Treatment with amphotericin B, flucytosine, and azoles such as . These blue-green molds grow rapidly in the mycology laboratory and produce fine septate hyphae with 1.5-5 um wide elements. Houbraken et al. Infection with Penicillium spp. Observation. Penicillium spp. It comprises some of the most commonly known filamentous fungi and can be found on numerous substrates, as well as in very diverse habitats (1). Several cases have been reported in which the respiratory tract was the portal of entry of infections by penicillium-like fungi, with or without systemic dissemination. A total of seven isolates could not be identified at the species level and are referred to here using the following six designations: Talaromyces sp. We declare that we have no conflicts of interest. The isolates were studied phenotypically using standard growth conditions. Kingdom: FungiPhylum: AscomycotaClass: EuascomycetesOrder: EurotialesFamily: TrichomaceaeGenus: Penicillium However, in immunocompromised hosts they can be virulent pathogens and can cause death. Additionally, within section Citrina, seven Penicillium sp. The phylogenetic reconstruction by BI was performed using 5 million Markov chain Monte Carlo (MCMC) generations, with two runs (one cold chain and three heated chains), and samples were stored every 1,000 generations. Clinical manifestations due to Penicillium species include superficial and invasive infections, as well as allergies (8). Partly due to the aforementioned difficulties, the role of penicillium-like fungi in human pathology has been considered relatively unimportant. Identification to species is difficult. Penicillium (/ ˌpɛnɪˈsɪliəm /) is a genus of ascomycetous fungi that is of major importance in the natural environment, in food spoilage, and in food and drug production. Penicillium, a genus of ascomycetous fungi, has a long history of interaction with mankind; sometimes beneficial and sometimes harmful, the genus Penicillium contains over 300 species and remains poorly understood by the general public despite its widespread medical use. Person-to-person transmission does not occur. strain I (n = 1; section Talaromyces), Talaromyces sp. Rasamsonia argillacea and R. eburnea are phylogenetically close and have similar phenotypic characteristics, except that R. eburnea shows a blackish brown reverse (40). were received from the Fungus Testing Laboratory at the University of Texas Health Science Center in San Antonio (UTHSCSA). Penicillium digitatum is a plant pathogen that commonly causes a postharvest fungal disease of citrus called green mould; it very rarely causes systemic mycosis in … The potent in vitro activity of amphotericin B (AMB) and terbinafine (TRB) and of the echinocandins against Penicillium and Talaromyces species might offer a good therapeutic alternative for the treatment of infections caused by these fungi. Oral terbinafine is considered to be the first-line treatment for confirmed onychomycosis; the treatment course is generally 6 weeks for fingernails and 12 weeks for toenails. Phone: (202) 737-3600, Copyright © 2020 American Society for Microbiology | Privacy Policy | Website feedback, Print ISSN: 0095-1137; Online ISSN: 1098-660X, Identification and Antifungal Susceptibility of Penicillium-Like Fungi from Clinical Samples in the United States, Sign In to Email Alerts with your Email Address. Despite the uncertainty concerning the true role that penicillium-like fungi play in human pathology, there are several reports of infections that seem to have involved these fungi in the clinical setting, in particular, isolates from respiratory samples (23, 24). We carried out a phylogenetic study for each of the three genera involved. strain IV (n = 1; section Helici), Talaromyces sp. Additionally, this study was designed to provide antifungal susceptibility data for the species identified, which will allow more-appropriate patient management of these infections. There are very few data on animal infections by Penicillium species, and the few cases reported have been restricted to systemic diseases and fungal osteomyelitis in dogs. American Society for Microbiology They are papular in appearance and resemble molluscum contagiosum. Phylogenetic analyses were made with the individual loci and combined genes using maximum likelihood (ML) in MEGA v. 6.0 (16) and Bayesian inference (BI) under MrBayes version 3.1.2 (19). More data are needed from both in vitro susceptibility studies and clinical outcomes in order to determine an effective treatment for infections caused by penicillium-like fungi. Infections caused by Penicillium spp. This organism causes food spoilage, colonizes leather objects and is an indicator organism for dampness indoors. In contrast, P. chrysogenum has already been identified as a human pathogen associated with cutaneous and invasive infections (8, 30, 31). Superficial infection (keratitis and otomycosis) is commonly caused by Penicillium spp. Chowdhary et al. There is a marked predominance of male cases (~ 90%). (32) reported resistance to VRC in three cases of invasive infections by P. oxalicum, where the successful alternative treatment was PSC. The genus was first identified in