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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5575_Библиотеки_им_академика_М_И_Перельмана
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Synonymy: Candida colliculosa (Hartmann) S.A. Meyer & Yarrow; Debaryomyces delbrueckii (Lindner)
Kudryavtsev.
Torulaspora delbrueckii is widely distributed in nature and is a common food and beverage spoilage
RG-1 organism
Culture: Colonies (SDA) white to cream coloured, smooth, glabrous, yeast-like.
Microscopy: Spherical to ellipsoidal budding blastoconidia, 2-6 x 3-7 μm in size. Ascospores may be
o
C.
India ink preparation: Negative - no capsules present.
Dalmau plate culture: Budding yeast cells only. No pseudohyphae or true hyphae produced.
Molecular identification: ITS sequencing recommended.
MALDI-ToF MS: Able to accurately identify this species.
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 v myo-Inositol –
Sucrose v L-Rhamnose – DL-Lactate v
Raffinose v D-Xylose v D-Gluconate v
Melibiose – L-Arabinose – 2-Keto-D-gluconate +
Galactose v D-Arabinose – D-Glucosamine –
Lactose – D-Ribose – N-Acetyl-D-glucosamine –
Trehalose s Glycerol v D-Glucuronate –
Maltose v Erythritol – Nitrate –
Melezitose v Ribitol v Urease –
Methyl-α-D-glucoside v Galactitol – 0.1% Cycloheximide –
Soluble starch – D-Mannitol + Growth at 30oC +
Cellobiose – D-Glucitol v Growth at 37oC v
Key features: Asci containing one to four spheroidal ascospores, growth at 37oC and a variable sugar assimi-
lation profile.
© CAB International 2023. Descriptions of Medical Fungi (eds S. Kidd, C.Halliday and D. Ellis) 256
Antifungal susceptibility: (Table 98.1).
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Table 98.1. Torulaspora delbrueckii, very limited data (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 1 1
FLU 1 1
VORI 1 1
POSA 1 1
ITRA 1 1
ANID 1 1
MICA 1 1
5FC 1 1
References: Kurtzman (2011d).
DOI: 10.1079/9781800622340.0098
Descriptions of Medical Fungi 257
99 Trematosphaeria grisea (MacKinnon
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et al.) S.A. Ahmed et al.
Synonymy: Madurella grisea Mackinnon, Ferrada and Montemayer.
Trematosphaeria grisea (formerly Madurella grisea) is a soil fungus and is a known causative agent of
mycetoma (de Hoog et al., 2004a, 2012; Desnos-Ollivier et al., 2006).
RG-2 organism
Morphological description: Colonies are slow growing, dark, leathery, folded with radial grooves and with
a light brown to greyish surface mycelium. With age, colonies become dark brown to reddish-brown and
have a brownish-black reverse. Microscopically, cultures are sterile, although hyphae of two widths have
been described, thin at 1-3 μm in width or broad at 3-5 μm in width. The optimum temperature for growth
of T. grisea is 30
Histopathology: Grains of Trematosphaeria grisea (tissue microcolonies) are black, round to lobed, soft to
firm, up to 1.0 mm, with two distinctive zones, a hyaline to weakly pigmented central zone and a deeply
pigmented periphery (Fig. 99.1).
Trematosphaeria grisea can be distinguished from Madurella mycetomatis by its inability to grow at 37
and its ability to assimilate sucrose but not lactose.
Key features: Black grain mycetoma, no growth at 37
and absence of conidia.
References: Chandler et al. (1980); Kwon-Chung and Bennett (1992); Ahmed et al. (2014b); Tanaka et al.
(2015); Suetrong et al. (2011).
o
C; this fungus does not grow at 37oC.
o
C, no diffusible brown pigment produced on culture
o
C,
100 ˜m
Fig. 99.1. Trematosphaeria grisea showing a typical “black grain” in a haematoxylin and eosin-stained tissue section.
DOI: 10.1079/9781800622340.0099
© CAB International 2023. Descriptions of Medical Fungi (eds S. Kidd, C.Halliday and D. Ellis) 258
100 Trichoderma Persoon ex Grey
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Trichoderma is a very common genus especially in soil and decaying wood. Gliocladium (with strongly
convergent phialides) and Verticillium (with straight and moderately divergent phialides) are closely related
genera. Trichoderma infections in humans have been associated with several risk factors, particularly
peritoneal dialysis, organ transplantation, and haematologic disorders (Sandoval-Denis et al., 2014b).
RG-1 organism
Morphological descriptions: Colonies are fast growing, at first white and downy, later developing yellowishgreen to deep green compact tufts, often only in small areas or in concentric ring-like zones on the agar surface.
Conidiophores are repeatedly branched, irregularly verticillate, bearing clusters of divergent, often irregularly
bent, flask-shaped phialides (Fig. 100.1). Conidia are mostly green, sometimes hyaline, with smooth or rough
walls and are formed in slimy conidial heads (gloiospora) clustered at the tips of the phialides.
