MALDI-TOF MS-Based Clustering and Antifungal Susceptibility Tests of Talaromyces marneffei Isolates from Fujian and Guangxi (China)

Lili Fang; Minxue Liu; Chunlan Huang; Xiaobo Ma; Yanqing Zheng; Wenjuan Wu; Jian Guo; Jiangshan Huang; Heping Xu

doi:10.2147/IDR.S364439

MALDI-TOF MS-Based Clustering and Antifungal Susceptibility Tests of Talaromyces marneffei Isolates from Fujian and Guangxi (China)

Infect Drug Resist. 2022 Jul 1:15:3449-3457. doi: 10.2147/IDR.S364439. eCollection 2022.

Authors

Lili Fang^#^{1

2

3}, Minxue Liu^#⁴, Chunlan Huang^#⁵, Xiaobo Ma^{1

2

3}, Yanqing Zheng^{1

2

3}, Wenjuan Wu⁶, Jian Guo^#⁶, Jiangshan Huang^{1

2

3}, Heping Xu^{1

2

3}

Affiliations

¹ Department of Laboratory Medicine, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, People's Republic of China.
² Xiamen Key Laboratory of Genetic Testing, Xiamen, Fujian, People's Republic of China.
³ School of Public Health, Xiamen University, Xiamen, Fujian, People's Republic of China.
⁴ The Maternal & Child Health Hospital, The Children's Hospital, The Obstetrics & Gynecology Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, People's Republic of China.
⁵ Department of Clinical Laboratory, Liuzhou People's Hospital, Liuzhou, Guangxi, People's Republic of China.
⁶ Department of Laboratory Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China.

^# Contributed equally.

Abstract

Introduction: Talaromyces marneffei is a life-threatening pathogen that causes systemic talaromycosis in immunocompromised and acquired immunodeficiency syndrome (AIDS) patients. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) as a tool to cluster T. marneffei isolates is rarely reported and the data on antifungal susceptibility of T. marneffei isolated in the southern region of China, especially in Fujian, is hardly found.

Methods: MALDI-TOF MS was used to cluster 135 T. marneffei isolates, and the minimum inhibitory concentration (MIC) values of amphotericin B, itraconazole, posaconazole, voriconazole, fluconazole, anidulafungin, micafungin, caspofungin and 5-fluorocytosine with Sensititre YeastOne™ YO10 assay were measured during January 2017 to October 2020 in Fujian and Guangxi.

Results: MALDI-TOF MS correctly identified 100% of the T. marneffei isolates. Hierarchical clustering of MALDI-TOF peak profiles identified four different clusters. MICs for itraconazole, posaconazole, voriconazole and amphotericin B were as follows: ≤0.015-0.03 μg/mL, ≤0.008-0.03 μg/mL, ≤0.008-0.06 μg/mL, ≤0.12-1 μg/mL, respectively. MICs for echinocandins and fluconazole were comparatively high.

Conclusion: Since only simple sample preparation is required and since results are available in a short period of time, MALDI-TOF MS can be considered as a method for identification and clustering of T. marneffei. Itraconazole, posaconazole, voriconazole and amphotericin B can be used to treat T. marneffei infected patients due to the low MICs.

Keywords: HIV-infected; MALDI-TOF; Talaromyces marneffei; antifungal susceptibility; non-HIV-infected.

Grants and funding

This work was supported by (1) the Fujian Health Education Joint Research Project [2019-WJ-42], (2) the Fujian Province Natural Science Foundation of China [2020J011233], (3) Guangxi Health Commission Key Lab of Fungi and Mycosis Research and Prevention [ZZH2020004], and (4) the First Affiliated Hospital of Guangxi Medical University Provincial and Ministerial Key Laboratory Cultivation Project: Guangxi Key Laboratory of Tropical Fungi and Mycosis Research [YYZS2020006].