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Identification of Mucorales From Clinical Specimens: A 4-Year Experience in a Single Institution

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키워드

주제분류병리학

초록

Mucormycosis, a fatal opportunistic infection in immunocompromised hosts, is caused by fungi belonging to the order Mucorales. Early diagnosis based on exact identification and multidisciplinary treatments is critical. However, identification of Mucorales fungi is difficult and often delayed, resulting in poor prognosis. This study aimed to compare the results of phenotypic and molecular identification of 12 Mucorales isolates collected from 4-yr-accumulated data. All isolates were identified on the basis of phenotypic characteristics such as growth rate, colony morphology, and reproductive structures. PCR and direct sequencing were performed to target internal transcribed spacer (ITS) and/or D1/D2 regions. Target DNA sequencing identified five Lichtheimia isolates, two Rhizopus microsporus isolates, two Rhizomucor pusillus isolates, one Cunninghamella bertholletiae isolate, one Mucor fragilis isolate, and one Syncephalastrum racemosum isolate. Five of the 12 (41.7%) isolates were incorrectly identified on the basis of phenotypic identification. DNA sequencing showed that of these five isolates, two were Lichtheimia isolates, one was Mucor isolate, one was Rhizomucor isolate, and one was Rhizopus microspores. All the isolates were identified at the species level by ITS and/or D1/D2 analyses. Phenotypic differentiation and identification of Mucorales is difficult because different Mucorales share similar morphology. Our results indicate that the molecular methods employed in this study are valuable for identifying Mucorales.

Abstract

Mucormycosis, a fatal opportunistic infection in immunocompromised hosts, is caused by fungi belonging to the order Mucorales. Early diagnosis based on exact identification and multidisciplinary treatments is critical. However, identification of Mucorales fungi is difficult and often delayed, resulting in poor prognosis. This study aimed to compare the results of phenotypic and molecular identification of 12 Mucorales isolates collected from 4-yr-accumulated data. All isolates were identified on the basis of phenotypic characteristics such as growth rate, colony morphology, and reproductive structures. PCR and direct sequencing were performed to target internal transcribed spacer (ITS) and/or D1/D2 regions. Target DNA sequencing identified five Lichtheimia isolates, two Rhizopus microsporus isolates, two Rhizomucor pusillus isolates, one Cunninghamella bertholletiae isolate, one Mucor fragilis isolate, and one Syncephalastrum racemosum isolate. Five of the 12 (41.7%) isolates were incorrectly identified on the basis of phenotypic identification. DNA sequencing showed that of these five isolates, two were Lichtheimia isolates, one was Mucor isolate, one was Rhizomucor isolate, and one was Rhizopus microspores. All the isolates were identified at the species level by ITS and/or D1/D2 analyses. Phenotypic differentiation and identification of Mucorales is difficult because different Mucorales share similar morphology. Our results indicate that the molecular methods employed in this study are valuable for identifying Mucorales.

참고문헌 (13)

  1. Chayakulkeeree M, "Zygomycosis: the re-emerging fungal infection", Eur J Clin Microbiol Infect Dis, 25, pp.215~229 (2006)
  2. Robin C, "Mucormycosis: a new concern in the transplant ward?", Curr Opin Hematol, 21, pp.482~490 (2014)
  3. Roden MM, "Epidemiology and outcome of zygomycosis: a review of 929 reported cases", Clin Infect Dis, 41, pp.634~653 (2005)
  4. Skiada A, "Zygomycosis in Europe: analysis of 230 cases accrued by the registry of the European Confederation of Medical Mycology (ECMM) Working Group on Zygomycosis between 2005 and 2007", Clin Microbiol Infect, 17, pp.1859~1867 (2011)
  5. Chamilos G, "Delaying amphotericin B-based frontline therapy significantly increases mortality among patients with hematologic malignancy who have zygomycosis", Clin Infect Dis, 47, pp.503~509 (2008)
  6. Larone D, "Medically important fungi: a guide to identification" (2011), ASM Press
  7. Clinical and Laboratory Standards Institute, "Interpretive criteria for identification of bacteria and fungi by DNA target sequencing: approved guideline", Clinical and Laboratory Standards Institute, ~ (2008)
  8. Kontoyiannis DP, "Zygomycosis in a tertiary-care cancer center in the era of Aspergillus-active antifungal therapy: a case-control observational study of 27 recent cases", J Infect Dis, 191, pp.1350~1360 (2005)
  9. Alvarez E, "Spectrum of zygomycete species identified in clinically significant specimens in the United States", J Clin Microbiol, 47, pp.1650~1656 (2009)
  10. 장자현, "Identification of Clinical Mold Isolates by Sequence Analysis of the Internal Transcribed Spacer Region, Ribosomal Large-Subunit D1", D2, and β-Tubulin, 2012, pp.32(2), 126~132[DOI]
  11. Schwarz P, "Molecular identification of zygomycetes from culture and experimentally infected tissues", J Clin Microbiol, 44, pp.340~349 (2006)
  12. Iwen PC, "Review of methods for the identification of zygomycetes with an emphasis on advances in molecular diagnostics", Lab Medicine, 42, pp.260~266 (2011)
  13. Dannaoui E, "Molecular tools for identification of Zygomycetes and the diagnosis of zygomycosis", Clin Microbiol Infect, 15(S5), pp.S66~S70 (2009)

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