Key features: Repeatedly branched conidiophores bearing clusters of divergent, flask-shaped phialides.
Fig. 100.1. Trichoderma harzianum microscopy showing flask-shaped phialides and conidia.
© CAB International 2023. Descriptions of Medical Fungi (eds S. Kidd, C.Halliday and D. Ellis)
20 ˜m
259
Chi18-5 and ACT genes (Sandoval-Denis et al. 2014b).
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Antifungal susceptibility: (Table 100.1).
Table 100.1. Trichoderma spp., very limited data (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 7 2 4 1
VORI 6 1 2 1 2
POSA 5 4 1
ITRA 7 5 1 1
References: McGinnis (1980); Rippon (1988); Samson et al. (1995); Domsch et al. (2007); Sandoval-Denis
et al. (2014b); de Hoog et al. (2015).
DOI: 10.1079/9781800622340.0100
Descriptions of Medical Fungi 260
Rippon (1988) accepted 22 species and four varieties in the genus Trichophyton based on morphology. DNA
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sequences now play a prominent role in delineating phylogenetic relationships, and as such species concepts
in Trichophyton have changed. Sixteen species are now recognised in the genus. The descriptions and species
concepts provided in this publication are based upon a combination of traditional morphological criteria and
the current recognised phylogenetic species (de Hoog etal., 2017).
Laboratory identification: The genus Trichophyton is characterised morphologically by the development of
both smooth-walled macro- and microconidia. Macroconidia are mostly borne laterally directly on the
hyphae or on short pedicels, and are thin- or thick-walled, clavate to fusiform, and range from 4-8 x 8-50
μm in size. Macroconidia are few or absent in many species. Microconidia are spherical, pyriform to clavate
or of irregular shape and range from 2-3 x 2-4 μm in size. The presence of microconidia differentiates this
genus from Epidermophyton, and the smooth-walled, mostly sessile macroconidia differentiates it from
Lophophyton, Microsporum, Nannizzia and Paraphyton.
In practice, two groups may be recognised on direct microscopy:
1. Those species that usually produce microconidia. Macroconidia may or may not be present i.e. T. rubrum,
T. interdigitale, T. mentagrophytes, T. equinum, T. erinacei, T. tonsurans and to a lesser extent T. verrucosum,
which may produce conidia on some media. In these species the shape, size and arrangement of the microconidia is the most important character. Culture characteristics are also useful.
2. Those species that usually do not produce conidia. Chlamydospores or other hyphal structures may be
present, but microscopy is generally non-diagnostic, i.e. T. verrucosum, T. violaceum, T. concentricum, T. sch-
oenleinii and T. soudanense. Culture characteristics and clinical information such as the site, appearance of
the lesion, geographic location, travel history, animal contacts and even occupation are most important.
Many laboratories have used growth on additional media and/or confirmatory tests to help differentiate
between species of Trichophyton, especially isolates of T. rubrum, T. interdigitale, T. mentagrophytes and
T. tonsurans. These include growth characteristics on media such as Littman oxgall agar, lactritmel agar,
potato dextrose agar, Sabouraud’s agar with 5% Salt, 1% peptone agar, bromocresol purple-milk solids
glucose agar (BCP), Trichophyton agars No. 1-5, hydrolysis of urea and hair perforation tests.
Molecular identification: ITS and TEF-1 sequencing is recommended for accurate species identification
(Graser et al., 1998, 1999a,b, 2000, 2008; Katiraee etal., 2021; Irinyi etal., 2015; Mirhendi etal., 2015;
Diongue etal., 2019).
MALDI-ToF MS: Methods reported by Erhard etal. (2008); Cassagne etal. (2011); L’Ollivier etal. (2013);
Nenoff etal. (2013); Packeu etal. (2013, 2014); Calderaro etal. (2014). A comprehensive “in-house” database of reference spectra allows accurate identification.
References: Rebell and Taplin (1970); Ajello (1977); Vanbreusegham etal. (1978); McGinnis (1980); Rippon
(1988); Kane etal. (1997); Domsch etal. (2007); Chen etal. (2011); de Hoog etal. (2017, 2020).
101. 1. Trichophyton concentricum Blanchard
Trichophyton concentricum is an anthropophilic fungus, which causes chronic widespread non-inflammatory
tinea corporis known as tinea imbricata because of the concentric rings of scaling it produces. It is not known
to invade hair. Distribution is restricted to the Pacific Islands of Oceania, South East Asia and Central and
South America.
© CAB International 2023. Descriptions of Medical Fungi (eds S. Kidd, C.Halliday and D. Ellis)
261
RG-2 organism
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Morphological description: Colonies are slow growing, raised and folded, glabrous becoming suede-like,
mostly white to cream coloured, but sometimes orange-brown coloured, often deeply folded into the agar
which may produce splitting of the medium in some cultures. Reverse is buff to yellow-brown to brown in
colour. Cultures consist of broad, much-branched, irregular, often segmented, septate hyphae which may have
“antler” tips resembling Trichophyton schoenleinii. Chlamydospores are often present in older cultures
(Fig.101.1). Microconidia and macroconidia are not usually produced, although some isolates will produce
occasional clavate to pyriform microconidia. Note: Hyphal segments may artificially resemble
macroconidia.
