Exophiala xenobiotica sp. nov., an opportunistic black yeast inhabiting environments rich in hydrocarbons

A new black yeast species, Exophiala xenobiotica, is described, a segregant of the Exophiala jeanselmei complex. It is morphologically very similar to E. jeanselmei, though with less melanized conidiogenous cells, but deviates unambiguously on the basis of molecular phylogeny. The species is a relatively common agent of cutaneous infections in humans, whereas E. jeanselmei is associated with subcutaneous infections. Environmental strains of E. xenobiotica are frequently found in habitats rich in monoaromatic hydrocarbons and alkanes.     

Identification of pathogenic dematiaceous fungi and related taxa based on large subunit ribosomal DNA D1/D2 domain sequence analysis

The nucleotide sequences of the D1/D2 domains of large subunit (26S) ribosomal DNA for 76 strains of 46 species of pathogenic dematiaceous fungi and related taxa were determined. Intra-species sequence diversity of medically important dematiaceous fungi including Phialophora verrucosa, Fonsecaea pedrosoi, Fonsecaea compacta, Cladophialophora carrionii, Cladophialophora bantiana, Exophiala dermatitidis, Exophiala jeanselmei, Exophiala spinifera, Exophiala moniliae, and Hortaea werneckii were extremely small; as few as 0 changes were detected in C. bantiana, Fonsecaea and Exophiala species, 1 bp in C. carrionii and H. werneckii, and 2 bp in P. verrucosa. Inter-species nucleotide diversity between most species was higher. These data suggested that the D1/D2 domain is sufficiently variable for identification of pathogenic dematiaceous fungi and relevant species. The phylogenetic trees constructed from the sequence data revealed that most human pathogenic species formed a single cluster and that Cladosporium and Phialophora species were distributed polyphyletically into several clusters.     

全球皮炎外瓶霉感染流行现状的回顾性分析

目的分析皮炎外瓶霉感染的流行病学和临床特征,为提高皮炎外瓶霉感染的诊治水平提供科学依据。方法采用文献回顾和荟萃分析的方法,分析全球范围内已报道的皮炎外瓶霉感染病例的国籍、性别、年龄分布、危险因素、发病部位、临床表现、诊疗方法及预后等流行病学和临床特征。结果皮炎外瓶霉感染在免疫功能正常和免疫功能缺陷患者中均可发生,患者的男女性别比为1.10∶1.00,最常发病年龄段为51~60岁,肺(27.90%,17/61)为最常受累的器官,但不同地域的病例感染器官存在差异。约半数(47.54%,29/61)病例伴有各种免疫抑制的基础疾病或危险因素。皮炎外瓶霉感染的临床确诊主要依赖培养和分子鉴定,系统感染患者推荐联合伊曲康唑和特比萘芬作为抗真菌治疗方案。结论近年来皮炎外瓶霉感染的发病率在全球范围内呈上升趋势,肺部为系统感染患者最常受累的器官,诊断主要依赖于真菌培养。加强皮炎外瓶霉菌株的药敏监测和分子流行病学研究,对于提高皮炎外瓶霉感染的临床诊治水平非常必要。     

Black Yeast Diversity on Creosoted Railway Sleepers Changes with Ambient Climatic Conditions

