Trichosporon Urinary Tract Infections: A Hidden Menace Revealed

TL;DR

This review highlights the risks and challenges of Trichosporon urinary tract infections, especially in vulnerable patients, and emphasizes the need for accurate diagnosis and effective treatment.

Contribution

The study identifies T. asahii G1 as the main cause of Trichosporon UTIs and evaluates drug resistance patterns and diagnostic methods.

Findings

T. asahii G1 is the most common Trichosporon species causing UTIs.

Prolonged hospitalization and immunosuppressive drug use are key risk factors.

Voriconazole shows the best in vitro activity against T. asahii isolates.

Abstract

Urinary tract infections (UTIs) caused by Trichosporon are a significant concern for hospitalized patients and those with weakened immune systems. This narrative review study aims to provide a comprehensive overview of UTIs caused by Trichosporon, including its frequency, risk factors, laboratory diagnostic aspects, drug resistance, and the importance of accurate identification in clinical settings. A search of international databases was conducted to identify relevant studies, and it was found that Trichosporon asahii, specifically the G1 type, is the predominant causative agent of UTIs among various Trichosporon species. Prolonged hospitalization and immunosuppressive drug use were identified as significant risk factors for this fungal infection. Conventional methods for laboratory identification are commonly used. Still, rapid and accurate tools such as Matrix-Assisted Laser Desorption-Ionisation-Time of Flight Mass Spectrometry (MALDI-TOF MS) and DNA sequencing can improve the diagnostic process. Against all T. asahii isolates for which this triazole, polyene, and echinocandin were tested, voriconazole demonstrated the most potent in vitro activity, while amphotericin B had high MIC values and echinocandins had inherent resistance. This review provides valuable insights into the clinical significance and management of UTIs caused by Trichosporon.

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