Добавил:
Sekretar
kiopkiopkiop18@yandex.ru
t.me/Prokururor I Вовсе не секретарь, но почту проверяю
Опубликованный материал нарушает ваши авторские права? Сообщите нам.
Вуз:
Предмет:
Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5333_Библиотеки_им_академика_М_И_Перельмана
.pdf
10 ˜m
Downloaded from https://cabidigitallibrary.org by Ivanov Ivan, on 11/04/24.
Subject to the CABI Digital Library Terms & Conditions, available at https://cabidigitallibrary.org/terms-and-conditions
Fig. 18.1. Cladophialophora bantiana culture, conidiophores and conidia. Note: Conidiophores produce branched
acropetal chains of conidia, where the youngest conidium (arrows) is at the tip of the chain.
Antifungal susceptibility: (Table 18.1).
Table 18.1. Cladophialophora bantiana (Australian national data); MIC μg/mL.
Antifungal No. ≤0.016 0.03 0.06 0.125 0.25 0.5 1 2 4 8 16 32 ≥64
AmB 27 1 3 2 6 6 9
ISAV 3 2 1
VORI 27 3 3 7 11 3
POSA 25 7 5 12 1
ITRA 27 6 3 5 11 2
References: McGinnis (1980); McGinnis and Borelli (1981); McGinnis et al. (1986a); Rippon (1988); Kwon-
Chung and Bennett (1992); Kantarcioglu et al. (2017); de Hoog et al. (2020).
18.2. Cladophialophora carrionii (Trejos) de Hoog et al.
Synonymy: Cladosporium carrionii Trejos.
Cladophialophora carrionii is a recognised agent of chromoblastomycosis and has been isolated from soil
and fence posts made from Eucalyptus wood. Cases of chromoblastomycosis caused by C. carrionii are com-
monly found in Australia, Venezuela, Madagascar and South America. Isolates from phaeomycotic cysts and
opportunistic infections have also been reported.
RG-2 organism
Morphological description: Colonies are slow growing, reaching 3-4 cm in diameter after one month, with a
compact suede-like to downy surface and are olivaceous-black in colour (Fig. 18.2). Microscopy shows
Descriptions of Medical Fungi 66
10 ˜m
Downloaded from https://cabidigitallibrary.org by Ivanov Ivan, on 11/04/24.
Subject to the CABI Digital Library Terms & Conditions, available at https://cabidigitallibrary.org/terms-and-conditions
Fig. 18.2. Cladophialophora carrionii culture, conidiophores and conidia. Note: Conidiophores produce branched
acropetal chains of conidia (arrows).
ascending to erect, olivaceous-green, apically branched, elongate conidiophores producing branched acropetal chains of smooth-walled conidia. Conidia are pale olivaceous, smooth-walled or slightly verrucose,
limoniform to fusiform, 1.5-3.0 x 2.0-7.0 μm in size (Fig. 18.2). Bulbous phialides with large collarettes and
minute, hyaline conidia are occasionally formed on nutritionally poor media. Maximum growth temperature
o
35-37
C.
Molecular identification: ITS sequencing is recommended (Abliz et al., 2004; de Hoog et al., 2007).
Key features: Conidia are smaller and comprise heavily branched systems which fall apart much more easily
than in the other Cladophialophora species.
Antifungal susceptibility: (Table 18.2).
Table 18.2. Cladophialophora carrionii limited data available (Australian national data); MIC μg/mL.
Antifungal No. ≤0.016 0.03 0.06 0.125 0.25 0.5 1 2 4 8 16 32 ≥64
AmB 2 1 1
VORI 2 1 1
POSA 2 1 1
ITRA 2 1 1
References: McGinnis (1980); Rippon (1988); de Hoog et al. (1995, 2015).
DOI: 10.1079/9781800622340.0018
Descriptions of Medical Fungi 67
Cladosporium species are ubiquitous worldwide, and commonly isolated from soil and organic matter. They
Downloaded from https://cabidigitallibrary.org by Ivanov Ivan, on 11/04/24.
Subject to the CABI Digital Library Terms & Conditions, available at https://cabidigitallibrary.org/terms-and-conditions
represent the most frequently isolated airborne fungi. The genus has undergone a number of revisions. The
well-known thermotolerant “true” human-pathogenic species, formerly known as C. bantiana, C. carrionii
and C. devriesii, characterised by the absence of conidiophores, and unpigmented conidial scars, were reclas-
sified to Cladophialophora (de Hoog et al., 1995; Bensch et al., 2012). The remaining species of medical
interest were C. cladosporioides, C. herbarum, C. oxysporum and C. sphaerospermum. More recently, exten-
sive revisions based on polyphasic approaches have recognised 169 species, and demonstrated that C. clad-
osporioides, C. herbarum and C. sphaerospermum are species complexes encompassing several sibling
species that can only be distinguished by phylogenetic analyses (Crous et al., 2007; Schubert et al., 2007;
Zalar et al., 2007; Bensch et al., 2010, 2012).
