A study on trichosporon isolation, its molecular identification, clinical manifestations and risk factors
Trichosporon infection is a rare opportunistic, life threatening mycosis in patients with predisposing factors such as underlying immunodeficiency. Conventional methods to diagnose trichosporonosis are inadequate compared to molecular methods in terms of species identification. We reviewed 155 pa...
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| Format: | Thesis |
| Language: | English |
| Published: |
2018
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| Subjects: | |
| Online Access: | http://eprints.usm.my/56626/1/Dr.%20Wan%20Amani%20Wan%20Abdul%20Azim-24%20pages.pdf |
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| Summary: | Trichosporon infection is a rare opportunistic, life threatening mycosis in patients with
predisposing factors such as underlying immunodeficiency. Conventional methods to
diagnose trichosporonosis are inadequate compared to molecular methods in terms of
species identification. We reviewed 155 patients with Trichosporon isolations in hospital
to study the proportion, clinical manifestations, outcome and risk factors for having
Trichosporon infections. We found out that the majority species isolated were T. asahii
(50.3%) and mostly were from urine samples (84.5%). Among risk factors for overall
Trichosporon infections were ICU admission (95%CI 1.70, 10.37, p=0.002) and
antifungal recipients (95%CI 0.06, 0.56, p=0.003). For Trichosporon fungemia, there
were significant associations among those with hematological malignancy (p=0.001),
antifungal recipients (p=0.002) and mortality (p=0.036). Mortality was observed more in
fungemia compared to overall infection (55.6% vs. 22.5%). We also performed molecular
identification on 39 available Trichosporon isolates (36 T. asahii, two T. mucoides and
one T. inkin) by ITS1/4 sequencing that were previously identified by conventional
method. We observed four discrepancies by conventional method where two T. asahii
were identified as T. montevideense and two T. mucoides were T. debeurmannianum by
ITS sequencing. In conclusion, Trichosporon infection in susceptible patients posed high
mortality risk which required molecular identification for species identification to guide
proper therapy. |
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