Multidrug-resistant Trichosporon species: underestimated fungal pathogens posing imminent threats in clinical settings

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art_ARASTEHFAR_Multidrugresistant_Trichosporon_species_underestimated_fungal_pathogens_posing_imminent_2021.PDF (3.72 MB)
Citações na Scopus
12
Tipo de produção
article
Data de publicação
2021
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
TAYLOR & FRANCIS LTD
Autores
ARASTEHFAR, Amir
PERLIN, David S.
ILKIT, Macit
BOEKHOUT, Teun
COLOMBO, Arnaldo Lopes
Citação
CRITICAL REVIEWS IN MICROBIOLOGY, v.47, n.6, p.679-698, 2021
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Species of Trichosporon and related genera are widely used in biotechnology and, hence, many species have their genome sequenced. Importantly, yeasts of the genus Trichosporon have been increasingly identified as a cause of life-threatening invasive trichosporonosis (IT) in humans and are associated with an exceptionally high mortality rate. Trichosporon spp. are intrinsically resistant to frontline antifungal agents, which accounts for numerous reports of therapeutic failure when echinocandins are used to treat IT. Moreover, these fungi have low sensitivity to polyenes and azoles and, therefore, are potentially regarded as multidrug-resistant pathogens. However, despite the clinical importance of Trichosporon spp., our understanding of their antifungal resistance mechanisms is quite limited. Furthermore, antifungal susceptibility testing is not standardized, and there is a lack of interpretive epidemiological cut-off values for minimal inhibitory concentrations to distinguish non-wild type Trichosporon isolates. The route of infection remains obscure and detailed clinical and environmental studies are required to determine whether the Trichosporon infections are endogenous or exogenous in nature. Although our knowledge on effective IT treatments is rather limited and future randomized clinical trials are required to identify the best antifungal agent, the current paradigm advocates the use of voriconazole, removal of central venous catheters and recovery from neutropenia.
Palavras-chave
Antifungal agent, drug resistance, invasive fungal infection, trichosporonosis, white piedra
URI
https://observatorio.fm.usp.br/handle/OPI/44130
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Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - LIM/03