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Acremonium Link ex Fries

Key Features: Hyphomycete with solitary, erect, hyaline, awl-shaped phialides


producing single-celled, globose to cylindrical conidia, mostly in slimy heads.

Antifungal Susceptibility: Acremonium spp. data from about 60 isolates


(Perdomo et al. 2011 and Australian National data); MIC µg/mL.

Antifungal Range MIC90 Antifungal Range MIC90


AmB 0.25-16 16 VORI 0.06-8 8
ITRA 0.25-16 16 POSA 0.125-8 16

References: Gams (1971), Domsch et al. (2007), Samson et al. (1995), de Hoog et al.
(2000, 2015), Glenn et al. (1996), Perdomo et al. (2011a), Summerbell et al. (2011).
Descriptions of Medical Fungi 1

Acremonium Link ex Fries


The genus Acremonium contains many species; most are saprophytic being isolated
from dead plant material and soil. Several species including A. recifei and A.
alabamense are recognised as opportunistic pathogens of man and animals, causing
mycetoma, mycotic keratitis and onychomycosis. Recently, several Acremonium-like
species recognised as opportunistic pathogens have been transferred to other genera;
Fusarium falciforme (formerly A. falciforme), Sarocladium kiliense (formerly
A. kiliense), Gliomastic roseogriseum (formerly A. roseogriseum) and Sarocladium
strictum (formerly A. strictum) (Glenn et al. 1996, Summerbell et al. 2011).
RG-2 for species isolated from humans.
Morphological Description: Colonies are usually slow growing, often compact and
moist at first, becoming powdery, suede-like or floccose with age, and may be white,
grey, pink, rose or orange in colour. Hyphae are fine and hyaline and produce mostly
simple awl-shaped erect phialides with inconspicuous collarettes. Conidia are usually
one-celled, hyaline or rarely pigmented, globose to cylindrical, and mostly aggregated
in slimy heads at the apex of each phialide. Chlamydospores may be present.
Comments: Microconidial Fusarium isolates may be confused with Acremonium, but
they usually grow faster and have colonies with a characteristic fluffy appearance.
Phialemonium species differ by having short, tapering phialides, mostly lacking a basal
septum. Coniochaeta is characterised by having sessile phialidic collarettes that are
formed directly on the hyphae.
Molecular Identification: Summerbell et al. (2011) revised the genus on the basis of
18S and D1/D2 sequence phylogeny. Sequence based identification may be
performed using the D1/D2 or the ITS region. Caution must be exercised in the
interpretation of database sequence comparisons due to the scarcity of database
sequences from well-characterised strains, and some sequences may have been
attributed to species that have been reclassified (Perdomo et al. 2011a).

10 µm

Acremonium spp. showing long awl-shaped phialides producing cylindrical, one-


celled conidia mostly aggregated in slimy heads at the apex of each phialide.
2 Descriptions of Medical Fungi

Acrophialophora fusispora (S.B. Saksena) Samson


The genus Acrophialophora contains 16 species that are most commonly associated
with soil, especially from India (Zhang et al. 2015a). Two species have been reported
as human pathogens, A. fusispora and A. levis (Sandoval-Denis et al. 2015). ITS
sequencing is recommended for species identification.
RG-1 organism.
Morphological Description: Colonies fast growing, greyish-brown with a black
reverse. Conidiophores arising singly, terminally and laterally from the hyphae, erect,
straight or slightly flexuose, tapering towards the apex, pale brown, rough-walled, up
to 15 μm long, 2-5 μm wide, with whorls of phialides on the upper part. Phialides flask-
shaped with a swollen base and a long, narrow neck, hyaline, smooth-walled or
echinulate, 9-15 x 3-4.5 μm in the broadest part. Conidia in long chains, limoniform,
one-celled, pale brown 5-12 x 3-6 μm, smooth to finely echinulate with indistinct spiral
bands. Temperature: optimum 40OC; maximum 50OC.
Key Features: Hyphomycete with flask-shaped phialides producing long chains of
one-celled, limoniform, pale brown conidia, with indistinct spiral bands. Note: In A.
levis the conidia lack spiral bands and the phialides have verruculose walls.
Molecular Identification: D1/D2, ITS, 18S and β-tubulin sequences have been
reported by Sandoval-Denis et al. (2015) and Zhang et al (2015a).
References: Domsch et al. (2007), de Hoog et al. (2000, 2015), Al-Mohsen et al.
(2000), Guarro et al. (2007), Sandoval-Denis et al. (2015), Zhang et al. (2015a).

