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_5575_Библиотеки_им_академика_М_И_Перельмана
.pdf
The genus Madurella was originally based on tissue morphology (mycetoma with black grains) and the
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
formation of sterile cultures on mycological media. Initially, two species were described M. mycetomatis and
M. grisea. However recent molecular studies have recognised five species: Madurella mycetomatis,
Trematosphaeria grisea (formerly M. grisea), M. fahalii, M. pseudomycetomatis and M. tropicana (de Hoog
et al., 2004a, 2012; Desnos-Ollivier et al., 2006; Yan et al., 2010; Ahmed et al., 2020). All species have been
isolated from soil and are major causative agents of mycetoma.
52.1. Madurella mycetomatis (Laveran) Brumpt
RG-2 organism
Morphological description: Colonies are slow growing, flat and leathery at first, white to yellow to yellowishbrown, becoming brownish, folded and heaped with age and the formation of aerial mycelia. A brown diffusible
pigment is characteristically produced in primary cultures. Although most cultures are sterile, phialides that
bear small rounded conidia in short chains may be occasionally present (Fig. 52.1). Sclerotia are frequently
formed. The optimum temperature for growth of this mould is 37
Grains of Madurella mycetomatis (tissue microcolonies) are brown or black, 0.5-1.0 mm in size, round or
lobed, hard and brittle, composed of hyphae which are 2-5 μm in diameter, with terminal cells expanded to
12-15 (30) μm in diameter.
Madurella mycetomatis can be distinguished from Trematosphaeria grisea by growth at 37
to assimilate lactose but not sucrose.
Key features: Black grain mycetoma, growth at 37
o
C, diffusible brown pigment produced on culture and the
occasional presence of phialides.
Molecular identification: ITS sequencing is recommended for species identification (Ahmed et al., 2014a;
Desnos-Olliver et al., 2006; Irinyi et al., 2015). A five-locus phylogenetic analysis was performed by Ahmed
et al. (2014b) using the ITS region 18S, D1/D2 region of the 28S, RPB2 and TEF-1 genes.
o
C.
o
C and its ability
References: Chandler et al. (1980); McGinnis (1980); Rippon (1988); Yan et al. (2010); de Hoog et al.
(2015); Ahmed et al. (2020).
© CAB International 2023. Descriptions of Medical Fungi (eds S. Kidd, C.Halliday and D. Ellis) 146
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. 52.1. Madurella mycetomatis culture showing the typical brown diffusible pigment in the agar and phialides
producing small conidia (rarely seen as most isolates are sterile).
DOI: 10.1079/9781800622340.0052
Descriptions of Medical Fungi 147
The name of this genus has changed several times in recent years because of changes in nomenclatural rules
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
(de Hoog et al., 2020). Based on a phylogenetic analysis of rDNA gene sequences, de Hoog and Smith (2004)
transferred Geotrichum capitatum to the genus Magnusiomyces, as M. capitatus; and Geotrichum clavatum
to Saprochaete clavata. More recently Kaplan et al. (2018, 2021) using multilocus sequence typing of five
genes, but principally RPB2, have re-defined Saprochaete clavata as Magnusiomyces clavatus.
Magnusiomyces capitatus and M. clavatus are human pathogens that are closely related and are frequently
mistaken for each other (Noster et al., 2022). Desnos-Ollivier et al. (2014) proposed species-specific carbon
assimilation patterns and MALDI-ToF MS profiles to enable the identification of M. capitatus, M. clavatus,
and Dipodascus geotrichum (Geotrichum candidum) to the species level.
53.1. Magnusiomyces capitatus (de Hoog et al.) de Hoog & M Th. Smith
Synonymy: Saprochaete capitata (Diddens & Lodder) de Hoog & M.Th. Smith; Geotrichum capitatum
(Diddens & Lodder) v. Arx; Trichosporon capitatum Diddens & Lodder; Blastoschizomyces capitis (Diddens
& Lodder) Salkin et al.
Magnusiomyces capitatus occurs quite commonly in humans, usually as a transient component of normal
skin flora and sputum. Systemic infections including pulmonary, fungaemia and endocarditis have been
reported in immunosuppressed patients.
RG-1 organism
Morphological description: Colonies are moderately fast growing, flat, whitish, and finely suede-like with no
reverse pigment. Hyphae are profusely branched at acute angles, with terminal and intercalary conidiogenous
cells which form long, cicatrised rachis on which conidia are borne. Conidia are hyaline, smooth, one-celled,
cylindrical to clavate, with a rounded apex and flat base, 7-10 x 2.5-3.5 m. Rectangular arthroconidia are
also often present.
