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Cladosporium halotolerans: Exploring an Unheeded Human Pathogen

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Abstract

Background

Cladosporium halotolerans is a saprobic fungus, rarely implicated in human infections. The identification is challenging due to non-specific phenotypic features.

Objective

To decipher clinical spectrum, microbiological and susceptibility profile of clinical and environmental isolates of Cladosporium halotolerans.

Method

All the isolates identified as Cladosporium halotolerans deposited in National Culture Collection for Pathogenic Fungi (NCCPF), Postgraduate Institute of Medical Education and Research, Chandigarh, India were revived. Phenotypic and molecular characterization targeting internal transcribed spacer (ITS) region of ribosomal DNA, large subunit of ribosomal DNA (LSU; NL1 and NL4), actin (ACT) and beta-tubulin (TUB) was done. Scanning electron microscopy (SEM) was performed to determine any phenotypic variations. Antifungal susceptibility testing (AFST) was carried out for eight antifungal agents as per CLSI M38 Ed3 guidelines. We also performed systematic literature review of all the cases of Cladosporium halotolerans reported till date.

Results

A total of four isolates (clinical, n = 3; soil, n = 1) identified as Cladosporium halotolerans were included in the study. The clinical sites were skin, maxillary tissue and nail. All patients were apparently immunocompetent, and history of trauma was recorded in one patient. All patients improved on antifungal therapy. The cultures revealed growth of black mycelial fungus and microscopic examination demonstrated dematiaceous septate hyphae with erect conidiophores and conidia in branched acropetal chains. Based on molecular methods, all the four isolates were identified as C. halotolerans. SEM revealed no variation in length and width of the conidia, conidiophores, ramoconidium and hyphae among the isolates. All molecular targets, such as ITS region, LSU (partially sequenced), ACT and TUB were able to differentiate the isolates. Minimum inhibitory concentrations for antifungals were: triazoles (0.12–2 μg/ml), amphotericin B (4 μg/ml) and echinocandins (2–8 μg/ml).

Conclusion

We report role of the rarely isolated dematiaceous fungus, C. halotolerans, in causing human infections. The study emphasizes the role of molecular methods in precisely identifying these species. Triazoles are more active against these black fungi compared to polyenes or echinocandins.

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Funding

We gratefully acknowledge the Department of Science and Technology-Science and Engineering Research Board (DST-SERB), New Delhi for extending financial support to carry out this research vide sanction number EMR/2017/003448 dated 03-10-2018.

Author information

Author notes

  1. Harsimran Kaur and Parakriti Gupta have equally contributed to this work.

  2. Joint first author: Harsimran Kaur and Parakriti Gupta.

Authors and Affiliations

  1. Mycology Division, Department of Medical Microbiology, PGIMER, Chandigarh, 160012, India

    Harsimran Kaur, Haseen Ahmad, Sunita Gupta, Anup Ghosh & Shivaprakash M. Rudramurthy

  2. Department of Microbiology, Government Medical College and Hospital, Chandigarh, India

    Parakriti Gupta

  3. Department of Physics, Charlebois Lab, Edmonton, AB, Canada

    Shamanth A. Shankarnarayan

  4. Department of Microbiology, AIIMS, Kalyani, West Bengal, India

    Sonakshi Srivastava

  5. Clinical Microbiology and Molecular Biology, Apollo Hospitals Bhubaneswar, Bhubaneswar, India

    Suneeta Sahu

  6. Department of Microbiology, AIIMS, Bhopal, Madhya Pradesh, India

    T. Karuna

  7. Department of Dermatology, Venereology and Leprology, PGIMER, Chandigarh, Chandigarh, 160012, India

    Tarun Narang

Authors
  1. Harsimran Kaur
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  7. T. Karuna
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  9. Sunita Gupta
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  10. Anup Ghosh
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  11. Shivaprakash M. Rudramurthy
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Contributions

HK: Supervision, study design, manuscript writing and editing; PG: Data collection, data analysis, review of literature, manuscript writing; HA: Data collection, experiments, phylogenetic analysis; SAS: experiments, phylogenetic analysis; SS: Data collection; SSahu: Data collection; KT: Data collection; TN: Data collection, patient management, manuscript editing; SG: Experiment supervision; AG: Experiment Supervision and manuscript editing; SMR: Study design, experiment designing, reviewing of manuscript, supervision.

Corresponding author

Correspondence to Shivaprakash M. Rudramurthy.

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Conflict of interest

The authors have reported no conflicts of interest.

Ethical Approval

The study was approved by Institute Ethics Committee vide number IEC-04/2018-927.

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Kaur, H., Gupta, P., Ahmad, H. et al. Cladosporium halotolerans: Exploring an Unheeded Human Pathogen. Mycopathologia 188, 1027–1040 (2023). https://doi.org/10.1007/s11046-023-00801-6

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  • DOI: https://doi.org/10.1007/s11046-023-00801-6

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