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Abstract：
Although Cyberlindnera fabinaii is a rare opportunist yeast species, its ability to cause septicemia, produce biofilm, and rapid acquisition of resistance to fluconazole and voriconazole, reinforced the urge for its identification from its closely related species. Widely used biochemical assays mainly identify Cyberlindnera fabinaii as Cyberlindnera jadinii and Wickerhamomyces anomalus, resulting in underestimation of this yeast in clinical settings. Moreover, the urge for a reliable molecular means of identification remains unsolved for 28 years. In order to unequivocally differentiate Cy. fabianii, Cy. mississipiensis, Cy. jadinii, and W. anomalus, we designed a dual-function multiplex polymerase chain reaction (PCR) assay. Challenging our dual-function multiplex PCR assay with 30 most clinically important yeast species, proved its specificity. Although conventional PCR could differentiate four target species, the real-time PCR counterpart due to Tm overlap misidentified Cy. mississipiensis as Cy. jadinii. Alongside of presenting a comprehensive literature review of published cases of Cy. fabianii from 1990 to 2018, we collected various clinical isolates from Tehran, Shiraz, and Fasa (July 1, 2017, to December 31, 2017) to find a passive relative distribution of these closely-related species in Iran. Subjecting our Iranian collection of yeast isolates to matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) MS and LSU and ITS rDNA sequencing revealed six isolates of Cy. fabianii (central venous catheter n = 2 and vaginal swabs n = 4) and one isolate of Cy. jadinii (vaginal swabs). Due to the use of biochemical assays in global ARTEMIS study, we encourage reidentification of clinical isolates of Cy. jadinii and Cy. jadinii using MALDI-TOF or Sanger sequencing that might lead to correcting the distribution of this fungus.
摘要：
尽管Cyberlindnerafabinaii是一种罕见的机会主义酵母，导致败血症的能力,产生生物膜，快速获得对氟康唑和伏立康唑的耐药性，加强了从其密切相关的物种中识别它的冲动。广泛使用的生化测定法主要将Cyberlindnerafabinaii鉴定为Cyberlindnerajadinii和Wickerhamomyces，导致在临床上低估了这种酵母。此外，28年来，对可靠分子鉴定手段的渴望仍未解决。为了明确区分Cy。Fabianii,Cy.密西西比州,Cy.Jadinii,和W.异常，我们设计了一种双功能多重聚合酶链反应（PCR）检测方法。挑战我们的双功能多重PCR检测与30个临床上最重要的酵母物种，证明了它的特殊性。尽管常规PCR可以区分四种目标物种，由于Tm重叠导致的实时PCR对应物错误鉴定了Cy。密西西比州作为Cy。Jadinii.除了对已发表的Cy案例进行全面的文献综述。从1990年到2018年，我们从德黑兰收集了各种临床分离株，设拉子,和Fasa（2017年7月1日至2017年12月31日），以发现这些密切相关的物种在伊朗的被动相对分布。对我们的伊朗酵母分离株进行基质辅助激光解吸/电离飞行时间（MALDI-TOF）MS和LSU以及ITSrDNA测序，发现了六个Cy分离株。fabianii（中心静脉导管n=2，阴道拭子n=4）和一个分离的Cy。jadinii（阴道拭子）。由于在全球ARTEMIS研究中使用生化测定，我们鼓励重新鉴定Cy的临床分离株。Jadinii和Cy.jadinii使用MALDI-TOF或Sanger测序可能导致纠正这种真菌的分布。