Confirmatory tests
Hydrolysis of urea: Negative after 7 days.
Vitamin free agar (Trichophyton agar No.1): Growth occurs on vitamin free agar (T1) but is usually slightly
better on media containing thiamine i.e. T3 = T1 + thiamine and inositol, and T4 = T1 + thiamine. The slight
enhancement of growth in the presence of thiamine helps to distinguish T. concentricum from T. schoenleinii,
although this does not occur in all strains.
Hair perforation test: Negative at 28 days.
Molecular identification: Species identification supported by ITS sequencing (Graser et al., 1999a; Chen
etal., 2011).
Key features: Clinical disease, geographical distribution and culture characteristics.
20 ˜m
Fig. 101.1. Trichophyton concentricum culture showing a typical heaped and folded colony and microscopy showing
the formation of typical balloon-shaped chlamydospores. Note: Microconidia and macroconidia are usually not
produced.
Descriptions of Medical Fungi 262
101.2. Trichophyton equinum (Matruchot & Dassonville) Gedoelst
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Synonomy: Trichophyton equinum var. autotrophicum J.M.B. Smith, Jolly, Georg & Connole
Trichophyton equinum is a zoophilic fungus causing ringworm in horses and rare infections in
humans. It has a worldwide distribution except for the autotrophicum strain which is restricted to
Australia and New Zealand. Invaded hairs show an ectothrix infection but do not fluoresce under
Wood’s ultra-violet light.
RG-2 organism
Morphological description: Colonies are usually flat, but some may develop gentle folds or radial grooves,
white to buff in colour, suede-like to downy in texture, and are similar to T. mentagrophytes. Cultures
usually have a deep-yellow submerged fringe and reverse, which later becomes dark red in the centre
(Fig. 101.2). Microscopically, abundant microconidia which may be clavate to pyriform and sessile or
spherical and stalked are formed laterally along the hyphae (Fig. 101.3). Macroconidia are only rarely
produced, but when present are clavate, smooth, thin-walled and of variable size. Occasional nodular
bodies may be present, and the microconidia often undergo a transformation to produce abundant
chlamydospores in old cultures.
Confirmatory tests
Hydrolysis of urea: Positive in 4-5 days.
Nutritional tests on Trichophyton agars: Most strains require nicotinic acid for growth except those from
Australia and New Zealand, which are autotrophic. T1 = vitamin free agar, T5 = vitamin free + nicotinic acid
agar (Fig. 101.4).
Hair perforation test: Negative; but positive for the autotrophicum strains.
Molecular identification: Species identification supported by ITS sequencing (Graser et al., 1999a; Chen
etal., 2011; Kandemir etal., 2020).
Key features: Microscopic morphology, culture characteristics, nicotinic acid requirement and clinical lesions
in horses. Most strains require nicotinic acid for growth except the autotrophic strains.
Fig. 101.2. Trichophyton equinum culture.
Descriptions of Medical Fungi 263
(b)
m 1
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(a)
(c)
10 ˜m
Fig. 101.3. Trichophyton equinum showing (a) macroconidium, (b) microconidia and (c) nodular bodies.
(a)
Fig. 101.4. Trichophyton equinum showing (a) no growth on T1 but good growth on T5; and T. equinum va r.
autotrophicum strain showing (b) good growth on both T1 and T5.
T
1
T
5 T
20 ˜
(b)
1
0 ˜m
T
5
101.3. Trichophyton erinacei (Smith & Marples) Quaife
Synonymy: Trichophyton mentagrophytes var. erinacei J.M.B. Smith & Marples; Trichophyton proliferans
English & Stockdale.
Trichophyton erinacei is a zoophilic fungus associated with hedgehogs and the epidermal mites, which they
often harbour. Human infections occur most frequently on the exposed parts of the body; but tinea of the
scalp and nails can also occur. Invaded hairs show an ectothrix infection but do not fluoresce under Wood’s
ultra-violet light. The distribution of this fungus is New Zealand and Europe.
Descriptions of Medical Fungi 264
RG-2 organism
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Morphological description: Colonies are white, flat, powdery, sometimes downy to fluffy with a brilliant
lemon-yellow reverse (Fig. 101.5). Numerous large clavate microconidia are borne on the sides of hyphae.
Macroconidia are smooth-walled, two- to six-celled, clavate, variable in size, and may have terminal appendages. Macroconidia are much shorter than those seen in Trichophyton interdigitale (Fig. 101.6).
Fig. 101.5. Trichophyton erinacei culture showing its typical brilliant lemon-yellow reverse pigment.
20 ˜m
Fig. 101.6. Trichophyton erinacei macroconidia and microconidia.
Descriptions of Medical Fungi 265
20 ˜m
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