Sandoval-Denis et al. (2015b) analysed 92 clinical isolates from the United States using phenotypic and
molecular methods, which included sequence analysis of the ITS and D1/D2 regions, partial TEF-1 and ACT
genes. Surprisingly, the most frequently isolated species was Cladosporium halotolerans (15%) a member of
C. sphaerospermum species complex, followed by C. tenuissimum (10%), C. subuliforme (6%) and C. pseudocladosporioides (5%), all members of the C. cladosporioides species complex. However, 40% of the iso-
lates did not correspond to any known species and were deemed to represent at least 17 new lineages for
Cladosporium. The most frequent anatomic site of isolation was the respiratory tract (55%), followed by
superficial (28%) and deep tissues and fluids (15%). Species of the two recently described Cladosporium-like
genera Toxicocladosporium and Penidiella were also reported for the first time from clinical samples
(Sandoval-Denis et al., 2015b).
RG-1 organisms
Morphological description: Colonies are slow growing, mostly olivaceous-brown to blackish-brown but also
sometimes grey, buff or brown, suede-like to floccose, often becoming powdery due to the production of
abundant conidia. The reverse is olivaceous-black (Fig. 19.1). Vegetative hyphae, conidiophores and conidia
are equally pigmented. Conidiophores are more or less distinct from the vegetative hyphae, being erect,
straight or flexuose, unbranched or branched only in the apical region, with geniculate sympodial elongation
in some species. Conidia are produced in branched acropetal chains, being smooth, verrucose or echinulate,
one to four-celled, and have a distinct dark hilum (Fig. 19.1). The term blastocatenate is often used to
describe chains of conidia where the youngest conidium is at the apical or distal end of the chain. Note: The
conidia closest to the conidiophore, and where the chains branch, are usually “shield-shaped”. The presence
of shield-shaped conidia, a distinct hilum, and chains of conidia that readily disarticulate, are characteristic
of the genus Cladosporium.
Key features: Darkly pigmented mould forming branched acropetal chains of conidia, each with a distinct
hilum.
Molecular identification: Genus level identification is usually sufficient and morphological identification can
be confirmed by ITS and D1/D2 sequence analysis. Multilocus gene analysis of the ITS, D1/D2, TEF-1 and
ACT gene loci is necessary for accurate species identification (Bensch et al., 2012).
© CAB International 2023. Descriptions of Medical Fungi (eds S. Kidd, C.Halliday and D. Ellis) 68
10 ˜m
Downloaded from https://cabidigitallibrary.org by Ivanov Ivan, on 11/04/24.
Subject to the CABI Digital Library Terms & Conditions, available at https://cabidigitallibrary.org/terms-and-conditions
Fig. 19.1. Cladosporium cladosporioides culture and conidiophores producing acropetal chains of conidia each with
a distinct darkly pigmented hilum. Note: The conidia closest to the conidiophore, and where the chains branch, are
usually “shield-shaped” (arrows).
Antifungal susceptibility: (Table 19.1).
Table 19.1. Cladosporium spp. (Australian national data); MIC μg/mL.
Antifungal No. ≤0.016 0.03 0.06 0.125 0.25 0.5 1 2 4 8 16 32 ≥64
AmB 15 2 4 6 3
ISAV 9 1 1 3 2 2
VORI 15 3 1 4 3 4
POSA 15 1 1 6 4 2 1
ITRA 15 1 1 2 9 1 1
References: Ellis (1971,1976); McGinnis (1980); Domsch et al. (2007); Crous et al. (2007); de Hoog et al.
(2015).
DOI: 10.1079/9781800622340.0019
Descriptions of Medical Fungi 69
Synonymy: Candida lusitaniae van Uden & do Carmo-Sousa.
Downloaded from https://cabidigitallibrary.org by Ivanov Ivan, on 11/04/24.
Subject to the CABI Digital Library Terms & Conditions, available at https://cabidigitallibrary.org/terms-and-conditions
Clavispora lusitaniae is a known cause of disseminated candidiasis, including septicaemia and pyelonephritis. C. lusitaniae was first isolated from the digestive tract of warm-blooded animals and environmental isola-
tions have been made from cornmeal, citrus peel, fruit juices, and milk from cows with mastitis.
