title: Clinical significance and molecular characterization of nonsporulating molds isolated from the respiratory tracts of bronchopulmonary mycosis patients with special reference to basidiomycetes.
abstract: Nonsporulating molds (NSMs), especially basidiomycetes, have predominantly been reported as human pathogens responsible for allergic and invasive disease. Their conventional identification is problematic, as many isolates remain sterile in culture. Thus, inconclusive culture reports might adversely affect treatment decisions. The clinical significance of NSMs in pulmonary mycoses is poorly understood. We sequenced the internal transcribed spacer (ITS) region and D1/D2 domain of the larger subunit (LSU) of 52 NSMs isolated from respiratory specimens. The basidiomycetes were the predominant NSMs, of which Schizophyllum commune was the most common agent in allergic bronchopulmonary mycosis (ABPM), followed by Ceriporia lacerata in invasive fungal disease. Porostereum spadiceum, Phanaerochaete stereoides, Neosartorya fischeri, and Marasmiellus palmivorus were the other molds observed. Application of ITS and LSU region sequencing identified 92% of the isolates. The antifungal susceptibility data revealed that all basidiomycetes tested were susceptible to amphotericin B and resistant to caspofungin, fluconazole, and flucytosine. Except for 3 isolates of S. commune and a solitary isolate of M. palmivorus, all basidiomycetes had low MICs for itraconazole, posaconazole, and voriconazole. Basidiomycetes were isolated from patients with ABPM, invasive pulmonary mycosis/pneumonia, or fungal balls. In addition, the majority of the basidiomycetes were isolated from patients with chronic respiratory disorders who were sensitized to one of the basidiomycetous fungi and demonstrated precipitating antibodies against the incriminating fungi, indicating an indolent tissue reaction. Thus, isolation of basidiomycetes from the lower respiratory tract could be significant, and it is important to monitor these patients in order to prevent subsequent lung damage.
authors.affiliation: Departments of Medical Mycology.
authors.forename: Pradeep Kumar
authors.initials: PK
authors.lastname: Singh
authors.forename: Shallu
authors.initials: S
authors.lastname: Kathuria
authors.forename: Kshitij
authors.initials: K
authors.lastname: Agarwal
authors.forename: Shailendra Nath
authors.initials: SN
authors.lastname: Gaur
authors.forename: Jacques F
authors.initials: JF
authors.lastname: Meis
authors.forename: Anuradha
authors.initials: A
authors.lastname: Chowdhary
mesh_terms: D000935:Antifungal Agents / Q000494:pharmacology; D001996:Bronchopneumonia / Q000382:microbiology*; D004271:DNA, Fungal / Q000737:chemistry / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D021903:DNA, Ribosomal Spacer / Q000737:chemistry / Q000235:genetics; D025141:Drug Resistance, Fungal; D005658:Fungi / Q000145:classification / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D008826:Microbial Sensitivity Tests; D008969:Molecular Sequence Data; D009181:Mycoses / Q000382:microbiology*; D017422:Sequence Analysis, DNA
chemical_list: D000935:Antifungal Agents; D004271:DNA, Fungal; D021903:DNA, Ribosomal Spacer
references.citation: Med Mycol. 2012 Nov;50(8):890-6
references.pmid: 22563857
references.citation: J Allergy Clin Immunol. 2006 Feb;117(2):326-33
references.pmid: 16514772
references.citation: Lung. 2004;182(5):279-84
references.pmid: 15742240
references.citation: J Clin Microbiol. 1995 Aug;33(8):1979-83
references.pmid: 7559933
references.citation: J Clin Microbiol. 2010 Mar;48(3):741-52
references.pmid: 20042628
references.citation: J Clin Microbiol. 2010 Nov;48(11):4329-32
references.pmid: 20826647
references.citation: J Clin Microbiol. 2004 Feb;42(2):925-8
references.pmid: 14766893
references.citation: Clin Infect Dis. 1994 Mar;18(3):305-9
references.pmid: 8011808
references.citation: J Med Vet Mycol. 1997 Sep-Oct;35(5):365-70
references.pmid: 9402531
references.citation: J Asthma. 2009 May;46(4):407-12
references.pmid: 19484679
references.citation: J Clin Microbiol. 1997 May;35(5):1216-23
references.pmid: 9114410
references.citation: Mycoses. 2013 Jan;56(1):1-10
references.pmid: 22524529
references.citation: Med Mycol. 2002 Apr;40(2):217-9
references.pmid: 12058736
references.citation: Emerg Infect Dis. 2002 Sep;8(9):989-91
references.pmid: 12194781
references.citation: J Clin Microbiol. 1997 Oct;35(10):2675-8
references.pmid: 9316933
references.citation: J Clin Microbiol. 2013 Feb;51(2):585-90
references.pmid: 23241374
references.citation: J Clin Microbiol. 1996 Jul;34(7):1628-32
references.pmid: 8784558
references.citation: Antimicrob Agents Chemother. 2001 Feb;45(2):633-5
references.pmid: 11158771
references.citation: Antimicrob Agents Chemother. 2013 Jun;57(6):2845-8
references.pmid: 23507274
references.citation: J Med Microbiol. 2005 Jul;54(Pt 7):685-688
references.pmid: 15947435
references.citation: Ann Allergy Asthma Immunol. 2004 May;92(5):483-91; quiz 492-4, 575
references.pmid: 15191015
references.citation: Bone Marrow Transplant. 1997 Apr;19(7):753-5
references.pmid: 9156256
references.citation: Respir Med. 2009 Oct;103(10):1492-7
references.pmid: 19473825
references.citation: J Asthma. 2009 Oct;46(8):849-55
references.pmid: 19863292
references.citation: J Clin Microbiol. 2012 Nov;50(11):3786-91
references.pmid: 22895039
references.citation: J Clin Microbiol. 2011 Jan;49(1):461-5
references.pmid: 21068290
references.citation: J Clin Microbiol. 2005 Apr;43(4):2009-11
references.pmid: 15815046
references.citation: Crit Rev Microbiol. 2014 Feb;40(1):30-48
references.pmid: 23383677
references.citation: J Infect. 2009 Feb;58(2):164-7
references.pmid: 19100626
references.citation: Pulm Pharmacol Ther. 2011 Oct;24(5):559-62
references.pmid: 21549852
references.citation: J Clin Microbiol. 2007 Feb;45(2):568-71
references.pmid: 17135442
references.citation: Clin Microbiol Infect. 2011 Feb;17(2):273-7
references.pmid: 20491830
references.citation: Antonie Van Leeuwenhoek. 1996 Jul;70(1):49-57
references.pmid: 8836441
references.citation: J Infect. 1996 Mar;32(2):147-50
references.pmid: 8708373