Polyphasic identification of three new species in Alternaria section Infectoriae causing human cutaneous infection

Isabel Iturrieta-González; Isabel Pujol; Simona Iftimie; Dania García; Vanesa Morente; Rosana Queralt; Marcela Guevara-Suarez; Ana Alastruey-Izquierdo; Frederic Ballester; Margarita Hernández-Restrepo; Josepa Gené

doi:10.1111/myc.13026

Polyphasic identification of three new species in Alternaria section Infectoriae causing human cutaneous infection

Isabel Iturrieta-González, Isabel Pujol, Simona Iftimie, Dania García, Vanesa Morente, Rosana Queralt, Marcela Guevara-Suarez, Ana Alastruey-Izquierdo, Frederic Ballester, Margarita Hernández-Restrepo, Josepa Gené

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Abstract

Background Cutaneous phaeohyphomycosis is an emerging disease in immunocompromised patients, being Alternaria one of the most common genera reported as a causative agent. Species identification is not carried out mainly due to the complexity of the genus. Analysis of the ITS barcode has become standard for fungal identification, but in Alternaria it is only able to discriminate among species-groups or sections. Methods We present three cases of cutaneous infection caused by Alternaria isolates morphologically identified as belonging to section Infectoriae. They have been morphologically characterised and phylogenetically delineated with five molecular markers (ITS, ATPase, gapdh, rpb2 and tef1). Results Mycotic infections have been diagnosed by repeated cultures and histopathological examination in two of the cases. The polyphasic approach has allowed to delineate three new species of Alternaria section Infectoriae, that is A anthropophila, A atrobrunnea and A guarroi. ATPase has been the only locus able to discriminate most of the species (29 out of 31) currently sequenced in this section, including A infectoria the commonest reported species causing alternariosis. Susceptibility test showed different antifungal patterns for the three species, although terbinafine was the most active in vitro drug against these fungi. Conclusions The ATPase gene is recommended as an alternative barcode locus to identify Alternaria clinical isolates in section Infectoriae. Our results reinforce the relevance of identification of Alternaria isolates at the species level and the necessity to carry out antifungal susceptibility testing to determine the most adequate drug for treatment.

Original language	English
Pages (from-to)	212-224
Number of pages	13
Journal	Mycoses
Volume	63
Issue number	2
DOIs	https://doi.org/10.1111/myc.13026
Publication status	Published - 01 Feb 2020

Keywords

Alternaria infectoria
alternariosis
antifungal susceptibility
immunocompromised patients
molecular identification
opportunistic infections
Pleosporaceae
taxonomy

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10.1111/myc.13026

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@article{b421eb5f077546a6b6432d0c8ae0ec3e,

title = "Polyphasic identification of three new species in Alternaria section Infectoriae causing human cutaneous infection",

abstract = "Background Cutaneous phaeohyphomycosis is an emerging disease in immunocompromised patients, being Alternaria one of the most common genera reported as a causative agent. Species identification is not carried out mainly due to the complexity of the genus. Analysis of the ITS barcode has become standard for fungal identification, but in Alternaria it is only able to discriminate among species-groups or sections. Methods We present three cases of cutaneous infection caused by Alternaria isolates morphologically identified as belonging to section Infectoriae. They have been morphologically characterised and phylogenetically delineated with five molecular markers (ITS, ATPase, gapdh, rpb2 and tef1). Results Mycotic infections have been diagnosed by repeated cultures and histopathological examination in two of the cases. The polyphasic approach has allowed to delineate three new species of Alternaria section Infectoriae, that is A anthropophila, A atrobrunnea and A guarroi. ATPase has been the only locus able to discriminate most of the species (29 out of 31) currently sequenced in this section, including A infectoria the commonest reported species causing alternariosis. Susceptibility test showed different antifungal patterns for the three species, although terbinafine was the most active in vitro drug against these fungi. Conclusions The ATPase gene is recommended as an alternative barcode locus to identify Alternaria clinical isolates in section Infectoriae. Our results reinforce the relevance of identification of Alternaria isolates at the species level and the necessity to carry out antifungal susceptibility testing to determine the most adequate drug for treatment.",

keywords = "Alternaria infectoria, alternariosis, antifungal susceptibility, immunocompromised patients, molecular identification, opportunistic infections, Pleosporaceae, taxonomy",