The environmental isolation of opportunistic pathogenic black yeasts, which are responsible for a wide spectrum of human infections, is essential to understanding the ecology of clinical fungi. Extreme outdoor environments polluted with aromatic hydrocarbons support the growth of black yeasts in unlikely places, such as railway sleepers. However, there are limited data concerning the diversity of these fungi growing on polluted railway sleepers. In this investigation, we examined 845 railway sleeper samples, obtained from 11 Turkish cities representing altitudes from 25 to 1,893 m, and inoculated the samples onto mycological media for the isolation of black yeasts. Ninety-four samples (11.1 %) yielded positive results for black yeast, with creosoted oak sleepers having a significantly higher number of isolates than concrete sleepers (p?rDNA) internal transcribed spacer region revealed the highest prevalence of Exophiala phaeomuriformis, followed by Exophiala dermatitidis, Exophiala heteromorpha, Exophiala xenobiotica, and Exophiala crusticola. This study revealed that railway sleepers harboring black yeasts were predominantly (>75 %) populated with thermophilic species. We observed that altitude might have a significant effect on species diversity. Briefly, E. phaeomuriformis exhibited growth over a wide altitude range, from 30 to 1,893 m. In contrast, E. dermatitidis had a remarkable aversion to low altitudes and exhibited maximum growth at 1,285 m. In conclusion, we speculate that one can predict what species will be found on railway sleepers and their probability and that species diversity primarily depends on sleeper type and altitude height. We believe that this study can contribute new insights into the ecology of black yeasts on railway sleepers and the railway factors that influence their diversity.     

A Rare Case Report of Subcutaneous Phaeohyphomycotic Cyst Caused by Exophiala oligosperma in an Immunocompetent Host with Literature Review

We report a rare case of phaeohyphomycotic cyst in an immunocompetent patient caused by Exophiala oligosperma. This fungus is earlier known to cause infections in the immunocompromised. Identification of black fungi at species level is more challenging by conventional methods, and hence final identification of the fungi was based on sequencing of rDNA. The patient was managed with surgical excision. To the best of our knowledge, this is the first case report of E. oligosperma human infection from India.     

Nutritional physiology of type isolates of currently accepted species ofExophiala andPhaeococcomyces

Nutritional physiological and tolerance tests were performed for all type strains of species currently classified in the black yeast generaExophiala andPhaeococcomyces, including some additional type strains of taxa recently reidentified asExophiala species. Most describedExophiala species can be distinguished by physiological characters.Exophiala jeanselmei with its varieties, andE. castellanii should all be retained as separate taxa. The pairs of strainsMycotorula schawii/Exophiala dermatitidis, Hormodendrum negronii/Exophiala jeanselmei var.lecaniicorni andSporotrichum gougerotii/Torula bergeri were found to be conspecific. Phenetic analyses of physiological data support the identity ofPhaeococcomyces exophialae as a yeast-like synanamorph ofExophiala spinifera. The taxonomic positions of the generaNadsoniella, Phaeoannellomyces andWangiella are discussed. The generaExophiala andPhaeococcomyces are unrelated.     

In vitro and in vivo investigations of human microsporidia.

The numerous infections of microsporidia which have been diagnosed in patients with AIDS have revealed the potential of these organisms for establishing themselves when the immune status of the host is compromised. Two species of Encephalitozoon, E. cuniculi and E. hellem, have been diagnosed in man, the former infecting a variety of tissues, the latter restricted to the corneal and conjunctival epithelia. These species are morphologically indistinguishable even at the ultrastructural level but can be separated biochemically. Two human sera were found to react with equal intensity in the ELISA on spores of E. cuniculi and E. hellem purified from in vitro cultures, and gave similar binding patterns in Western blots on SDS-PAGE protein profiles of the two species. This has raised questions about the identity of Encephalitozoon infections diagnosed previously in man. The diagnosis of Enterocytozoon bieneusi, which infects the intestinal enterocytes of AIDS patients and is associated with chronic diarrhoea, requires observation of smears or sections of biopsies or specialist observation of stool preparations. In vitro cultures, which would facilitate the raising of specific antisera, have proved difficult to establish. In vitro and in vivo systems for assaying drugs for microsporidia have revealed that albendazole has a marked effect on parasite numbers and morphology but does not eliminate infection, which resurges when drug pressure is removed.     

