title: A five-year survey of dematiaceous fungi in a tropical hospital reveals potential opportunistic species.
abstract: Dematiaceous fungi (black fungi) are a heterogeneous group of fungi present in diverse environments worldwide. Many species in this group are known to cause allergic reactions and potentially fatal diseases in humans and animals, especially in tropical and subtropical climates. This study represents the first survey of dematiaceous fungi in Malaysia and provides observations on their diversity as well as in vitro response to antifungal drugs. Seventy-five strains isolated from various clinical specimens were identified by morphology as well as an internal transcribed spacer (ITS)-based phylogenetic analysis. The combined molecular and conventional approach enabled the identification of three classes of the Ascomycota phylum and 16 genera, the most common being Cladosporium, Cochliobolus and Neoscytalidium. Several of the species identified have not been associated before with human infections. Among 8 antifungal agents tested, the azoles posaconazole (96%), voriconazole (90.7%), ketoconazole (86.7%) and itraconazole (85.3%) showed in vitro activity (MIC ≤ 1 µg/mL) to the largest number of strains, followed by anidulafungin (89.3%), caspofungin (74.7%) and amphotericin B (70.7%). Fluconazole appeared to be the least effective with only 10.7% of isolates showing in vitro susceptibility. Overall, almost half (45.3%) of the isolates showed reduced susceptibility (MIC >1 µg/mL) to at least one antifungal agent, and three strains (one Pyrenochaeta unguis-hominis and two Nigrospora oryzae) showed potential multidrug resistance.
authors.affiliation: Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Su Mei
authors.initials: SM
authors.lastname: Yew
authors.affiliation: Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Chai Ling
authors.initials: CL
authors.lastname: Chan
authors.affiliation: Codon Genomics SB, Jalan Bandar Lapan Belas, Pusat Bandar Puchong, Selangor Darul Ehsan, Malaysia.
authors.forename: Kok Wei
authors.initials: KW
authors.lastname: Lee
authors.affiliation: Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Shiang Ling
authors.initials: SL
authors.lastname: Na
authors.affiliation: Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Ruixin
authors.initials: R
authors.lastname: Tan
authors.affiliation: Codon Genomics SB, Jalan Bandar Lapan Belas, Pusat Bandar Puchong, Selangor Darul Ehsan, Malaysia.
authors.forename: Chee-Choong
authors.initials: CC
authors.lastname: Hoh
authors.affiliation: Codon Genomics SB, Jalan Bandar Lapan Belas, Pusat Bandar Puchong, Selangor Darul Ehsan, Malaysia.
authors.forename: Wai-Yan
authors.initials: WY
authors.lastname: Yee
authors.affiliation: Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Yun Fong
authors.initials: YF
authors.lastname: Ngeow
authors.affiliation: Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Kee Peng
authors.initials: KP
authors.lastname: Ng
mesh_terms: D001203:Ascomycota / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D002963:Cladosporium / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D003428:Cross Infection / Q000145:classification / Q000235:genetics / Q000382:microbiology; D005260:Female; D006761:Hospitals; D006801:Humans; D008296:Malaysia; D008297:Male; D009181:Mycoses / Q000145:classification / Q000235:genetics / Q000382:microbiology; D014329:Tropical Climate
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