Fatal break-through infection with Fusarium andiyazi: new multi-resistant etiological agent cross-reacting with Aspergillus galactomannan enzyme immunoassay

Ref ID: 19395

Author:

N. Kebabci,2 A. D.Van Diepeningen,1 B. Ener,2 T. Ersal,2
M. Meijer,1 A. M. S. al-Hatmi,1 €O. €Ozkocaman,2 A. Ursavas,2
E. Demird€ogen C etinoglu2 and H. Akali2

Author address:

1CBS-KNAW Fungal Biodiversity Centre, Utrecht, the Netherlands
and 2Uludag University, Faculty of Medicine, Bursa, Turkey

Full conference title:

6th Trends in Medical Mycology 2013

Date: 11 October 2014

Abstract:

Objectives We present the first human disseminated infection
caused by Fusarium fujikuroi species complex (FFSC) member Fusarium
andiyazi. F. andiyazi is so far only known as plant pathogen, but
disseminated infections by members of the Fusarium fujikuroi species
complex (FFSC) occur regularly in immunocompromised patients. We
want to alert the community to this new etiological agent, which is
multi-resistant and can cross-react with the Aspergillus galactoman-
nan enzyme immunoassay.
Methods/results
Case report Fever, respiratory symptoms, and abnormal computer-
ized tomography findings developed in a 65 years old man with
AML, who was under posaconazole prophylaxis during his remission-
induction chemotherapy. During the course of infection, two consec-
utive blood galactomannan values were found positive and two blood
cultures yielded strains resembling Fusarium species according to
morphological appearances.
Identification and characterization of the etiological agent
The etiological agent proved to be F. andiyazi based on multilocus
sequence typing (MLST). Sequencing of the ITS region did not resolve
the closely related members of the FFSC, but additional data on par-
tial sequences of transcription elongation factor 1 alfa did. A detailed
morphological study confirmed the identification of F. andiyazi that
had previously only been reported as a plant pathogen on different
food crops. Antifungal susceptibility tests against 8 antifungal drugs,
showed that the strain is multi-resistant to many currently applied
drugs, including amphotericin B and voriconazole.
Conclusion F. andiyazi proved multi-resistant to all tested antifungal
drugs, cross reacts with the Aspergillus galactomannan assay, and a
DNA-based identification of gene sequences not currently adopted in
many labs is necessary for its identification. This case of a patient
under prophylactic posaconazole treatment, who was infected with
this new opportunistic pathogen which caused galactomannan posi-
tivity is presented to attract attention on the matter.

Abstract Number: p101

Conference Year: 2013

Link to conference website: NULL

New link: NULL

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