b 10 μm a

Acrophialophora fusispora (a) culture and (b)


phialides and conidia with spiral striations (arrows).
Antifungal Susceptibility: A. fusispora data from about 40 isolates (Sandoval-
Denis et al. 2015 and Australian National data); MIC µg/mL.
Antifungal Range MIC90 Antifungal Range MIC90
AmB 1-32 16 VORI 0.06-0.5 0.25
ITRA 0.125-4 1 POSA 0.25-1 1
Descriptions of Medical Fungi 3

Alternaria Nees ex Fries

A ubiquitous genus containing common saprophytes in soil and air, and plant
pathogens. A. infectoria is the most common clinical species (Pastor and Guarro,
2008). Although usually seen as saprophytic contaminants, Alternaria species in
particular A. alternata and A. infectoria are recognised causative agents of
subcutaneous phaeohyphomycosis and mycotic keratitis. They are a rare cause of
onychomycosis, usually following trauma to the nail.

RG-1 organisms.

Morphological Description: Colonies are fast growing, black to olivaceous-black or


greyish, and are suede-like to floccose. Microscopically, branched acropetal chains
(blastocatenate) of multicellular conidia (dictyoconidia) are produced sympodially from
simple, sometimes branched, short or elongate conidiophores. Conidia are obclavate,
obpyriform, sometimes ovoid or ellipsoidal, often with a short conical or cylindrical
beak, pale brown, smooth-walled or verrucose. Temperature: optimum 25-28OC;
maximum 31-32OC.

Molecular Identification: Multilocus genotype studies have shown the Alternaria


complex currently comprises nine genera and eight Alternaria sections (Woudenbert
et al. 2013). ITS sequencing is sufficient for genus and usually species level
identification and can clearly differentiate A. alternata and A. infectoria (Pastor and
Guarro, 2008). However, it is estimated that >14% of GenBank sequences of Alternaria
species are misclassified, so unknown sequences should be compared to those of
well-characterised reference strains (Woudenberg et al. 2013).

Comments: Alternaria species soon lose their ability to sporulate in culture. Potato
dextrose agar and cornmeal agar are the most suitable media to use, and incubation
under ultra-violet light is recommended to maintain sporulation.

Key Features: Dematiaceous hyphomycete producing chains of darkly pigmented,


ovoid to obclavate dictyoconidia, often with short conical or cylindrical beaks.

References: Simmons (1967, 2007), Ellis (1971), Domsch et al. (2007), Samson et al.
(1995), de Hoog et al. (2000, 2015), Pryor and Gilbertson (2000), de Hoog and Horre
(2002), Pastor and Guarro (2008), Woudenberg et al. (2013).

Antifungal Susceptibility: Alternaria spp. (Australian National data); MIC µg/mL.

No <0.008 0.016 0.03 0.06 0.125 0.25 0.5 1 2 4 >8

AmB 10 3 1 4 2
VORI 10 1 3 5 1
POSA 9 2 1 5 1
ITRA 10 1 1 2 5 1
4 Descriptions of Medical Fungi
Alternaria Nees ex Fries

Alternaria alternata colonies are black to olivaceous-black or


greyish, and are suede-like to floccose.

20 μm

Alternaria alternata showing branched acropetal chains and


multicelled, obclavate to obpyriform conidia with short conical beaks.