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Front Microbiol. 2019 Apr 10;10:737. doi: 10.3389/fmicb.2019.00737. eCollection 2019.

Molecular Characterization and Antifungal Susceptibility of Clinical Fusarium Species From Brazil.

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Instituto Carlos Chagas, Fundação Oswaldo Cruz, Curitiba, Brazil.
Instituto Nacional de Ciência e Tecnologia de Inovação em Doenças de Populações Negligenciadas, Brasília, Brazil.
Centre of Expertise in Mycology Radboudumc/CWZ, Nijmegen, Netherlands.
Department of Medical Mycology, Westerdijk Fungal Biodiversity Institute, Utrecht, Netherlands.
Directorate General of Health Services, Ministry of Health, Ibri Hospital, Ibri, Oman.
Department of Internal Medicine, Federal University of Paraná, Curitiba, Brazil.
Laboratory of Mycology, Hospital de Clínicas, Federal University of Paraná, Curitiba, Brazil.
Department of Internal Medicine, Hematology Service, University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
Infectious Diseases Unit, Department of Public Health, Hospital de Clínicas, Federal University of Paraná, Curitiba, Brazil.
Postgraduate Program in Microbiology, Parasitology and Pathology, Biological Sciences, Department of Basic Pathology, Federal University of Paraná, Curitiba, Brazil.
Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, Netherlands.


Fusarium is widely distributed in the environment and is involved with plant and animal diseases. In humans, several species and species complexes (SC) are related to fusariosis, i.e., F. solani SC, F. oxysporum SC, F. fujikuroi SC, F. dimerum, F. chlamydosporum, F. incarnatum-equiseti, and F. sporotrichoides. We aimed to investigate the susceptibility of Fusarium clinical isolates to antifungals and azole fungicides and identify the species. Forty-three clinical Fusarium isolates were identified by sequencing translation elongation factor 1-alpha (TEF1α) gene. Antifungal susceptibility testing was performed to the antifungals amphotericin B, itraconazole, voriconazole, posaconazole, and isavuconazole, and the azole fungicides difenoconazole, tebuconazole, and propiconazole. The isolates were recovered from patients with median age of 36 years (range 2-78 years) of which 21 were female. Disseminated fusariosis was the most frequent clinical form (n = 16, 37.2%) and acute lymphoblastic leukemia (n = 7; 16.3%) was the most commonly underlying condition. A few species described in Fusarium solani SC have recently been renamed in the genus Neocosmospora, but consistent naming is yet not possible. Fusarium keratoplasticum FSSC 2 (n = 12) was the prevalent species, followed by F. petroliphilum FSSC 1 (n = 10), N. gamsii FSSC 7 (n = 5), N. suttoniana FSSC 20 (n = 3), F. solani sensu stricto FSSC 5 (n = 2), Fusarium sp. FSSC 25 (n = 2), Fusarium sp. FSSC 35 (n = 1), Fusarium sp. FSSC18 (n = 1), F. falciforme FSSC 3+4 (n = 1), F. pseudensiforme (n = 1), and F. solani f. xanthoxyli (n = 1). Amphotericin B had activity against most isolates although MICs ranged from 0.5 to 32 μg mL-1. Fusarium keratoplasticum showed high MIC values (8->32 μg mL-1) for itraconazole, voriconazole, posaconazole, and isavuconazole. Among agricultural fungicides, difenoconazole had the lowest activity against FSSC with MICs of >32 μg mL-1 for all isolates.


Fusarium; antifungal; fungicide; fusariosis; molecular identification; susceptibility

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