Yasmim Passos Lima

Background: The Trichosporonaceae family includes genera such as Trichosporon, Apiotrichum, and Cutaneotrichosporon, which are components of the human microbiota but may cause infections under conditions such as immunosuppression, prolonged hospitalization, invasive procedures, and broad-spectrum antimicrobial use. Objectives: This study aimed to describe the clinical and epidemiological characteristics of hospitalized and outpatient individuals with positive cultures for Trichosporonaceae species in Juiz de Fora, Minas Gerais, Brazil, and to correlate these findings with antifungal susceptibility profiles. Methods: Clinical isolates collected between 2020 and 2023 were identified using the Vitek 2^® system, and antifungal susceptibility was assessed by disk diffusion. Clinical and epidemiological data were obtained from electronic health records. Results: Among 40 isolates, Trichosporon asahii predominated (92.5%). Most cases involved hospitalized individuals (83.8%), mainly from intensive care units (81.8%). Respiratory infections and acute renal failure were the most common reasons for admission. The mean hospital stay was 34.8 days, and overall mortality reached 51.6%. Most individuals were male (77.5%) and older than 61 years (57.5%). Urine was the most frequent specimen (52.5%), and invasive infections predominated (87.5%). Corticosteroid use and invasive devices were common, and prior antibiotic use occurred in most cases. Only 35.0% of patients received antifungal therapy, predominantly fluconazole. Conclusions: Trichosporonaceae infections, particularly those caused by T. asahii, are associated with critically ill patients and high mortality, highlighting the need for early diagnosis, appropriate therapy, and continuous surveillance.

Background: Trichosporon spp. are opportunistic fungi, capable of causing infection, especially in critically ill individuals who often use broad-spectrum antibiotics, invasive devices, and have comorbidities. Objectives The aim of this study was to analyze individuals’ clinical characteristics, evaluate tolerance to biocides, as well as biofilm formation and efflux pump activity in isolates of Trichosporon asahii. Methods: Clinical isolates of T. asahii collected between 2020 and 2023 from both hospitalized and non-hospitalized individuals, of both sexes, regardless of age, were tested for tolerance to sodium hypochlorite, hydrogen peroxide, benzalkonium chloride, and ethyl alcohol. Efflux pump activity was also assessed using ethidium bromide, and biofilm formation was measured with the Safranin test. Clinical parameters such as outcomes, source, and length of hospitalization were analyzed through electronic medical records. Results: A total of 37 clinical isolates of T. asahii were identified. Thirty-three (83.8%) isolates were from hospitalized individuals, with 81.82% collected in ICUs, an average hospital stay of 35 days, and a mortality rate of 51.6%. The tested strains displayed the largest mean inhibition zone for 2% sodium hypochlorite, indicating lower tolerance. A high level of efflux pump expression was detected among clinical isolates. Biofilm formation was detected in 25/67.5% of the isolates. Conclusions: These findings highlight the clinical relevance of T. asahii, particularly in critically ill individuals, and underscore the pathogen’s ability to tolerate biocides, express efflux pumps, and form biofilms, all of which may contribute to its persistence and pathogenicity in hospital environments. Enhanced surveillance and effective microbial control measures are essential to mitigate the risks associated with T. asahii infections.