Article

Brief Communication

Ann Lab Med 2016; 36(1): 60-63

Published online January 1, 2016 https://doi.org/10.3343/alm.2016.36.1.60

Copyright © Korean Society for Laboratory Medicine.

Identification of Mucorales From Clinical Specimens: A 4-Year Experience in a Single Institution

Mina Yang, M.D.1,*, Jang Ho Lee, M.T.2,*, Young-Kwon Kim, M.T.3, Chang-Seok Ki, M.D.1, Hee Jae Huh, M.D.1, and Nam Yong Lee, M.D.1

Department of Laboratory Medicine and Genetics1, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; Department of Clinical Laboratory Science2, Semyung University, Jecheon; Department of Biomedical Laboratory Science3, Konyang University, Daejeon, Korea

Correspondence to: Nam Yong Lee
Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea
Tel: +82-2-3410-2706
Fax: +82-2-3410-2719
E-mail: micro.lee@samsung.com

Hee Jae Huh
Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea
Tel: +82-2-3410-1836
Fax: +82-2-3410-2719
E-mail: pmhhj@gmail.com

*These authors contributed equally to this work.

Received: March 19, 2015; Revised: July 28, 2015; Accepted: September 16, 2015

Abstract

Mucormycosis, a fatal opportunistic infection in immunocompromised hosts, is caused by fungi belonging to the order Mucorales. Early diagnosis based on exact identification and multidisciplinary treatments is critical. However, identification of Mucorales fungi is difficult and often delayed, resulting in poor prognosis. This study aimed to compare the results of phenotypic and molecular identification of 12 Mucorales isolates collected from 4-yr-accumulated data. All isolates were identified on the basis of phenotypic characteristics such as growth rate, colony morphology, and reproductive structures. PCR and direct sequencing were performed to target internal transcribed spacer (ITS) and/or D1/D2 regions. Target DNA sequencing identified five Lichtheimia isolates, two Rhizopus microsporus isolates, two Rhizomucor pusillus isolates, one Cunninghamella bertholletiae isolate, one Mucor fragilis isolate, and one Syncephalastrum racemosum isolate. Five of the 12 (41.7%) isolates were incorrectly identified on the basis of phenotypic identification. DNA sequencing showed that of these five isolates, two were Lichtheimia isolates, one was Mucor isolate, one was Rhizomucor isolate, and one was Rhizopus microspores. All the isolates were identified at the species level by ITS and/or D1/D2 analyses. Phenotypic differentiation and identification of Mucorales is difficult because different Mucorales share similar morphology. Our results indicate that the molecular methods employed in this study are valuable for identifying Mucorales.

Keywords: Mucorales, Mucormycosis, Mycological typing