RG-2 organism
Culture: Colonies (SDA) white to cream coloured, smooth, glabrous, yeast-like.
Microscopy: Ovoid to ellipsoidal budding blastoconidia, 1.5-6.0 x 2.5-10.0 μm.
India ink preparation: Negative - no capsules present.
Dalmau plate culture: Abundant pseudohyphae with short chains of blastoconidia.
Germ tube formation: Negative.
Physiological tests: (+ Positive, - Negative, v Variable, w Weak, s Slow, n not done).
Fermentation:
Glucose + Sucrose v Lactose –
Galactose v Maltose v Trehalose v
Growth reactions:
Glucose + L-Sorbose + myo-Inositol –
Sucrose + L-Rhamnose + DL-Lactate v
Raffinose – D-Xylose + D-Gluconate v
Melibiose – L-Arabinose – 2-Keto-D-gluconate +
Galactose v D-Arabinose v D-Glucosamine v
Lactose – D-Ribose v N-Acetyl-D-glucosamine +
Trehalose + Glycerol + D-Glucuronate –
Maltose + Erythritol – Nitrate –
Melezitose + Ribitol + Urease –
Methyl-α-D-glucoside v Galactitol – 0.1% Cycloheximide –
Soluble starch – D-Mannitol + Growth at 37oC +
Cellobiose v D-Glucitol +
© CAB International 2023. Descriptions of Medical Fungi (eds S. Kidd, C.Halliday and D. Ellis) 70
Molecular identification: ITS sequencing recommended.
Downloaded from https://cabidigitallibrary.org by Ivanov Ivan, on 11/04/24.
Subject to the CABI Digital Library Terms & Conditions, available at https://cabidigitallibrary.org/terms-and-conditions
MALDI-ToF MS: Able to accurately identify this species.
Key features: Germ tube negative yeast and sugar assimilation pattern. Note: Clavispora lusitaniae may be
difficult to distinguish from Candida tropicalis using some yeast identification systems.
Antifungal susceptibility: (Table 20.1).
Table 20.1. Clavispora lusitaniae (Diekema et al., 2009, Pfaller et al., 2013a,b; and Australian national data); MIC μg/mL.
Antifungal No. ≤0.016 0.03 0.06 0.125 0.25 0.5 1 2 4 8 16 32 ≥64
AmB 273 1 9 34 99 102 20 6 2
FLU 355 13 38 86 106 52 32 11 4 2 5 6
ISAV 50 17 20 10 3
VORI 349 291 25 16 4 4 6 2 1
POSA 326 59 108 111 26 16 2 4
ITRA 169 3 6 47 61 28 19 4 1
ANID 263 2 15 65 85 78 16 2
MICA 247 3 22 60 78 60 16 7 1
5FC 275 15 77 22 54 67 20 5 3 2 1 5 4
References: Lachance (2011a); de Hoog et al. (2015).
DOI: 10.1079/9781800622340.0020
Descriptions of Medical Fungi 71
21 Coccidioides immitis/posadasii
Downloaded from https://cabidigitallibrary.org by Ivanov Ivan, on 11/04/24.
Subject to the CABI Digital Library Terms & Conditions, available at https://cabidigitallibrary.org/terms-and-conditions
complex
Coccidioides immitis has been separated into two distinct species: C. immitis and C. posadasii (Fisher et al.,
2002). The two species are morphologically identical and can be distinguished only by molecular analysis
and different rates of growth in the presence of high salt concentrations (C. posadasii grows more slowly).
C. immitis is geographically limited to California’s San Joaquin Valley region and Mexico, whereas C. posadasii
is found in California, Arizona, Texas, Mexico and South America.
WARNING: RG-3 organism
Cultures of Coccidioides immitis/posadasii represent a severe biohazard to laboratory personnel and must be
handled with extreme caution in a Class II Biological safety cabinet (BSCII). Cultures can grow rapidly
(within 48 hours on blood agar) and are often first encountered in routine microbiology laboratories, rather
than specialised and contained mycology laboratories. Therefore, routine bacteriology staff should be made
aware of the risks in handling this organism and steps should be taken to limit these risks.
Morphological description: Colonies of Coccidioides immitis and C. posadasii grown at 25
be moist and glabrous, but rapidly become suede-like to downy, greyish-white with a tan to brown reverse
(Fig. 21.1). However, considerable variation in growth rate and culture morphology has been noted.