Histopathology of the mangrove land crab Ucides cordatus (Ocypodidae) affected by lethargic crab disease

Lethargic crab disease (LCD) has caused extensive epizootic mortality of the mangrove land crab Ucides cordatus (Linnaeus 1763) (Brachyura: Ocypodidae) along the Brazilian coast. Direct culture of tissue samples from sick crabs and subsequent isolation and purification identified the causative agent as an Exophiala species of fungus. The histopathology of crabs with variable signs of LCD indicates that the most affected tissues are the epidermis, connective tissue, heart, hepatopancreas, nervous system, and gills. Gonads, somatic muscles, and digestive system are less affected by the fungus. The observed pathology is compatible with the clinical signs of LCD. Necrosis, tissue degeneration, and congestion of hemal sinuses and vessels are present in heavily infected organs. Nerve fibers may be compressed by accumulations of yeast-like cells. In heavy infections the tissue of gill lamellae is destroyed with subsequent dilation or compression. Cellular immune responses include hemocytic infiltration, agglutination and encapsulation, and phagocytosis. Phagocytosis of yeast-like cells is abundant in the connective tissue associated with the exoskeleton. These results indicate that LCD is the result of a systemic phaeohyphomycosis caused by a species of Exophiala. The present study also suggests that dispersal of the fungus within the crab occurs through the hemal system.     

Exophiala macquariensis sp. nov., a cold adapted black yeast species recovered from a hydrocarbon contaminated sub-Antarctic soil

A new black yeast species, Exophiala macquariensis is described that is a member of the ascomycete family Herpotrichiellaceae, order Chaetothyriales. The genus Exophiala is comprised of opportunistic pathogens isolated from clinical specimens as well as species recovered from hydrocarbon contaminated environments. Several species have been reported to be able to degrade benzene, toluene, ethylbenzene and xylenes. Here, a novel species of Exophiala (CZ06) previously isolated from a Sub-Antarctic, Macquarie Island soil that was spiked with Special Antarctic Blend diesel fuel (SAB) is described. This isolate has the capacity of toluene biodegradation at cold temperatures. Multilocus sequence typing showed that this fungus was closely related to the pathogenic species Exophiala salmonis and Exophiala equina. With the capacity to utilise hydrocarbons as a sole carbon source at 10 °C, this fungus has great potential for future bioremediation applications.     

Dishwashers--a man-made ecological niche accommodating human opportunistic fungal pathogens

Habitats in human households may accommodate microorganisms outside the common spectrum of ubiquitous saprobes. Enrichment of fungi that may require specific environmental conditions was observed in dishwashers, 189 of which were sampled in private homes of 101 towns or communities. One-hundred-two were sampled from various localities in Slovenia; 42 from other European countries; 13 and 3 from North and South America, respectively; 5 from Israel; 10 from South Africa; 7 from Far East Asia; and 7 from Australia. Isolation was performed on samples incubated at 37°C. Species belonging to genera Aspergillus, Candida, Magnusiomyces, Fusarium, Penicillium and Rhodotorula were found occasionally, while the black yeasts Exophiala dermatitidis and Exophiala phaeomuriformis (Chaetothyriales) were persistently and most frequently isolated. Sixty-two percent of the dishwashers were positive for fungi, and 56% of these accommodated Exophiala. Both Exophiala species are known to be able to cause systemic disease in humans and frequently colonize the lungs of patients with cystic fibrosis. We conclude that high temperature, high moisture and alkaline pH values typically occurring in dishwashers can provide an alternative habitat for species also known to be pathogenic to humans.     

