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Trichosporon Urinary Tract Infections: A Hidden Menace Revealed

Summary

Trichosporon is a fungus that causes urinary tract infections primarily in hospitalized patients and those with weakened immune systems. This review found that Trichosporon asahii is the most common species responsible for these infections, especially in patients with prolonged hospital stays or using immunosuppressive medications. The drug voriconazole works best against this fungus, while some common antifungal medications like amphotericin B are less effective. Accurate identification using modern laboratory techniques is crucial for proper treatment.

Background

Urinary tract infections (UTIs) caused by Trichosporon are a significant concern for hospitalized patients and those with weakened immune systems. Trichosporon species are opportunistic pathogens that can result in invasive diseases, particularly in immunocompromised patients, with crude mortality rates ranging from 42% to 87%.

Objective

This narrative review aims to provide a comprehensive overview of UTIs caused by Trichosporon, including frequency, risk factors, laboratory diagnostic aspects, drug resistance patterns, and the importance of accurate identification in clinical settings.

Results

Trichosporon asahii, specifically the G1 genotype (>69% of isolates), is the predominant causative agent of UTIs. Prolonged hospitalization and immunosuppressive drug use are significant risk factors. Voriconazole demonstrated the most potent in vitro activity against T. asahii, while amphotericin B showed high MIC values and echinocandins exhibited inherent resistance.

Conclusion

Accurate identification of Trichosporon species is crucial for appropriate treatment as different species exhibit varying antifungal susceptibility. Molecular techniques like MALDI-TOF MS and DNA sequencing provide rapid and accurate diagnosis. The review highlights the clinical significance and management challenges of UTIs caused by Trichosporon, emphasizing the need for comprehensive research on prevalence, identification methods, and antifungal susceptibility testing.
  • Published in:Iran Journal of Pathology,
  • Study Type:Narrative Review,
  • Source: 10.30699/ijp.2025.2039595.3348, PMID: 41104092
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