean (GM) MICs/MECs values followed by miltefosine (1.44 μg/mL), voriconazole (2.15 μg/mL), caspofungin (7.23 μg/mL), and itraconazole (14.19 μg/mL). Miltefosine was the most effective agent against Fusarium isolates after amphotericin B indicating that miltefosine has the potential to be studied as a novel treatment for Fusarium infections. Full article
(This article belongs to the Special Issue Clinically Relevant Fusarium Species)
12 pages, 671 KiB  
Article
CYP51 Mutations in the Fusarium solani Species Complex: First Clue to Understand the Low Susceptibility to Azoles of the Genus Fusarium
by Pierre Vermeulen, Arnaud Gruez, Anne-Lyse Babin, Jean-Pol Frippiat, Marie Machouart and Anne Debourgogne
J. Fungi 2022, 8(5), 533; https://doi.org/10.3390/jof8050533 - 20 May 2022
Cited by 8 | Viewed by 2883
Abstract
Members of Fusarium solani species complex (FSSC) are cosmopolitan filamentous fungi responsible for invasive fungal infections in immunocompromised patients. Despite the treatment recommendations, many strains show reduced sensitivity to voriconazole. The objective of this work was to investigate the potential relationship between azole [...] Read more.
Members of Fusarium solani species complex (FSSC) are cosmopolitan filamentous fungi responsible for invasive fungal infections in immunocompromised patients. Despite the treatment recommendations, many strains show reduced sensitivity to voriconazole. The objective of this work was to investigate the potential relationship between azole susceptibility and mutations in CYP51 protein sequences. Minimal inhibitory concentrations (MICs) for azole antifungals have been determined using the CLSI (Clinical and Laboratory Standards Institute) microdilution method on a panel of clinical and environmental strains. CYP51A, CYP51B and CYP51C genes for each strain have been sequenced using the Sanger method. Amino acid substitutions described in multiple azole-resistant Aspergillus fumigatus (mtrAf) strains have been sought and compared with other Fusarium complexes’ strains. Our results show that FSSC exhibit point mutations similar to those described in mtrAf. Protein sequence alignments of CYP51A, CYP51B and CYP51C have highlighted different profiles based on sequence similarity. A link between voriconazole MICs and protein sequences was observed, suggesting that these mutations could be an explanation for the intrinsic azole resistance in the genus Fusarium. Thus, this innovative approach provided clues to understand low azole susceptibility in FSSC and may contribute to improving the treatment of FSSC infection. Full article
(This article belongs to the Special Issue Clinically Relevant Fusarium Species)
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10 pages, 1939 KiB  
Article
Fungal Keratitis Due to Fusarium lichenicola: A Case Report and Global Review of Fusarium lichenicola Keratitis
by Isra Halim, Prabhakar Singh, Asim Sarfraz, Prathyusha Kokkayil, Binod Kumar Pati, Bhaskar Thakuria and Amit Raj
J. Fungi 2021, 7(11), 889; https://doi.org/10.3390/jof7110889 - 21 Oct 2021
Cited by 4 | Viewed by 2797
Abstract
Fusarium species are among the most commonly isolated causes of fungal keratitis. Most species of the genus Fusarium belong to Fusarium solani species complex (FSSC). Fusarium lichenicola, a member of the FSSC complex, is a well-established plant and human pathogen. However, reports [...] Read more.
Fusarium species are among the most commonly isolated causes of fungal keratitis. Most species of the genus Fusarium belong to Fusarium solani species complex (FSSC). Fusarium lichenicola, a member of the FSSC complex, is a well-established plant and human pathogen. However, reports of fungal keratitis due to Fusarium lichenicola have not been frequently reported. To the best of our knowledge, only twelve cases of Fusarium lichenicola keratitis have been reported in the past fifty years. Clinical cases of Fusarium lichenicola may have most likely been misidentified because of the lack of clinical and microbiological suspicion, as well as inadequate diagnostic facilities in many tropical countries where the burden of the disease may be the highest. We report a case of fungal keratitis caused by Fusarium lichenicola and present a global review of the literature of all cases of fungal keratitis caused by this potentially blinding fungus. Full article
(This article belongs to the Special Issue Clinically Relevant Fusarium Species)
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12 pages, 495 KiB  
Article
Fusarium musae from Diseased Bananas and Human Patients: Susceptibility to Fungicides Used in Clinical and Agricultural Settings
by Valeria Tava, Anna Prigitano, Paolo Cortesi, Maria Carmela Esposto and Matias Pasquali
J. Fungi 2021, 7(9), 784; https://doi.org/10.3390/jof7090784 - 21 Sep 2021
Cited by 13 | Viewed by 2842
Abstract
Fusarium musae belongs to the Fusarium fujikuroi species complex. It causes crown rot disease in banana but also keratitis and skin infections as well as systemic infections in immunocompromised patients. Antifungal treatments in clinical and agricultural settings rely mostly on molecules belonging to [...] Read more.