Molecular identification: Molecular detection was developed by Arrieta-Aguirre et al. (2017). ITS sequencing
may not resolve species; use of RPB2 is recommended for definitive identification (Kaplan et al., 2018, 2021).
Note: Magnusiomyces capitatus can be recognised by its arthroconidia and by absence of growth with
-xylose, sucrose, cellobiose, but growth at 45
o
C and resistance to 0.1% cycloheximide. The closely related
species M. clavatus differs by being cellobiose (+), arbutin (+) and salicin (+) (Desnos-Ollivier et al., 2014).
Physiological tests: (+ Positive, − Negative, v Variable, w Weak, s Slow, n not done).
© CAB International 2023. Descriptions of Medical Fungi (eds S. Kidd, C.Halliday and D. Ellis) 148
Fermentation: Absent.
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
Growth reactions:
Glucose + L-Sorbose v myo-Inositol –
Sucrose – L-Rhamnose – DL-Lactate +
Raffinose – D-Xylose – D-Gluconate –
Melibiose – L-Arabinose – 2-Keto-D-gluconate –
Galactose + D-Arabinose – D-Glucosamine –
Lactose – D-Ribose – N-Acetyl-D-glucosamine n
Trehalose – Glycerol + D-Glucuronate n
Maltose – Erythritol – Nitrate –
Melezitose – Ribitol – Urease –
Methyl-⍺-D-glucoside – Galactitol – 0.1% Cycloheximide +
Soluble starch – D-Mannitol + Growth at 40oC +
Cellobiose – D-Glucitol +
Antifungal susceptibility: (Table 53.1).
Table 53.1. Magnusiomyces capitatus limited data (Garcia-Ruiz et al., 2013; and Australian national data); MIC μg/mL.
Note: Isolates of M. capitatus are intrinsically resistant to echinocandins (Arendrup et al., 2014).
Antifungal No. ≤0.016 0.03 0.06 0.125 0.25 0.5 1 2 4 8 16 32 ≥64
AmB 11 1 1 5 4
FLU 11 2 2 2 3 2
VORI 10 2 3 2 1 1 1
POSA 10 2 1 3 2 2
ITRA 11 2 4 5
5FC 6 4 1 1
References: de Hoog and Smith (2004, 2011c); Garcia-Ruiz et al. (2013); Desnos-Ollivier et al. (2014);
Arendrup et al. (2014); Kaplan et al. (2018, 2021); Noster et al. (2022).
53.2. Magnusiomyces clavatus (de Hoog et al.) Kaplan
Synonymy: Geotrichum clavatum de Hoog, M.Th. Smith & Gueho; Saprochaete clavata (de Hoog, M.Th.
Smith & Gueho) de Hoog & M.Th. Smith.
Magnusiomyces clavatus (formerly known as Geotrichum capitatum or Saprochaete clavata), has only very
infrequently been implicated in invasive human infection. However, an outbreak of invasive infections caused
by M. clavatus in haematology patients has been reported (Vaux et al., 2014).
RG-1 organism
Morphological description: Colonies are moderately fast growing, flat, whitish and butyrous. True hyphae
are abundant, soon breaking up into rectangular arthroconidia of variable size, 2.8-4 3 x 6-20 m. Sympodial
conidiogenesis is occasionally present. Terminal parts of hyphae may swell and become thick-walled.
Note: Magnusiomyces clavatus and M. capitatus are human pathogens that are closely related and are fre-
quently mistaken for each other.
Descriptions of Medical Fungi 149
Molecular identification: ITS and/or RPB2 sequencing is recommended for accurate species identification
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
(Kaplan et al., 2018, 2021).
MALDI-ToF MS: Reliably identifies M. capitatus, M. clavatus, and Dipodascus geotrichum (Geotrichum
candidum) to species level (Desnos-Ollivier et al., 2014).
Physiological tests: (+ Positive, - Negative, v Variable, w Weak, s Slow, n not done).
Fermentation: Absent.
Growth reactions:
Glucose + L-Sorbose + myo-Inositol –
Sucrose – L-Rhamnose – DL-Lactate +,w
Raffinose – D-Xylose – D-Gluconate –
Melibiose – L-Arabinose – 2-Keto-D-gluconate –
Galactose + D-Arabinose – D-Glucosamine –
Lactose – D-Ribose – N-Acetyl-D-glucosamine n
Trehalose – Glycerol + D-Glucuronate n
Maltose – Erythritol – Nitrate –
Melezitose – Ribitol – Urease –
Methyl-α-D-glucoside – Galactitol – 0.1% Cycloheximide –
Soluble starch – D-Mannitol + Growth at 40oC +
Cellobiose + D-Glucitol –
Antifungal susceptibility: (Table 53.2).