致病性暗色霉的浆膜超微结构分类学意义初探

对致病性暗色霉中的着色霉(Fonsecaea Negroni)外瓶霉(Exophiala Charmichael)瓶霉(Phialophoro Medlar)中的五种真菌浆膜超微结构进行了冰冻蚀刻研究,发现裴氏着色霉(Fonsecaea pedrosoi)和紧密着色霉(F.compacta)的内折长而宽,较深,略有弯曲,数量少,多呈平行或垂直排列。皮炎外瓶霉(Exophiala dermatitidis)的内折数量多,密集而分布均匀,呈圆点状或圆棒状。棘状外瓶霉(Exophiala spinifera)的内折少而表浅,多为圆形。疣状瓶霉(Phialophora verrucosa)的内折数量,排列,形状无一定规律。据上述特征,着色霉可以与外瓶霉,疣状瓶霉区别开来,皮炎外瓶霉也可与棘状外瓶霉区分。浆膜超微结构的性状有一定的分类学意义。     

临床皮炎外瓶霉荧光定量PCR检测方法的建立

目的 建立基于TaqMan探针技术的皮炎外瓶霉荧光定量PCR检测方法.方法 通过对皮炎外瓶霉ITS区域基因组序列（GenBank：JN675373.1）进行分析,设计合成特异性引物和荧光标记探针,优化荧光定量PCR反应条件.以临床标本中分离的皮炎外瓶霉为阳性菌株,及其他种类真菌和细菌作为阴性对照菌株,从特异性、敏感性及重复性方面对该方法检测效果进行评价.结果 该研究设计的引物和探针能扩增皮炎外瓶霉特异性序列.临床分离得到的皮炎外瓶霉在反应中有明显扩增曲线,而甄氏外瓶霉、棘状外瓶霉、烟曲霉、白色念珠菌、新生隐球菌、马内菲青霉等20株菌在CT值≤38范围内均未有扩增;利用基因重组构建的标准品完成了标准曲线的绘制,在1.0×103～1.0×107拷贝数（Cp）内具有良好的线性关系（R2=1.000）,最低可检出量为10 Cp/μL.结论 成功建立了荧光定量PCR检测皮炎外瓶霉方法,该法特异度强、敏感度高、重复性好,将有助于临床皮炎外瓶霉感染的早期诊断和针对性治疗.     

Cytodiagnosis of eumycotic mycetoma: a case report

BACKGROUND: Mycetoma is a late-stage clinical manifestation of a subcutaneous infection produced by bacteria (actinomycetoma) or fungi (eumycetoma). Only a few articles have described the morphologic appearance of this uncommon pathology on cytology. The distinction between eumycetoma and actinomycetoma in fine needle aspiration cytology (FNAC) is as accurate as in histopathology, as demonstrated in the present case. CASE: A 30-year-old man presented with a large swelling on his left foot with a discharging sinus. FNAC of the swelling yielded pus-like material. Initial Papanicolaou and Giemsa stains showed the presence of septate, branching fungal hyphae and black granules against the inflammatory background. The presence of fungus was confirmed by PAS stain. The species was identified as Exophiala jeanselmei on fungal culture. CONCLUSION: Mycotic mycetoma can be accurately diagnosed by FNAC, which is a simple, inexpensive and rapid technique when there is a high index of suspicion. Special stains and culture studies are helpful in confirmation of diagnosis and species identification.     

Isolation and Identification of Black Yeasts by Enrichment on Atmospheres of Monoaromatic Hydrocarbons

Black yeast members of the Herpotrichiellaceae present a complex ecological behavior: They are often isolated from rather extreme environments polluted with aromatic hydrocarbons, while they are also regularly involved in human opportunistic infections. A selective technique to promote the in vitro growth of herpotrichiellaceous fungi was applied to investigate their ecophysiology. Samples from natural ecological niches and man-made environments that might contain black yeasts were enriched on an inert solid support at low humidity and under a controlled atmosphere rich in volatile aromatic hydrocarbons. Benzene, toluene, and xylene were provided separately as the sole carbon and energy source via the gas phase. The assayed isolation protocol was highly specific toward mesophilic Exophiala species (70 strains of this genus out of 71 isolates). Those were obtained predominantly from creosote-treated railway ties (53 strains), but isolates were also found on wild berries (11 strains) and in guano-rich soil samples (six strains). Most of the isolates were obtained on toluene (43 strains), but enrichments on xylene and benzene also yielded herpotrichiellaceous fungi (17 and 10 isolates, respectively). Based upon morphological characterizations and DNA sequences of the full internal transcriber spacers (ITS) and the 8.5S rRNA genes, the majority of the obtained isolates were affiliated to the recently described species Exophiala xenobiotica (32 strains) and Exophiala bergeri (nine strains). Members of two other phylogenetic groups (24 and two strains, respectively) somewhat related to E. bergeri were also found, and a last group (three strains) corresponded to an undescribed Exophiala species.     