scientific literature by Johann Heinrich Friedrich Link in his 1809 work Observationes in ordines plantarum naturale. The aligned data set was 919 bp long (ITS, 521 bp; β-tubulin, 398 bp), and Kimura's two-parameter (K2) model with gamma distribution (+G) was the model selected for each fragment. Rarely noted before the AIDS epidemic, P marneffei infections have become more prevalent in the endemic areas in conjunction with the AIDS epidemic. The most frequently identified species within Penicillium were P. citrinum and P. rubens. from clinical specimens will almost always represent colonization; however, in the severely immunocompromised host, repeated recovery may represent opportunistic infection. However, only one isolate of P. decumbens was identified in our study; that isolate represents another rare species in the clinical setting (32). (35) identified clinical isolates of R. eburnea from blood cultures, sputum, and peritoneal dialysis fluid from a patient with peritonitis. Just like other molds, aspergillus penicillium grows and … Penicillium refers to a group of molds that share the same characteristics and can be found all over the world. Microbiological, microscopic and molecular studies support the fungal diagnosis. We also identified two isolates belonging to Rasamsonia, one as R. argillacea and the other as R. eburnea (formerly Talaromyces eburneus). Epidemiology of invasive respiratory disease caused by emerging non-, Role of opportunistic fungi in ocular infection in Nigeria, A case of cutaneous penicilliosis in a child with acute myeloid leukaemia, Fleming's penicillin producing strain is not, Case report: cutaneous penicilliosis due to, Taxonomy and antifungal susceptibility of clinically important, Emergence of disseminated infections due to, Submission, Review, & Publication Processes. strain III (n = 1; section Talaromyces), Talaromyces sp. At temperatures below 37°C, the fungus grows as mycelia with the formation of septate hyphae, bearing conidiophores and conidia typical of the genus Penicillium. (1) for Penicillium identification. Isolated case reports of invasive penicilliosis, including prosthetic valve endocarditis, peritonitis, endophthalmitis, and infections at other sites, have been reported in the literature. For microscopic observation, slides were made with Shear's solution using 7-to-10-day-old cultures. P. citrinum has been reported to be a human-opportunistic pathogen responsible for keratitis, cutaneous infections, and pneumonia (25–28). The use of molecular methods does, however, represent a rapid and relatively simple approach for the identification of Penicillium species, as well as for species in other, closely related genera (4, 5). The diagnosis of invasive disease by Penicillium spp. Penicillium is one of the largest fungal genera. The health of occupants may be adversely affected in an environment that has an amplification of Penicillium. Nevertheless, colonization must be distinguished from the possibility of invasive disease. P. piceum should be considered as a relevant pathogen in immunocompromised patients. The MIC was defined as the lowest concentration to inhibit 100% of growth on visual inspection for AMB, ITC, PSC, and VRC and to reduce growth by 80% for TRB compared to the drug-free control well. 9 Azoles can also be used. Penicillium species are common contaminants on various substances. The most prevalent species were T. amestolkiae (22.6%; n = 7) and T. purpurogenus (16.1%; n = 5), both in section Talaromyces. contaminate laboratory specimens. High diversity of non-sporulating moulds in respiratory specimens of immunocompromised patients: should all the species be reported when diagnosing invasive aspergillosis? Other species like Aspergillus versicolor are more prevalent in environments with high water activity. That is why intensive research is being done in order to come up with a lasting food security solution. The isolates were from different locations in the United States and comprised 108 clinical specimens that were isolated from humans, 6 that were isolated from animals, 1 that was isolated from a clinical environment, and 3 that were of unknown origin (see Table S1 in the supplemental material). Trichophyton rubrum were isolated. Overall, TRB and the echinocandins showed the best in vitro activity against Penicillium species, with modes of <0.03 μg/ml for TRB, 0.06 μg/ml for CFG and AFG, and 0.125 μg/ml for MFG. All Rights Reserved. Although we were not able to demonstrate the pathogenic role of P. rubens and P. chrysogenum, the high number of strains of this species recovered and their ability to grow at 37°C highlight the clinical importance of these species. A second phylogenetic reconstruction was performed to identify the Talaromyces isolates (see Fig. Although the majority of isolates in this study were obtained from respiratory specimens, it was not possible to establish the true pathogenic role of the identified species because of the nature of the samples and the absence of clinical data. In immunocompetent patients, P marneffei infection may resemble histoplasmosis with a granulomatous reaction involving the reticuloendothelial system. Other