Table 53.2. Magnusiomyces clavatus very limited data (Australian national data); MIC μg/mL. Note: Isolates of
M. clavatus are intrinsically resistant to echinocandins (Arendrup et al., 2014).
Antifungal No. ≤0.016 0.03 0.06 0.125 0.25 0.5 1 2 4 8 16 32 ≥64
AmB 4 1 1 1 1
VORI 3 1 1 1
POSA 3 2 1
ITRA 4 2 2
5FC 4 2 1 1
References: de Hoog and Smith (2004, 2011b); Desnos-Ollivier et al. (2014); Arendrup et al. (2014); Kaplan
et al. (2018, 2021); de Hoog et al. (2020); Noster et al. (2022).
DOI: 10.1079/9781800622340.0053
Descriptions of Medical Fungi 150
Malassezia species are basidiomycetous yeasts and form part of the normal skin flora of humans and
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
animals. The genus now includes 16 species of which 15 are lipid dependent. These include M. arunalokei
(human), M. caprae (goat, horse), M. cuniculi (rabbit), M. dermatis (human), M. equina (horse, cow), M. furfur
(human, cow, elephant, pig, monkey, ostrich, pelican), M. globosa (human, cheetah, cow), M. japonica (human),
M. nana (cat, cow, dog), M. obtusa (human), M. pachydermatis (dog, cat, carnivores, birds), M. restricta
(human), M. slooffiae (human, pig, goat, sheep), M. sympodialis (human, horse, pig, sheep), M. vespertilionis
(bats) and M. yamatoensis (human) (Cabanes et al., 2011, 2016; Honnavar et al., 2016; Lorch et al., 2018).
Malassezia species may cause various skin manifestations including pityriasis versicolor, seborrhoeic dermatitis, dandruff, atopic eczema and folliculitis. M. pachydermatis known to cause external otitis in dogs.
Fungaemia due to lipid-dependent Malassezia species usually occurs in patients with central line catheters
receiving lipid replacement therapy, especially in infants (Tragiannidis et al., 2010; Gaitanis et al., 2012;
Arendrup et al., 2014).
Note: With the exception of M. pachydermatis, the primary isolation and culture of Malassezia species is
challenging because in vitro growth must be stimulated by natural oils or other fatty substances. The most
common method used is to overlay Sabouraud’s dextrose agar containing cycloheximide (actidione) with
olive oil or alternatively to use a more specialised media like modified Leeming and Notham agar (Kaneko
et al., 2007), or modified Dixon’s agar (see chapter 111.8).
Comment: For clinical management at the level of the individual patient, species identification is less important,
although it is necessary for epidemiological surveillance and outbreak investigation (Arendrup et al., 2014).
RG-1 organisms
Morphological description: On media like modified Dixon’s agar, colonies are cream to yellowish, smooth
or lightly wrinkled, glistening or dull, and with the margin being either entire or lobate (Fig. 54.1). Malassezia
is characterised by globose, oblong-ellipsoidal to cylindrical, yeast cells. Reproduction is by budding on a
broad base and from the same site at one pole (unipolar) (Fig. 54.1). Malassezia sympodialis, M. globosa,
M. slooffiae and M. restricta are the most frequently found species colonising humans (Table 54.1).
CHROMagar™ Malassezia medium is commercially available for the primary isolation and differentiation
of the most common Malassezia species. Identification and growth criteria for the differentiation of all
Malassezia species is provided (Table 54.2).
Molecular identification: ITS and D1/D2 sequencing may be used for accurate species identification (de Hoog
et al., 2015).
MALDI-ToF MS: Capable of identifying all Malassezia species (Kolecka et al., 2014).
Antifungal susceptibility: There is no standardised method for testing Malassezia species, special growth
conditions are needed, and published results may be variable (Table 54.3). Note: Susceptibility testing is not
recommended for guiding treatment.
References: Guillot and Gueho (1995); Gueho et al. (1996); Guillot et al. (1996, 2000); Boekhout et al.
(2010); Cabanes et al. (2011, 2016); Cafarchia et al. (2011); Honnavar et al. (2016); Lorch et al. (2018);
de Hoog et al. (2020).
