A case report of a cystic fibrosis patient with repeated isolation of Trichosporon mycotoxinivorans identified by a novel short-extraction method


Background:
Trichosporon mycotoxinivorans is a recently described yeast-like fungal organism and its association as a pathogen for patients with cystic fibrosis (CF) was reported previously. We show the clinical course of a CF patient over 9 years as well as the applications of modern molecular and proteomic identification techniques of this rare fungus.

Case presentation:
We present the case of a 32-year-old male CF patient with sputum cultures continuously positive with the anamorphic yeast T. mycotoxinivorans during 9 years. Furthermore, susceptibility testing of T. mycotoxinivorans to different antifungals were performed. In addition, a rapid identification method of this novel fungal pathogen with matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) was applied using a simple extraction protocol.

Conclusions:
Our case presentation confirms T. mycotoxinivorans as a potential emerging pathogen in patients with CF. However, our CF patient showed mild symptoms over a very long time period of 9 years. A short MALDI-TOF MS procedure allows reliable and rapid identification of T. mycotoxinivorans and therefore should facilitate further study on the clinical relevance and epidemiology of this unusual fungal organism.

Keywords:
Trichosporon mycotoxinivorans, Cystic fibrosis (CF), Internal transcribed spacer (ITS), Emerging pathogen, MALDI-TOF MS


Autoři: Daniel Goldenberger† 1*;  Vladimira Hinić† 1;  Spasenija Savic Prince 2;  Michael Tamm 3;  Anna-Maria Balestra 3,4;  Doris Hohler 1;  Reno Frei 1
Působiště autorů: Division of Clinical Microbiology, University Hospital Basel, Petersgraben , CH-40 1 Basel, Switzerland. 1;  Division of Pathology, University Hospital Basel, Schönbeinstrasse 0, CH-40 1 Basel, Switzerland. 2;  Division of Pneumology, University Hospital Basel, Petersgraben , CH- 031 Basel, Switzerland. 3;  Present address: Division of Pneumology, St. Claraspital Basel, Basel, Switzerland. 4
Vyšlo v časopise: BMC Infectious diseases 2016, 16:601
Kategorie: Case report
prolekare.web.journal.doi_sk: 10.1186/s12879-016-1910-7

© 2016 The Author(s).

Open access
This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
The electronic version of this article is the complete one and can be found online at: http://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-016-1910-7

Souhrn

Background:
Trichosporon mycotoxinivorans is a recently described yeast-like fungal organism and its association as a pathogen for patients with cystic fibrosis (CF) was reported previously. We show the clinical course of a CF patient over 9 years as well as the applications of modern molecular and proteomic identification techniques of this rare fungus.

Case presentation:
We present the case of a 32-year-old male CF patient with sputum cultures continuously positive with the anamorphic yeast T. mycotoxinivorans during 9 years. Furthermore, susceptibility testing of T. mycotoxinivorans to different antifungals were performed. In addition, a rapid identification method of this novel fungal pathogen with matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) was applied using a simple extraction protocol.

Conclusions:
Our case presentation confirms T. mycotoxinivorans as a potential emerging pathogen in patients with CF. However, our CF patient showed mild symptoms over a very long time period of 9 years. A short MALDI-TOF MS procedure allows reliable and rapid identification of T. mycotoxinivorans and therefore should facilitate further study on the clinical relevance and epidemiology of this unusual fungal organism.

Keywords:
Trichosporon mycotoxinivorans, Cystic fibrosis (CF), Internal transcribed spacer (ITS), Emerging pathogen, MALDI-TOF MS


Zdroje

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12. Van Herendael BH, Bruynseels P, Bensaid M, Boekhout T, De Baere T, Surmont I, et al. Validation of a modified algorithm for the identification of yeast isolates using matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF MS). Eur J Clin Microbiol Infect Dis. 2012;31:841–8.

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