Non-dermatophytic moulds: onychomycosis in four patients infected with the human immunodeficiency virus

Patients infected with human immunodeficiency virus (HIV) are a risk group for onychomycosis, fungal infections caused mainly by dermatophytes and yeast. However, non-dermatohytic moulds are becoming common agents for nail infections in this population of patients. We report four cases of onychomycosis caused by non-dermatophytic moulds (Aspergillus niger, Scytalidium hyalinum, Scytalidium dimidiatum and Fusarium solani) in patients infected with HIV from Recife, Pernambuco, Brazil. Onychomicosis by non-dermatophytic species in HIV-positive patients requires special attention in the clinical and the laboratory. A proper diagnosis is necessary to establish the specific and adequate treatment, preventing fungal invasion.     

Subcutaneous phaeohyphomycosis caused by Exophiala spinifera

The second human subcutaneous infection due to Exophiala spinifera from the United States is described. Identification was based on the morphology of the fungus in tissue and the morphological features of the culture obtained from the biopsy material. Correct diagnosis and treatment with ketoconazole and 5-fluorocytosine cured the infection.     

Deoxyribonucleic acid hybridization studies of Exophiala dermatitidis and Exophiala jeanselmei

Exophiala dermatitidis and Exophiala jeanselmei share similar morphological features and have been confused with each other. To clarify the relationship between the two fungi, we conducted a deoxyribonucleic acid (DNA)-DNA hybridization study using a dot blot method. Between E. dermatitidis and E. jeanselmei, only a very low level of DNA relatedness was seen and it was confirmed that these two fungi are distinct species based on DNA similarity. Close correspondence of DNA from the isolates of E. dermatitidis was obtained, whereas the isolates of E. jeanselmei were divided into 6 groups according to their DNA similarity and a possibility was shown that E. jeanselmei is composed of genetically heterogeneous groups. The subdivision of the species E. jeanselmei by the DNA-DNA hybridization method was in agreement with serotyping exoantigens. This result suggests that DNA-DNA hybridization studies provide an excellent tool for the identification and grouping of pathogenic dematiaceous fungi.     

镰刀菌所致皮肤感染的文献回顾

镰刀菌主要为植物致病菌,但也可引起严重人类感染。镰刀菌病临床表现形式多样,本文主要综述相关的皮肤感染,分为局限性皮肤感染及播散性感染,诊断多较困难。由于该属真菌对抗真菌药物存在天然耐药,播散性镰刀菌病死亡率可达80%-90%。本文对Medline和中文文献数据库中的相关文献进行了系统查阅和分析,综合归纳了镰刀菌所致皮肤感染的致病种、地域分布、危险因子、临床表现形式、药物敏感性及其诊疗方案等,该综述对全面了解镰刀菌病的特征及对临床医师对本病的诊断具有重要的意义。     

外瓶霉属真菌耐药性和降解能力的研究

外瓶霉属(Exophiala)真菌对五氯酚和杂酚油都有很强的耐药性,其中以菌株P-3182对五氯酚和菌株P-2830、P-3182对杂酚油的耐药性最强。外瓶霉属真菌不但能在五氯酚和杂酚油溶液中生长,而且具有降解这两种防腐剂的能力。而在砷铬酸铜溶液中不能生长,对环烷酸铜和砷铬酸铜的耐药性与对照菌种相似或稍高。