Purpureocillium roseum sp. nov. A new ocular pathogen for humans and mice resistant to antifungals

Mycoses. 2021 Feb;64(2):162-173. doi: 10.1111/myc.13198. Epub 2020 Nov 1.

Abstract

Background: Infectious keratitis is the main cause of preventable blindness worldwide, with about 1.5-2.0 million new cases occurring per year. This inflammatory response may be due to infections caused by bacteria, fungi, viruses or parasites. Fungal keratitis is a poorly studied health problem.

Objectives: This study aimed to identify a new fungal species by molecular methods and to explore the possible efficacy of the three most common antifungals used in human keratitis in Mexico by performing in vitro analysis. The capacity of this pathogen to cause corneal infection in a murine model was also evaluated.

Methods: The fungal strain was isolated from a patient with a corneal ulcer. To identify the fungus, taxonomic and phylogenetic analyses (nrDNA ITS and LSU data set) were performed. An antifungal susceptibility assay for amphotericin B, itraconazole and voriconazole was carried out. The fungal isolate was used to develop a keratitis model in BALB/c mice; entire eyes and ocular tissues were preserved and processed for histopathologic examination.

Results and conclusion: This fungal genus has hitherto not been reported with human keratitis in Mexico. We described a new species Purpurecillium roseum isolated from corneal infection. P roseum showed resistance to amphotericin B and itraconazole and was sensitive to voriconazole. In vivo study demonstrated that P roseum had capacity to developed corneal infection and to penetrate deeper corneal tissue. The global change in fungal infections has emphasised the need to develop better diagnostic mycology laboratories and to recognise the group of potential fungal pathogens.

Keywords: antifungal susceptibility; deep fungal infection; keratomycosis; minimum inhibitory concentration; murine model; new species.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Amphotericin B / therapeutic use
  • Animals
  • Antifungal Agents / therapeutic use*
  • Cornea
  • DNA, Fungal
  • Drug Resistance, Fungal / drug effects
  • Female
  • Humans
  • Hypocreales / classification*
  • Hypocreales / drug effects*
  • Hypocreales / isolation & purification*
  • Hypocreales / pathogenicity
  • Itraconazole / therapeutic use
  • Keratitis / drug therapy
  • Keratitis / microbiology*
  • Keratitis / pathology
  • Mexico
  • Mice
  • Mice, Inbred BALB C
  • Microbial Sensitivity Tests
  • Mycological Typing Techniques
  • Mycoses / drug therapy
  • Mycoses / microbiology
  • Phylogeny
  • Voriconazole / therapeutic use

Substances

  • Antifungal Agents
  • DNA, Fungal
  • Itraconazole
  • Amphotericin B
  • Voriconazole