© CAB International 2023. Descriptions of Medical Fungi (eds S. Kidd, C.Halliday and D. Ellis)
151
(a)
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. 54.1. Malassezia furfur showing (a) culture on modified Dixon's agar and (b) direct microscopy of skin scrapings
showing budding yeast-like cells and short angular hyphal forms (the so-called spaghetti and meatballs appearance)
typically seen in pityriasis versicolor.
Table 54.1. Basic phenotypic key to medically important species (Arendrup et al., 2014; de Hoog et al., 2020).
1 Growth on SGA M. pachydermatis
No growth on SGA 2
2 Catalase reaction positive 3
No catalase reaction M. restricta
3 Growth on SGA with Tween 40 4
No growth on SGA with Tween 40 5
4 Growth on SGA with Tween 80 6
No growth on SGA with Tween 80 M. slooffiae
5 Cells long, cylindrical M. obtusa
Cells spherical M. globosa
6 Growth on SGA with cremophor EL M. furfur
No growth on SGA with cremophor EL M. sympodialis
(b)
10 ˜m
Descriptions of Medical Fungi 152
Table 54.2. Identification and growth criteria for the differentiation of Malassezia species (Cabanes et al., 2011, 2016;
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
Honnavar et al., 2016; Lorch et al., 2018).
+ Positive, − Negative, v Variable, w Weak, s Slow, nd No Data, SDA Sabouraud’s dextrose agar, T80 Tween 80,
T60 Tween 60, T40 Tween 40, T20 Tween 20.
o
Species Buds SDA 40
C Cremophor EL T80 T60 T40 T20 Esculine Catalase
M. arunalokei narrow – – – v – – – nd –
M. caprae narrow – – – + + + + + +
M. cuniculi narrow – + – – – – – nd +
M. dermatis wide – + w,+ + + + + w +
M. equina narrow – – – + + + + + +
M. furfur wide – + + + + + + w +
M. globosa narrow – – – – – – – +
M. japonica wide – – nd – + w – nd +
M. nana narrow – v – w + + v nd +
M. obtusa wide – – – – – – + +
M. pachydermatis wide + + –,w + + + –,w v v
M. restricta narrow – – – – – – – –
M. slooffiae wide – + – +,w + + + – +
M. sympodialis narrow – + + –,w + + + + + +
M. vespertilionis narrow – w – w + + w nd –
M. yamatoensis wide – – nd + + + + nd +
Table 54.3. Malassezia spp., limited data available (Velegraki et al., 2004; Miranda et al., 2007; Rojas et al., 2014);
MIC μg/mL.
M. furfur M. sympodialis M. globosa
Antifungal Range MIC
90
Range MIC
90
Range MIC
AmB 0.125–16 2 0.06–4 2 0.03–4 1
FLU 0.125–64 16 0.125–16 8 0.125–32 4
KETO 0.03–4 0.25 0.03–0.25 0.125 0.03–0.5 0.06
ITRA 0.03–0.25 0.25 0.03–0.125 0.06 0.03–0.125 0.125
VORI 0.03–16 1 0.03–0.125 0.125 0.3–0. 25 0.125
POS 0.03–32 2 0.03–0.06 0.03 0.03–0.06 0.06
DOI: 10.1079/9781800622340.0054
90
Descriptions of Medical Fungi 153
Sacc. & Penz.
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
Coccidioides immitis/posadasii. Note: Culture identification by ITS sequencing is the method of choice if
there is any suspicion or possibility of an isolate being C. immitis/posadasii.
RG-1 organism
Morphological description: Colonies are white to sulphur-yellow to ochre-brown in colour, suede-like in
texture, with a reddish-brown reverse, and often a reddish diffusible pigment. Microscopic morphology
shows typical hyaline, one-celled, cylindrical, truncate, alternate arthroconidia produced in terminal fertile
portions of the hyphae (Fig. 55.1). Arthroconidia are released by lysis of the disjunctor cells. These arthroconidia may be perceived as a yellow dust when released at maturity.
Key features: Ascomycetous mould producing alternate arthroconidia with disjunctor cells.
References: Cooney and Emerson (1964); Sigler and Carmichael (1976); McGinnis (1980); Rippon (1988);
de Hoog et al. (2015).
© CAB International 2023. Descriptions of Medical Fungi (eds S. Kidd, C.Halliday and D. Ellis) 154
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. 55.1. Malbranchea pulchella arthroconidia produced in tightly coiled, terminal fertile branches of the hyphae.
DOI: 10.1079/9781800622340.0055
Descriptions of Medical Fungi 155
Соседние файлы в папке Библиотека им академика М.И. Перельмана