Urinary Tract Infections Caused by Fluconazole-Resistant Trichosporon japonicum in 2 Kidney Transplant Patients and Analysis of Their Homology.

Urinary Tract Infections Caused by Fluconazole-Resistant Trichosporon japonicum in 2 Kidney Transplant Patients and Analysis of Their Homology.

Open Forum Infect Dis. 2020 Sep;7(9):ofaa365

Authors: Li T, Huang Y, Chen X, Wang Z, Xu Y

Abstract
Trichosporon spp. are emerging opportunistic agents that cause systemic diseases and life-threatening disseminated disease in immunocompromised hosts. Trichosporon japonicum is a highly rare cause of invasive trichosporonosis. In this study, we describe 2 cases of urinary tract infection caused by Trichosporon japonicum in kidney transplant patients. Culturing of urine samples yielded bluish-green colonies of T. japonicum on Candida chromogenic fungal medium. The isolates were identified as T. japonicum by matrix-assisted laser desorption ionization-time-of-flight mass spectrometry (MALDI TOF-MS; Autof MS 1000). The identification of T. japonicum was further confirmed by 18S rRNA gene sequencing. In vitro drug susceptibility testing showed that the 2 strains of T. japonicum were resistant to 5-flucytosine, fluconazole, and caspofungin, with dose-dependent sensitivity to itraconazole and voriconazole but sensitivity to amphotericin B. The homology of the 2 T. japonicum strains, as determined by cluster analysis and principal component analysis of MALDI-TOF MS, was ~85%, suggesting a common nosocomial origin. The first 2 case reports of fluconazole-resistant T. japonicum urinary infection in kidney transplant recipients are presented.

PMID: 33024792 [PubMed]