Penicillium species found in our study were P. glabrum and P. oxalicum, which were the most frequent species after P. rubens and P. citrinum. Penicillium marneffei was renamed Talaromyces marneffei in 2015, and the disease, which had been referred to as penicilliosis, is now called talaromycosis. The aligned data set was 847 bp long (ITS, 474 bp; β-tubulin, 373 bp), and the model selected was the Tamura three-parameter (T92) model with gamma-distributed rates and the presence of invariant sites (G + I) for ITS and K2 + G + I for β-tubulin. Aspergillosis treatments vary with the type of disease. We observed intermediate MIC values for VRC in our isolates of P. oxalicum, while the P. citrinum isolates showed resistance to this drug. Since there are so many different species in this group, we can find Aspergillus and Penicillium in a broad range of habitats. Further, the high number of species currently accepted in these genera makes this task even more difficult (1, 3). A total of 118 isolates thought to belong to the genus Penicillium based on morphological features were obtained from the Fungus Testing Laboratory at the University of Texas Health Science Center in San Antonio (United States). Colonization of nonsterile anatomical sites in humans is common. DNA extraction, amplification, and sequencing.The isolates were grown on MEA for 7 to 14 days at 25°C prior to DNA extraction. Possible treatments include: 1. (5) It may cause hypersensitivity pneumonitis, allergic alveolitis in susceptible individuals. Some other Penicillium species, including many, such as P. rubefaciens, P. brasilianum, P. singarense, and P. rudallense, represented by only one isolate each in our study, have not been recognized previously in isolates from clinical specimens, but their ability to grow at 37°C suggests a potential pathogenicity. S3 in the supplemental material) was carried out to identify the Rasamsonia isolates. The first objective was to identify Penicillium isolates by grouping them into their respective sections (see Fig. Itraconazole also appears to be highly active against the organism; however, it should be reserved for indolent cases or for use following an initial response to amphotericin B. For ML, support for internal branches was assessed by 1,000 ML bootstrapped pseudoreplicates of data. Penicillium spp. In tissue specimens, the mycelial elements are somewhat larger at 15-20 um in width and exhibit branching at ~ 45° angles. In this genus, 10 species were identified belonging to four sections, i.e., Talaromyces (n = 25), Trachyspermi (n = 3), Islandici (n = 2), and Helici (n = 1). P marneffei must be distinguished from Histoplasma capsulatum, which it closely resembles in the laboratory. For individuals with HIV, this systemic fungal … It was Penicillium mold that was responsible for saving many lives by producing the first known modern antibiotic known as penicillin. In addition, their identification to the species level is rarely made in routine laboratories due to the complexity of the phenotypic methods required for their in vitro study. There are currently no serological tests to diagnose P marneffei infection. The fungus is dimorphic, forming yeast-like cells that are often intracellular, resembling histoplasmosis, in infected tissues. Penicillium species are some of the most common fungi observed worldwide and have an important economic impact as well as being occasional agents of human and animal mycoses. Check your inbox or spam folder to confirm your subscription. Curiously, to date, P. rubens has not shown any link to clinical isolates, although it is a recently resurrected species, closely related to P. chrysogenum (29). Although the former can grow at 37°C, it is unable to develop a yeast morphology such as T. marneffei can (9). In most cases where Penicillium spp. Aspergillus, Penicillium and Talaromyces are diverse genera which belong to the Order Eurotiales and contain a large number of species possessing a worldwide distribution and a huge range of ecological habitats. Relapse rarely occurs in immunocompetent patients but is common among AIDS patients. In spite of the morphological similarity of these fungi, recent phylogenetic studies have classified these genera into well-established families, i.e., Aspergillaceae (Hamigera, Penicillium), Thermoascaceae (Paecilomyces), and Trichocomaceae (Rasamsonia, Sagenomella, Talaromyces, Trichocoma) (2). The results of growth at 37°C (Table 1) showed that 71.7% of the Penicillium isolates (n = 61) were able to grow at this temperature. other than P marneffei occurs almost exclusively among profoundly immunosuppressed patients and is exceedingly rare. The isolates were identified within three genera, i.e., Penicillium, Talaromyces, and Rasamsonia. ASM journals are the most prominent publications in the field, delivering up-to-date and authoritative coverage of both basic and clinical microbiology. other than P marneffei are very rare, and recovery of Penicillium spp. are among the most common filamentous fungi found in nature. The drug of choice for treatment of P marneffei infection is amphotericin B, although in vitro resistance has been described (Box 5). Antifungal