Emergence of fusarioses in a university hospital in Turkey during a 20-year period

Abstract

Fusarium species have started appearing increasingly as the main cause of infections, particularly in immunocompromised patients. In this study, we aimed to present the first epidemiological data from Turkey, analyze fusariosis cases that have been monitored in a university hospital during the past 20 years, identify the responsible Fusarium species, and determine antifungal susceptibilities. A total of 47 cases of fusariosis was included in the study. Fusarium isolates were identified by multilocus sequence typing (MLST). Antifungal susceptibility was tested by the broth microdilution method according to the Clinical and Laboratory Standards Institute (CLSI) methodology. Of the Fusarium infections, 23.4 % were superficial, 44.7 % were locally invasive, and 31.9 % were disseminated. A significant increase was observed over the years. The Fusarium fujikuroi species complex (FFSC) proved to be the most frequent agent group (17 cases; 51.5 %), followed by the Fusarium solani species complex (FSSC) (14 cases; 42.4 %), the Fusarium dimerum species complex (FDSC), and the Fusarium oxysporum species complexes (FOSC) (one case each). Amphotericin B had the highest in vitro activity against all species. Voriconazole and posaconazole showed interspecies variability across and within Fusarium species complexes. In conclusion, our data support the fact that regional differences exist in the distribution of the Fusarium species and that species-specific differences are observed in antifungal susceptibility patterns. The monitoring of local epidemiological data by determining fungal identity and susceptibility are of importance in guiding the clinical followup of patients.Electronic supplementary material The online version of this article

Antifungal Susceptibility Testing of Fusarium: A Practical Approach

“…In vitro antifungal susceptibility profiles of Fusarium species demonstrate high MICs to most antifungal agents [ 10 , 11 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 ]. Notably, some species may exhibit different patterns of susceptibility: F. solani species complex are usually resistant to azoles and exhibit higher amphotericin B MIC values than other species, whereas F. oxysporum and F. verticilloides may be susceptible to voriconazole and posaconazole [ 10 , 11 , 55 ].…”

Genotyping of Fusarium Isolates from Onychomycoses in Colombia: Detection of Two New Species Within the Fusarium solani Species Complex and In Vitro Antifungal Susceptibility Testing

“…In general, a prevalence of Fusarium in dermatological infections has been reported to range between 2 and 8 % [6][7][8], but this is particularly higher in Colombia, being estimated at 15-30 % [9][10][11][12][13]. In two studies, conducted in 2003 and 2009 in Medellín and Bogotá, respectively, Fusarium solani was the most frequent cause of onychomycosis, followed by Fusarium oxysporum and Fusarium verticillioides [14,15], although the distribution of Fusarium species in dermatological infections varies around the world.…”

Global molecular epidemiology and genetic diversity of Fusarium , a significant emerging group of human opportunists from 1958 to 2015

“…Most published studies have focused on prevalence in single healthcare centers. 10, 11, 12, 13, 14, 15, 16 Nucci et al 17 reported 233 cases from different hospitals on a global scale. Mohammed et al 18 reported 26 cases from the United States and reviewed 97 cases from the literature, and Horn et al 12 described 65 cases from the North American Path Alliance Registry.…”