Fusarium musae belongs to the Fusarium fujikuroi species complex. It causes crown rot disease in banana but also keratitis and skin infections as well as systemic infections in immunocompromised patients. Antifungal treatments in clinical and agricultural settings rely mostly on molecules belonging to the azole class. Given the potential risk of pathogen spread from food to clinical settings, the goal of the work was to define the level of susceptibility to different azoles of a worldwide population of F. musae. Eight fungicides used in agriculture and five antifungals used in clinical settings (4 azoles and amphotericin B) were tested using the CLSI (Clinical and Laboratory Standards Institute) protocol methodology on 19 F. musae strains collected from both infected patients and bananas. The level of susceptibility to the different active molecules was not dependent on the source of isolation with the exception of fenbuconazole and difenoconazole which had a higher efficiency on banana-isolated strains. Minimal inhibitory concentrations (MICs) of the different molecules ranged from 0.12–0.25 mg/L for prochloraz to more than 16 mg/L for tetraconazole and fenbuconazole. Compared to the F. verticillioides, F. musae MICs were higher suggesting the importance of monitoring the potential future spread of this species also in clinical settings. Full article
(This article belongs to the Special Issue Clinically Relevant Fusarium Species)
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14 pages, 520 KiB  
Article
Eye Infections Caused by Filamentous Fungi: Spectrum and Antifungal Susceptibility of the Prevailing Agents in Germany
by Grit Walther, Anna Zimmermann, Johanna Theuersbacher, Kerstin Kaerger, Marie von Lilienfeld-Toal, Mathias Roth, Daniel Kampik, Gerd Geerling and Oliver Kurzai
J. Fungi 2021, 7(7), 511; https://doi.org/10.3390/jof7070511 - 26 Jun 2021
Cited by 17 | Viewed by 4246
Abstract
Fungal eye infections can lead to loss of vision and blindness. The disease is most prevalent in the tropics, although case numbers in moderate climates are increasing as well. This study aimed to determine the dominating filamentous fungi causing eye infections in Germany [...] Read more.
Fungal eye infections can lead to loss of vision and blindness. The disease is most prevalent in the tropics, although case numbers in moderate climates are increasing as well. This study aimed to determine the dominating filamentous fungi causing eye infections in Germany and their antifungal susceptibility profiles in order to improve treatment, including cases with unidentified pathogenic fungi. As such, we studied all filamentous fungi isolated from the eye or associated materials that were sent to the NRZMyk between 2014 and 2020. All strains were molecularly identified and antifungal susceptibility testing according to the EUCAST protocol was performed for common species. In total, 242 strains of 66 species were received. Fusarium was the dominating genus, followed by Aspergillus, Purpureocillium, Alternaria, and Scedosporium. The most prevalent species in eye samples were Fusarium petroliphilum, F. keratoplasticum, and F. solani of the Fusarium solani species complex. The spectrum of species comprises less susceptible taxa for amphotericin B, natamycin, and azoles, including voriconazole. Natamycin is effective for most species but not for Aspergillus flavus or Purpureocillium spp. Some strains of F. solani show MICs higher than 16 mg/L. Our data underline the importance of species identification for correct treatment. Full article
(This article belongs to the Special Issue Clinically Relevant Fusarium Species)
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14 pages, 1529 KiB  
Article
Clinical Origin and Species Distribution of Fusarium spp. Isolates Identified by Molecular Sequencing and Mass Spectrometry: A European Multicenter Hospital Prospective Study
by Anne-Cécile Normand, Sébastien Imbert, Sophie Brun, Abdullah M. S. Al-Hatmi, Erja Chryssanthou, Sophie Cassaing, Christine Schuttler, Lilia Hasseine, Caroline Mahinc, Damien Costa, Christine Bonnal, Stéphane Ranque, Marc Sautour, Elisa Rubio, Laurence Delhaes, Arnaud Riat, Boualem Sendid, Lise Kristensen, Marcel Brandenberger, Juliette Guitard, Ann Packeu, Renaud Piarroux and Arnaud Fekkaradd Show full author list remove Hide full author list
J. Fungi 2021, 7(4), 246; https://doi.org/10.3390/jof7040246 - 25 Mar 2021
Cited by 12 | Viewed by 3201
Abstract
Fusarium spp. are widespread environmental fungi as well as pathogens that can affect plants, animals and humans. Yet the epidemiology of human fusariosis is still cloudy due to the rapidly evolving taxonomy. The Mass Spectrometry Identification database (MSI) has been developed since 2017 [...] Read more.
