Work

Species distribution and antifungal susceptibility profiles of Trichosporon species: a multicenter study of 223 clinical isolates from South China

Year: 2026

Type: article

Abstract: Background Trichosporon species have emerged as opportunistic pathogens, causing life-threatening invasive infections. However, epidemiological data from South China remain limited. This multicenter study investigates the species distribution, genotypic characteristics, and antifungal susceptibility profiles of clinical Trichosporon isolates from this region. Methods A total of 223 unique clinical Trichosporon isolates were collected from 18 centers in five South China provinces. These isolates were identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) and sequencing of the intergenic spacer 1 ( IGS1 ) region. The Trichosporon asahii isolates were further analyzed through IGS1 sequence analysis for genotyping. The minimum inhibitory concentrations (MICs) of six antifungal agents were determined using the broth microdilution method outlined by the Clinical and Laboratory Standards Institute (CLSI). Whole-genome sequencing (WGS) was performed on isolates with high fluconazole MICs and on randomly selected low-MIC isolates to characterize ERG11 mutations. Results IGS1 sequencing identified 220 of the 223 isolates to the species level, representing eight species, with T. asahii predominating (171, 77.7%). The species-level concordance between MALDI-TOF MS and IGS1 sequencing was 85.5% (188/220), with substantial interspecies variation. Genotypes 1 (32.7%) and 3 (32.2%) co-predominated among T. asahii isolates, with no significant association found between genotype and specimen source (P = 0.663). Voriconazole was the most active agent, with a MIC 90 of 0.125 μg/mL and a geometric mean (GM) of 0.06 μg/mL. High fluconazole MICs were consistently associated with specific ERG11 substitutions: Y133F in T. dohaense and L229I, V132A, and Y133F in T. asteroides. Conclusions T. asahii is the predominant clinical Trichosporon species in South China. Voriconazole is the most effective antifungal agent against Trichosporon . Species-specific ERG11 polymorphisms may be associated with elevated fluconazole MICs.

Source: Frontiers in Cellular and Infection Microbiology

DOI: 10.3389/fcimb.2026.1982885