author = "Isabel Iturrieta-Gonz{\'a}lez and Isabel Pujol and Simona Iftimie and Dania Garc{\'i}a and Vanesa Morente and Rosana Queralt and Marcela Guevara-Suarez and Ana Alastruey-Izquierdo and Frederic Ballester and Margarita Hern{\'a}ndez-Restrepo and Josepa Gen{\'e}",

note = "doi: 10.1111/myc.13026",

year = "2020",

month = feb,

day = "1",

doi = "10.1111/myc.13026",

language = "English",

volume = "63",

pages = "212--224",

journal = "Mycoses",

issn = "0933-7407",

publisher = "John Wiley and Sons Ltd",

number = "2",

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TY - JOUR

T1 - Polyphasic identification of three new species in Alternaria section Infectoriae causing human cutaneous infection

AU - Iturrieta-González, Isabel

AU - Pujol, Isabel

AU - Iftimie, Simona

AU - García, Dania

AU - Morente, Vanesa

AU - Queralt, Rosana

AU - Guevara-Suarez, Marcela

AU - Alastruey-Izquierdo, Ana

AU - Ballester, Frederic

AU - Hernández-Restrepo, Margarita

AU - Gené, Josepa

N1 - doi: 10.1111/myc.13026

PY - 2020/2/1

Y1 - 2020/2/1

N2 - Background Cutaneous phaeohyphomycosis is an emerging disease in immunocompromised patients, being Alternaria one of the most common genera reported as a causative agent. Species identification is not carried out mainly due to the complexity of the genus. Analysis of the ITS barcode has become standard for fungal identification, but in Alternaria it is only able to discriminate among species-groups or sections. Methods We present three cases of cutaneous infection caused by Alternaria isolates morphologically identified as belonging to section Infectoriae. They have been morphologically characterised and phylogenetically delineated with five molecular markers (ITS, ATPase, gapdh, rpb2 and tef1). Results Mycotic infections have been diagnosed by repeated cultures and histopathological examination in two of the cases. The polyphasic approach has allowed to delineate three new species of Alternaria section Infectoriae, that is A anthropophila, A atrobrunnea and A guarroi. ATPase has been the only locus able to discriminate most of the species (29 out of 31) currently sequenced in this section, including A infectoria the commonest reported species causing alternariosis. Susceptibility test showed different antifungal patterns for the three species, although terbinafine was the most active in vitro drug against these fungi. Conclusions The ATPase gene is recommended as an alternative barcode locus to identify Alternaria clinical isolates in section Infectoriae. Our results reinforce the relevance of identification of Alternaria isolates at the species level and the necessity to carry out antifungal susceptibility testing to determine the most adequate drug for treatment.

AB - Background Cutaneous phaeohyphomycosis is an emerging disease in immunocompromised patients, being Alternaria one of the most common genera reported as a causative agent. Species identification is not carried out mainly due to the complexity of the genus. Analysis of the ITS barcode has become standard for fungal identification, but in Alternaria it is only able to discriminate among species-groups or sections. Methods We present three cases of cutaneous infection caused by Alternaria isolates morphologically identified as belonging to section Infectoriae. They have been morphologically characterised and phylogenetically delineated with five molecular markers (ITS, ATPase, gapdh, rpb2 and tef1). Results Mycotic infections have been diagnosed by repeated cultures and histopathological examination in two of the cases. The polyphasic approach has allowed to delineate three new species of Alternaria section Infectoriae, that is A anthropophila, A atrobrunnea and A guarroi. ATPase has been the only locus able to discriminate most of the species (29 out of 31) currently sequenced in this section, including A infectoria the commonest reported species causing alternariosis. Susceptibility test showed different antifungal patterns for the three species, although terbinafine was the most active in vitro drug against these fungi. Conclusions The ATPase gene is recommended as an alternative barcode locus to identify Alternaria clinical isolates in section Infectoriae. Our results reinforce the relevance of identification of Alternaria isolates at the species level and the necessity to carry out antifungal susceptibility testing to determine the most adequate drug for treatment.

KW - Alternaria infectoria

KW - alternariosis

KW - antifungal susceptibility

KW - immunocompromised patients

KW - molecular identification

KW - opportunistic infections

KW - Pleosporaceae

KW - taxonomy

U2 - 10.1111/myc.13026

DO - 10.1111/myc.13026

M3 - Article

SN - 0933-7407

VL - 63

SP - 212

EP - 224

JO - Mycoses

JF - Mycoses

IS - 2

ER -

Polyphasic identification of three new species in Alternaria section Infectoriae causing human cutaneous infection

Abstract

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