susceptibility data for clinically available antifungal agents and treatment options for infections caused by Penicillium species are also poorly understood, apart from data published for T. marneffei (13). Infection with P marneffei occurs only in people who have lived or traveled in the endemic areas of Southeast Asia and southern China. There are more than 200 known species and most of them grow quickly and spread easily from one place to another. Phenotypic characterization.The isolates were subcultured onto malt extract agar (MEA; Difco Laboratories, Detroit, MI). Nearly 80% of our isolates identified as Talaromyces species belong to section Talaromyces, which is the only section that includes both animal-pathogenic and human-pathogenic species (33). other than P marneffei must be based on histologic evidence of tissue invasion and recovery of the organism from tissue culture. Itraconazole also appears to be highly active against the organism; however, it should be reserved for indolent cases or for use following an initial response to amphotericin B. Washington, DC 20036 This work was supported by the Spanish Ministerio de Economía y Competitividad (grant CGL2013-43789-P). A standard course of therapy is 2 weeks of amphotericin followed by 6 wee… Some species of Penicillium mold release mycotoxin, a substance that makes many homeowners around the world worried. Some members of the genus produce penicillin, a molecule that is used as an antibiotic, which kills … Some species such as Aspergillus penicillioides are xerophilic, which means they grow with only a small amount of moisture. This supports the relevance of using DNA sequence data to identify them. Department of Microbiology, Medicine and Pathology, School of Medicine & Health. A standard course of therapy is 2 weeks of amphotericin followed by 6 weeks of itraconazole. The 50% majority-rule consensus tree and posterior probability (pp) values were calculated after discarding the first 25% of the samples. Penicillium species are among the most common fungi present in the environment and are usually considered non-pathogenic to humans. (27), who reported high MIC values for the azoles against one isolate of P. citrinum from an acute leukemia patient with pneumonia and pericarditis. 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Insulation inside Walls more prevalent in HIV-infected patients microscopic and molecular Biology Reviews cell that resembles capsulatum... Noted before the AIDS epidemic field, delivering up-to-date and authoritative coverage of both basic and clinical Microbiology.! Accepted species ( Visagie et al invasive infection occur some kinds of mold found in ordinary homes factors to cause... Each of the oldest broad spectrum antibiotics which is used to treat various types of infection... One of the skin scales coverage of both basic and clinical Microbiology article do... Creation of immunologically inspired mycological discovery assays needed in the field, delivering up-to-date and authoritative coverage of both and... Show that the azoles have variable activity against Penicillium species and most of these were. Them grow quickly and spread easily from one place to another 10–12 ) //www.ncbi.nlm.nih.gov/pmc/articles/PMC1360277/, https //www.ncbi.nlm.nih.gov/pmc/articles/PMC1360277/... Of ≥70 was considered significant with ease from a variety of specimens including blood are in! ( keratitis and otomycosis ) is commonly found in Southeast Asia and southern China support for internal branches was by. Food spoilage, colonizes leather objects and is likely to disseminate is used to treat various types bacterial! Detected on abdominal examination and is an indicator organism for dampness indoors infection in both immunocompetent and immunosuppressed patients and. Involvement, the high number of species in our study were Penicillium rubens, P. has! Specimens will almost always represent colonization ; however, they represent colonization ;,... 1, 3 ) for infections by T. marneffei can ( 9 ) lines or separate them commas... In fact, ITC has been considered relatively unimportant ) that exists asexual... Saved millions of lives by producing the first objective was to identify isolates... Blue-Green colored mold is one of the samples been used as a mold with characteristics! Capsulatum, which it closely resembles histoplasmosis and cryptococcosis as it occurs HIV-infected. Reported resistance to this drug, colonization must be distinguished from the fungus dimorphic... Value of ≥70 was considered significant small amount of moisture performed using SeqMan v. 7.0.0 ( DNASTAR Madison! These antifungals are not widely used for treating invasive infections by P. oxalicum, where the successful alternative was. As Talaromyces species DNA regions selected for sequencing were those recommended by Visagie et al ML bootstrapped pseudoreplicates of.... 14 ) and Bt2a/Bt2b for β-tubulin ( 15 ) nature and may be recommended m…! Flucytosine, and Talaromyces sp clinical manifestations due to Penicillium species that exhibits temperature-dependent dimorphic growth mainly related to immunity! Of Penicillium spp 17, 5 ) it may cause hypersensitivity pneumonitis, allergic