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The High Diversity and Variable Susceptibility of Clinically Relevant Acremonium-Like Species in China

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Abstract

Acremonium-like fungi are emerging as important opportunistic pathogens in cutaneous, subcutaneous and serious invasive infections, especially in immunocompromised and debilitated individuals, and Acremonium infections are usually resistant to antifungal therapy. Several molecular studies have demonstrated that many species in the genus Acremonium are polyphyletic, and currently, the genus is restricted to the family Bionectriaceae (Hypocreales). Molecular identification and in vitro antifungal susceptibility tests of Acremonium-like fungi isolated from human clinical specimens in China were performed in this study. Three genetic loci: the large subunit ribosomal RNA gene (LSU), ribosomal internal transcribed spacer and elongation factor 1-α (EF1-α), were used to assess their taxonomic position for correct identification among various species. The multilocus study of twenty-eight strains showed that these strains were distributed in three main lineages: egyptiacum, Cordycipitaceae and Sarocladium; Acremonium egyptiacum and Sarocladium kiliense were the main species of these strains, and three isolates were too phylogenetically distant to be considered undescribed species. Relatively low minimum inhibitory concentrations (MICs) of 0.25–2 and 0.031–0.5 μg/mL were found for voriconazole and terbinafine for most species, respectively. Varied antifungal activities of ciclopirox olamine, amorolfine and posaconazole were found in our study. However, no antifungal effect of sertaconazole, itraconazole or fluconazole was observed against most strains. This is the first study on Acremonium-like species diversity by multilocus sequence analyses and antifungal susceptibility of clinically relevant isolates in China.

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Funding

This study was funded by the Chinese National Natural Science Foundation (Grant No. 31570015).

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Authors and Affiliations

  1. Department of Dermatology and Venereology, Peking University First Hospital, Research Center for Medical Mycology, Peking University, Beijing, China

    Limin Yao, Hong Wang, Zhe Wan, Ruoyu Li & Jin Yu

  2. Beijing Key Laboratory of Molecular Diagnosis of Dermatoses, Beijing, China

    Limin Yao, Hong Wang, Zhe Wan, Ruoyu Li & Jin Yu

  3. National Clinical Research Center for Skin and Immune Diseases, Beijing, China

    Limin Yao, Hong Wang, Zhe Wan, Ruoyu Li & Jin Yu

  4. Department of Dermatology and Venereology, Bethune International Peace Hospital, Shijiazhuang, China

    Limin Yao

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  1. Limin Yao
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  2. Hong Wang
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  3. Zhe Wan
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Correspondence to Jin Yu.

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Yao, L., Wang, H., Wan, Z. et al. The High Diversity and Variable Susceptibility of Clinically Relevant Acremonium-Like Species in China. Mycopathologia 184, 759–773 (2019). https://doi.org/10.1007/s11046-019-00399-8

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