Molecular and MALDI-ToF MS differentiation and antifungal susceptibility of prevalent clinical Fusarium species in China
Molecular and MALDI-ToF MS differentiation and antifungal susceptibility of prevalent clinical Fusarium species in China
复制标题
中国临床流行镰刀菌的分子和MALDI-ToF MS分化及抗真菌敏感性
作者：
Song Yinggai;Liu Xiao;Yang Zhining;Meng Xingye;Xue Ruoning;Yu Jin;Al-Hatmi Abdullah M. S.;de Hoog G. Sybren;Li Ruoyu
研究背景镰刀菌是引起人类浅表和播散性感染的病原菌。早期诊断和治疗有助于改善严重感染的预后。目的检测基质辅助激光解吸电离飞行时间质谱的有效性（MALDI-ToF MS）用于镰刀菌鉴定，方法应用翻译延伸因子1 α（translation elongation factor 1-alpha，TEF 1）对203株临床分离的镰刀菌和25株环境分离的镰刀菌进行鉴定，并对临床常用的抗真菌药物进行敏感性分析结果228株分离株的种和属鉴定正确率分别为89.04%（203/228）和95.18%（217/228），药敏试验采用微量稀释法，药敏试验采用CLSI批准的M38-A3标准。使用Bruker丝状真菌文库1.0结合新数据库。共鉴定出7种镰刀菌复合体，其中茄镰孢（59.21%，n = 135）、轮枝镰孢（17.54%，n = 40）、增殖镰孢（6.58%，n = 15）和尖孢镰孢（4.39%，n = 10）。还鉴定了四种不常见的复合种（F. incarnatum‐ equiseti SC、F. dimerumSC、F. redolens SC和F. sporotrichioides SC）。镰刀菌分离株对卢立康唑和特比萘芬的MIC低于阿替霉素B和伏立康唑，而阿替霉素B和伏立康唑的活性又显著高于阿莫罗芬、氟康唑和伊曲康唑。结论MALDI-ToF MS在适应Bruker文库和扩展数据库的镰刀菌中表现出良好的性能。镰刀菌分离株对卢立康唑和特比萘芬的MIC低于阿替霉素B和伏立康唑。
BackgroundFusariumspecies are emerging causative agents of superficial and disseminated human infections. Early diagnosis and treatment contribute to better prognosis of severe infection.ObjectivesTo detect the effectiveness of matrix‐assisted laser desorption ionisation time of flight mass spectrometry (MALDI‐ToF MS) forFusariumidentification, and evaluate the susceptibility profiles to clinical available antifungals.MethodsAll 203 clinicalFusariumisolates and 25 environmental isolates were identified by using translation elongation factor 1‐alpha (TEF1) and RNA polymerase subunit II (RPB2) sequencing and MALDI‐ToF MS. Antifungal susceptibility testing was determined by a microdilution method following the CLSI approved standard M38‐A3 document.ResultsCorrect identification rates at the species and genus levels were 89.04% (203/228) and 95.18% (217/228), respectively, using Bruker Filamentous Fungi Library 1.0 combined with the novel database. Seven species complexes with 19Fusariumspecies were identified, includingF. solani(59.21%,n= 135),F. verticillioides(17.54%,n= 40),F. proliferatum(6.58%,n= 15) andF. oxysporum(4.39%,n= 10). Four uncommon species complexes (F. incarnatum‐equisetiSC,F. dimerumSC,F. redolensSC andF. sporotrichioidesSC) were also identified. A high degree of antifungal resistance was observed.Fusariumisolates exhibited lower MICs to luliconazole and terbinafine compared with amphotericin B and voriconazole, which in turn were significantly more active than amorolfine, fluconazole and itraconazole.ConclusionsMALDI‐ToF MS showed good performance inFusariumspecies with an adapted Bruker library and expanded database.Fusariumisolates exhibited lower MICs to luliconazole and terbinafine compared to amphotericin B and voriconazole.