Fusarium spp. are widespread environmental fungi as well as pathogens that can affect plants, animals and humans. Yet the epidemiology of human fusariosis is still cloudy due to the rapidly evolving taxonomy. The Mass Spectrometry Identification database (MSI) has been developed since 2017 in order to allow a fast, accurate and free-access identification of fungi by matrix-assisted laser desorption ionization—time of flight (MALDI-TOF) mass spectrometry. Taking advantage of the MSI database user network, we aim to study the species distribution of Fusarium spp. isolates in an international multicenter prospective study. This study also allowed the assessment of the abilities of miscellaneous techniques to identify Fusarium isolates at the species level. The identification was performed by PCR-sequencing and phylogenic-tree approach. Both methods are used as gold standard for the evaluation of mass spectrometry. Identification at the species complex was satisfactory for all the tested methods. However, identification at the species level was more challenging and only 32% of the isolates were correctly identified with the National Center for Biotechnology Information (NCBI) DNA database, 20% with the Bruker MS database and 43% with the two MSI databases. Improvement of the mass spectrometry database is still needed to enable precise identification at the species level of any Fusarium isolates encountered either in human pathology or in the environment. Full article
(This article belongs to the Special Issue Clinically Relevant Fusarium Species)
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Review

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11 pages, 599 KiB  
Review
Onychomycosis Caused by Fusarium Species
by Eduardo Vinicius Grego Uemura, Marcelo dos Santos Barbosa, Simone Simionatto, Ahmed Al-Harrasi, Abdullah M. S. Al-Hatmi and Luana Rossato
J. Fungi 2022, 8(4), 360; https://doi.org/10.3390/jof8040360 - 31 Mar 2022
Cited by 20 | Viewed by 4221
Abstract
Onychomycosis is a nail fungal infection that produces nail discolouration, thickness, and separation from the nail bed. The species of the Fusarium genus that cause onychomycosis are emerging and the number of cases has increased throughout the years. Microscopic examination, as well as [...] Read more.
Onychomycosis is a nail fungal infection that produces nail discolouration, thickness, and separation from the nail bed. The species of the Fusarium genus that cause onychomycosis are emerging and the number of cases has increased throughout the years. Microscopic examination, as well as cultures, are required for the accurate diagnosis of onychomycosis. The goal of treatment is to eliminate the organism that causes the disease and restore the nail’s normal appearance. Here, we provide an overview of the onychomycosis cases that have been reported in literature over the last 24 years, which have been caused by the Fusarium species. We performed a review on the onychomycosis cases caused by the Fusarium species from January 1997 to January 2021. Patients aged between 40 and 49 years made up 30.23% of the cases. The most common aetiologic species was Fusarium solani species complex (FSSC), which accounted for 44.11% of the cases, followed by F. fujikuroi species complex (FFSC), which accounted for 17.64%; 14.70% of the cases were due to F. dimerum species complex (FDSC) and 14.70% of the cases were due F. oxysporum species complex (FOSC). Europe accounted for 29.06% of the cases caused by FOSC, whereas Africa accounted for 46.67% of the cases due to FSSC. The clinical presentation of onychomycosis due to Fusarium spp. is commonly the distal–lateral pattern of onychomycosis. Identification of the infectious agent in onychomycosis cases due to Fusarium is crucial in deciding the proper treatment. Although antifungal susceptibility tests have only been performed in a few cases, susceptibility testing can help with patient management. Full article
(This article belongs to the Special Issue Clinically Relevant Fusarium Species)
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