Microscopy shows typical single-celled, hyaline, rectangular to barrel-shaped, alternate arthroconidia, 2.5-4
x 3-6 μm in size, separated from each other by a disjunctor cell (Fig. 21.1). This arthroconidial state is also
seen in the genus Malbranchea and is similar to that produced by many non-pathogenic soil fungi, e.g.
Gymnoascus species.
o
C may initially
Histopathology: Tissue morphology shows typical endosporulating spherules. Young spherules have a clear
centre with peripheral cytoplasm and a prominent thick wall. Endospores (sporangiospores) are later formed
within the spherule by repeated cytoplasmic cleavage. Rupture of the spherule releases endospores into the
surrounding tissue where they re-initiate the cycle of spherule development (Fig. 21.2).
Comment: Coccidioides immitis and C. posadasii are dimorphic fungi, existing in living tissue as spherules
and endospores, and in soil or culture in a mycelial form. Despite its dimorphism, the “spherule phase” will
not be observed using routine laboratory procedures and inducing this phase should not be attempted.
Culture identification by DNA sequencing is preferred to minimise exposure to the infectious propagule.
Key features: Clinical history, tissue pathology, culture identification by ITS sequence analysis.
Molecular identification: ITS sequencing is recommended for differentiation of species (Tintelnot et al., 2007;
Binnicker et al., 2010).
© CAB International 2023. Descriptions of Medical Fungi (eds S. Kidd, C.Halliday and D. Ellis) 72
Fig. 21.1. Coccidioides immitis culture and arthroconidia with disjunctor cells (arrows).
Downloaded from https://cabidigitallibrary.org by Ivanov Ivan, on 11/04/24.
Subject to the CABI Digital Library Terms & Conditions, available at https://cabidigitallibrary.org/terms-and-conditions
5 ˜m
Descriptions of Medical Fungi 73
20 ˜m
Downloaded from https://cabidigitallibrary.org by Ivanov Ivan, on 11/04/24.
Subject to the CABI Digital Library Terms & Conditions, available at https://cabidigitallibrary.org/terms-and-conditions
Fig. 21.2. Coccidioides immitis showing typical endosporulating spherules in a periodic acid-Schiff stained tissue
section.
Antifungal susceptibility: (Table 21.1).
Table 21.1. Coccidioides immitis (Ramani and Chaturvedi, 2007); MIC μg/mL. Antifungal susceptibility testing is not
recommended.
Antifungal No. ≤0.016 0.03 0.06 0.125 0.25 0.5 1 2 4 8 16 32 ≥64
AmB 45 7 25 8 4 1
FLU 45 1 4 10 27 3
VORI 45 13 9 15 8
POSA 45 25 13 3 4
ITRA 45 23 22
References: Sigler and Carmichael (1976); Chandler et al. (1980); McGinnis (1980); Stevens (1980); Rippon
(1988); de Hoog et al. (2015); Kirkland and Fierer (2018); Barker et al. (2019).
DOI: 10.1079/9781800622340.0021
Descriptions of Medical Fungi 74
22 Colletotrichum coccodes
Downloaded from https://cabidigitallibrary.org by Ivanov Ivan, on 11/04/24.
Subject to the CABI Digital Library Terms & Conditions, available at https://cabidigitallibrary.org/terms-and-conditions
(Wallroth) S. Hughes
Over 500 Colletotrichum species have been reported. C. coccodes is a common soil and plant pathogen
widely distributed in Africa, Asia, Australasia, Europe, and the Americas. Colletotrichum species are a rare
yet important cause of human mycotic keratitis (Hung et al., 2020a).
RG-1 organism
Morphological description: Colonies are usually darkly pigmented with white aerial mycelium, consisting of
numerous black sclerotia and light, brown coloured conidial masses, reverse is dark brown (Fig. 22.1).
Sclerotia are usually abundant, setose, spherical and are often confluent (Fig. 22.2). Conidia are straight,
fusiform, attenuated at the ends, 16-22 x 3-4 μm. Appressoria are common, clavate, brown, 11-16.5 x 6-9.5
μm, variable in shape (Fig. 22.1).
Molecular identification: GAPDH gene sequencing is the recommended barcoding gene for species identification.
ITS sequencing is not able to distinguish most species (Vieira et al., 2020).
(a) (c)
(b)
20 ˜m
Fig. 22.1. Colletotrichum coccodes showing (a) culture, (b) conidia and (c) appressoria (arrow).
© CAB International 2023. Descriptions of Medical Fungi (eds S. Kidd, C.Halliday and D. Ellis)
10 ˜m
75
Соседние файлы в папке Библиотека им академика М.И. Перельмана