<p>Melanized or black fungi are a heterogeneous group of fungi causing cutaneous to systemic diseases with high mortality. These fungi are rarely reported as agent of human infections primarily due to difficulties in their classical identification. In this study we examined using molecular methods and MALDI-TOF MS the diversity of melanized fungi (MF) isolated from patients in 19 medical centers in India. Overall, during a 4-year period, 718 (5.3%) clinical specimens yielded MF. Of these, 72 (10%) isolates had clinical significance and were identified primarily by sequencing the ITS and LSU regions. MF represented 21 genera comprising 29 species, the majority of them belonging to the order Pleosporales (50%) and Chaetothyriales (22%). Among the 29 fungal species identified in this study only 6 (20%) species were identified by the MALDI-TOF MS due to the limited commercial database of Bruker Daltonics for MF. However, a 100% identification rate of 20 additional species identified in this study was obtained by constructing an in house data base using 24-96 hour old liquid cultures. Further, CLSI micro-broth dilution method revealed low MIC values for POS (≤1 μg/ml) and VRC (≤2 μg/ml) in 96% and 95% isolates respectively. Skin/subcutaneous and sino-nasal and pulmonary phaeohyphomycosis due to MF were diagnosed in 21.4% (n=15) and 28.5% (n=20) cases. Also, 10% of patients had CNS involvement (n=7) and 3 cases of fungal osteomyelitis due to Cladophialophora bantiana and Corynespora spp. were observed.</p>
A. Singh, Singh, P. Kumar, Kumar, A., Chander, J., Khanna, G., Roy, P., Meis, J. F., and Chowdhary, A., “Molecular and Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry Characterization of Clinically Significant Melanized Fungi in India.”, J Clin Microbiol, 2017.