Molecular profile and phylogenetic analysis of Fusarium species recovered from air and isolated from blood cultures of immunocompromised patients

Abstract

Fusarium species can cause invasive infections with high mortality rates in patients with severe and persistent neutropenia. From 2006 to 2013, 34 patients from Hospital de Clínicas - Unicamp were diagnosed with invasive fusariosis. The incidence density in our hospital was surprisingly higher than most hospitals worldwide. Considering that the quality of the environment can have a direct and significant influence on the occurrence of nosocomial infections, the aim of this study is to evaluate the hospital air as a potential environmental source of fusariosis in immunocompromised patients by molecular techniques. We will evaluate 32 isolates of Fusarium spp. recovered from hospital air (N=14) and patient's blood cultures (N=18) at Hospital de Clínicas, Unicamp, Campinas - SP. Fifteen clinical isolates and 13 environmental samples were identified as F. solani; three clinical samples and one environmental isolate were classified as F. napiforme. Fungi samples will be submitted to sequencing of ITS and D1/D2 regions of ribosomal DNA and haplotypes will be generated for each isolate by using MLST methodology. The evolutionary relatedness between clinical and air samples will be addressed with MEGA5 software (http://www.megasoftware.net/). By using this approach, we intend to establish a clonal relation for clinical and environmental isolates, as well as to confirm the hospital air as a source of Fusarium spp. infection in immunocompromised patients and stress the relevance of a controlled environment in health services. To the best of our knowledge, there are no studies describing a genetic relation between air and clinical samples of Fusarium spp.