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Human Blastomycosis in South Africa Caused by Blastomyces percursus and Blastomyces emzantsi sp. nov., 1967 to 2014.

Publication ,  Journal Article
Maphanga, TG; Birkhead, M; Muñoz, JF; Allam, M; Zulu, TG; Cuomo, CA; Schwartz, IS; Ismail, A; Naicker, SD; Mpembe, RS; Corcoran, C; de Hoog, S ...
Published in: J Clin Microbiol
February 24, 2020

We reevaluated 20 cases of blastomycosis diagnosed in South Africa between 1967 and 2014, with Blastomyces dermatitidis considered to be the etiological agent, in light of newly described species and the use of more advanced technologies. In addition to histopathological and/or culture-based methods, all 20 isolates were phenotypically and genotypically characterized, including multilocus typing of five genes and whole-genome sequencing. Antifungal susceptibility testing was performed as outlined by Clinical and Laboratory Standards Institute documents M27-A3 and M38-A2. We merged laboratory and corresponding clinical case data, where available. Morphological characteristics and phylogenetic analyses of five-gene and whole-genome sequences revealed two groups, both of which were closely related to but distinct from B. dermatitidis, Blastomyces gilchristii, and Blastomyces parvus The first group (n = 12) corresponded to the recently described species Blastomyces percursus, and the other (n = 8) is described here as Blastomyces emzantsi sp. nov. Both species exhibited incomplete conversion to the yeast phase at 37°C and were heterothallic for mating types. All eight B. emzantsi isolates belonged to the α mating type. Whole-genome sequencing confirmed distinct species identities as well as the absence of a full orthologue of the BAD-1 gene. Extrapulmonary (skin or bone) disease, probably resulting from hematogenous spread from a primary lung infection, was more common than pulmonary disease alone. Voriconazole, posaconazole, itraconazole, amphotericin B, and micafungin had the most potent in vitro activity. Over the 5 decades, South African cases of blastomycosis were caused by species that are distinct from B. dermatitidis Increasing clinical awareness and access to simple rapid diagnostics may improve the diagnosis of blastomycosis in resource-limited countries.

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Published In

J Clin Microbiol

DOI

EISSN

1098-660X

Publication Date

February 24, 2020

Volume

58

Issue

3

Location

United States

Related Subject Headings

  • South Africa
  • Phylogeny
  • Microbiology
  • Male
  • Humans
  • Blastomycosis
  • Blastomyces
  • 3207 Medical microbiology
  • 3202 Clinical sciences
  • 11 Medical and Health Sciences
 

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Maphanga, T. G., Birkhead, M., Muñoz, J. F., Allam, M., Zulu, T. G., Cuomo, C. A., … Govender, N. P. (2020). Human Blastomycosis in South Africa Caused by Blastomyces percursus and Blastomyces emzantsi sp. nov., 1967 to 2014. J Clin Microbiol, 58(3). https://doi.org/10.1128/JCM.01661-19
Maphanga, Tsidiso G., Monica Birkhead, José F. Muñoz, Mushal Allam, Thokozile G. Zulu, Christina A. Cuomo, Ilan S. Schwartz, et al. “Human Blastomycosis in South Africa Caused by Blastomyces percursus and Blastomyces emzantsi sp. nov., 1967 to 2014.J Clin Microbiol 58, no. 3 (February 24, 2020). https://doi.org/10.1128/JCM.01661-19.
Maphanga TG, Birkhead M, Muñoz JF, Allam M, Zulu TG, Cuomo CA, et al. Human Blastomycosis in South Africa Caused by Blastomyces percursus and Blastomyces emzantsi sp. nov., 1967 to 2014. J Clin Microbiol. 2020 Feb 24;58(3).
Maphanga, Tsidiso G., et al. “Human Blastomycosis in South Africa Caused by Blastomyces percursus and Blastomyces emzantsi sp. nov., 1967 to 2014.J Clin Microbiol, vol. 58, no. 3, Feb. 2020. Pubmed, doi:10.1128/JCM.01661-19.
Maphanga TG, Birkhead M, Muñoz JF, Allam M, Zulu TG, Cuomo CA, Schwartz IS, Ismail A, Naicker SD, Mpembe RS, Corcoran C, de Hoog S, Kenyon C, Borman AM, Frean JA, Govender NP. Human Blastomycosis in South Africa Caused by Blastomyces percursus and Blastomyces emzantsi sp. nov., 1967 to 2014. J Clin Microbiol. 2020 Feb 24;58(3).

Published In

J Clin Microbiol

DOI

EISSN

1098-660X

Publication Date

February 24, 2020

Volume

58

Issue

3

Location

United States

Related Subject Headings

  • South Africa
  • Phylogeny
  • Microbiology
  • Male
  • Humans
  • Blastomycosis
  • Blastomyces
  • 3207 Medical microbiology
  • 3202 Clinical sciences
  • 11 Medical and Health Sciences