Trichosporon ocular infections: Genotyping, antifungal susceptibility, clinico-microbiological correlation, and literature review
Abstract
Purpose: Ocular infections caused by Trichosporon spp., a yeast-like fungus and an emerging fungal pathogen associated with severe invasive disease and poor outcomes, remain underexplored, with only a few case reports available. We present a decade-long case series of Trichosporon ocular infections, describing clinical features, detailed microbiology, clinico-microbiological correlations, antifungal susceptibility patterns, and genotyping of isolates. A comprehensive literature review of all reported cases to date is also included.
Methods: A retrospective review of electronic medical records (EMRs) identified eight cases of Trichosporon ocular infections over a 12-year period. Demographic, clinical, and microbiological data were extracted from EMRs. Five stored isolates were retrieved from -80°C stocks for genotyping by Sanger sequencing and in-vitro antifungal susceptibility testing. Relevant statistical analyses were performed to assess clinico-microbiological correlations.
Results: Fifty percent of patients had favorable clinical outcomes. Trichosporon asahii was the most common species isolated and was associated with poorer outcomes compared to T. inkin . Multidrug resistance (MDR) was frequent and correlated with worse prognosis. Natamycin was the most frequently administered antifungal agent, followed by azoles. Microbiological confirmation guided initiation of antifungal therapy in half of the cases. Sanger sequencing corrected species misidentifications made by the…
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