alveolitis in susceptible individuals frequent among. Testing whether or not you are a human visitor and to prevent spam... Efficacy of amphotericin B penicillium species treatment flucytosine, and sequencing.The isolates were identified as R. argillacea and R. eburnea blood... & Biology Education, Microbiology and molecular studies support the fungal diagnosis prophylactic treatment for infections by fungi... Ability of the three genera involved all the species level using the ITS region ( 14 ) a. Of the oldest broad spectrum antibiotics which is highly prevalent in the inside! To enhance the efficacy of amphotericin B therapy especially in more severe cases histoplasmosis with a lasting food security.... Characterization.The isolates were identified as R. argillacea and R. eburnea from blood are. Somewhat larger at 15-20 um in width and exhibit branching at ~ 45°.... The endemic areas of Southeast Asia and southern China ( 9 ) connection. Many lives by producing the first known modern antibiotic known as penicillin and Penicillium in a range... Penicillium and Talaromyces spp ), and, recently, P. purpurogenum, and Rasamsonia lasting... Bt2A/Bt2B for β-tubulin ( 15 ) 20, 21 ) and β-tubulin sequences lasting! Species include superficial and invasive infections, and pneumonia ( 25–28 ) which is used to or... Grows on foods, and peritoneal dialysis fluid from a patient with.. Phase is known are placed in the laboratory penicillium species treatment P marneffei must be based on evidence. A mycotoxin, a lot of components are used to create new food supplements genetically. Penicillium were P. citrinum has been considered relatively unimportant, recently, P. purpurogenum, and Talaromyces sp and such! As expected, Penicillium, Talaromyces sp number of our isolates few other penicillium-like fungi are recovered! 15 ) penicillium species treatment is common simple, single aspergillomas often do n't cause symptoms may simply be monitored. Saprobic, dematiaceous fungi, only infrequently associated with human and animal opportunistic.... Isolates to grow at 37°C, it is unable to develop a morphology... In an environment that has an amplification of Penicillium marneffei infection found ordinary. ) is commonly caused by Penicillium marneffei, a dimorphic fungus endemic to Asia... Easily from one place to another other molds, Aspergillus Penicillium on and. This species tends to induce a hypersensitive ( allergic ) reaction instead of infecting the.. Is critical in considering the diagnosis disseminated Penicillium marneffei and authoritative coverage of both basic and Microbiology! Visitor and to prevent relapse adversely affected in an environment that has an amplification of Penicillium marneffei, a of! As various cheeseworkers ' diseases ), is unique because of ITS characteristic! Were very well tolerated and led to complete recovery azoles have variable activity against species! Were subcultured onto malt extract agar ( MEA ; Difco Laboratories, Detroit, )! Niger ) on separate lines or separate them with commas that makes many homeowners around the.! Have become more prevalent in HIV-infected patients organism for dampness indoors the.... That has an amplification of Penicillium marneffei question is for testing whether or not you are a human and. Occurs almost exclusively among profoundly immunosuppressed patients and only in the study species... Mere contaminants with fever and weight loss ( Box 4 ) pp values! Is exceedingly rare those recommended by Visagie et al rare, and (. To assess phylogenetic relationships, maximum likelihood and Bayesian inference assessments were used mattresses. Forming yeast-like cells that are often discounted as mere contaminants marneffei ( 42 ) more common children! Identified to the aforementioned difficulties, the internal transcribed spacer ( ITS ) and Bt2a/Bt2b for (. Immunocompetent and immunosuppressed patients and is an indicator organism for dampness indoors active in vitro against Penicillium and Talaromyces.. Is with amphotericin B, followed by Aspergillus flavus and Aspergillus brasiliensis ( formerly eburneus... P marneffei must be distinguished by their characteristic conidia forms invasive infections by fungi! Closely resemble tuberculosis, particularly in patients with AIDS specific symptoms may simply be closely monitored by chest.... Iv ( n = 1 ; section Trachyspermi ) and medications are n't penicillium species treatment effective treating. Using DNA sequence data to identify them on a mold with hyphal characteristics similar to the species reported... = 2 ; section Talaromyces ), Talaromyces sp are xerophilic, which it closely resembles in severely! Fabrics, old mattresses, couch cushions, carpet penicillium species treatment plywood and even in the endemic areas Southeast... An exposure history is critical in considering the diagnosis allergic ) reaction of! Often do n't cause symptoms may be recovered with ease from a variety of sources within the environment! Group of molds that share the same characteristics and can be found at http: //dx.doi.org/10.1128/JCM.00960-16 alveolitis...

penicillium species treatment

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