Phylogenetic diversity of human pathogenic Fusarium and emergence of uncommon virulent species.
OBJECTIVE
Fusarium species cause a broad spectrum of infections. However, little is known about the etiological agents to the species level. We identified Fusarium species isolated from clinical specimens including those of high risk patients to better understand the species involved in the pathogenesis.


METHODS
A set of 44 Fusarium isolates were identified by two-locus sequence typing using partial sequences of the second largest subunit of RNA polymerase (RPB2) and translation elongation factor 1 alpha (TEF-1α).


RESULTS
The identified species belonged to four species complexes (SC); the most common SC was Fusarium solani (FSSC) (75%), followed by Fusarium oxysporum (FOSC) (4.5%), Fusarium fujikuroi (FFSC) (13.6%), and Fusarium dimerum (FDSC) (6.8%). Sites of infections were nails (n = 19, 43.2%), skin (n = 7, 15.9%), cornea (n = 6, 13.6%), blood (n = 3, 9%), wound (n = 4, 6.8%), burn (n = 2, 4.5%), tissue (n = 2, 4.5%), and urine (n = 1, 2.27%). Fusarium acutatum was rare and seem restricted to the Middle East. Comorbidities associated with invasive infections were hematological malignancy and autoimmune disorders.


CONCLUSIONS
Members of the FSSC predominantly caused cornea, nail and bloodstream infections. Less frequently encountered were the FOSC, FFSC and FDSC. More accurate molecular identification of Fusarium species is important to predict therapeutic outcome and the emergence of these species.
Mycology Unit, Microbiology Division, Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, P. O. Box 3050, Doha, Qatar; CBS-KNAW Fungal Biodiversity Centre, Utrecht, The Netherlands.
Husam
H
Salah
CBS-KNAW Fungal Biodiversity Centre, Utrecht, The Netherlands; Institute of Biodiversity and Ecosystem Dynamics, University of Amsterdam, Amsterdam, The Netherlands; Directorate General of Health Services, Ministry of Health, Ibri Hospital, Ibri, Oman.
Abdullah M S
AM
Al-Hatmi
CBS-KNAW Fungal Biodiversity Centre, Utrecht, The Netherlands.
Bart
B
Theelen
Department of Medicine, Infectious Disease Division, Hamad Medical Corporation, P. O. Box 3050, Doha, Qatar.
Mohammed
M
Abukamar
Department of Medicine, Infectious Disease Division, Hamad Medical Corporation, P. O. Box 3050, Doha, Qatar.
Samar
S
Hashim
CBS-KNAW Fungal Biodiversity Centre, Utrecht, The Netherlands.
Anne D
AD
van Diepeningen
Division of Hygiene and Medical Microbiology, Innsbruck Medical University, Innsbruck, Austria.
Cornelia
C
Lass-Florl
CBS-KNAW Fungal Biodiversity Centre, Utrecht, The Netherlands; Department of Dermatology, Shanghai Key Laboratory of Molecular Medical Mycology, Institute of Dermatology and Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, People's Republic of China; Institute of Microbiology, Chinese Academy of Science, Beijing, People's Republic of China.
Teun
T
Boekhout
Department of Medicine, Infectious Disease Division, Hamad Medical Corporation, P. O. Box 3050, Doha, Qatar.
Muna
M
Almaslamani
Mycology Unit, Microbiology Division, Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, P. O. Box 3050, Doha, Qatar. Electronic address: saadtaj51@gmail.com.
Saad J
SJ
Taj-Aldeen
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D021821:Communicable Diseases, Emerging / Q000382:microbiology; D004271:DNA, Fungal; D012321:DNA-Directed RNA Polymerases / Q000235:genetics; D005260:Female; D060585:Fusariosis / Q000382:microbiology*; D005670:Fusarium / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification / Q000472:pathogenicity*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008877:Middle East; D058885:Multilocus Sequence Typing; D020648:Peptide Elongation Factor 1 / Q000235:genetics; D010802:Phylogeny; D017422:Sequence Analysis, DNA; D012867:Skin / Q000382:microbiology; D014556:Urine / Q000382:microbiology; D014774:Virulence; D055815:Young Adult
D004271:DNA, Fungal; D020648:Peptide Elongation Factor 1; D012321:DNA-Directed RNA Polymerases
Emerging fungal infections; Fusarium; Invasive infections; Local infections; Two-locus sequence typing