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    Rapid and Robust Identification of the Agents of Black-Grain Mycetoma by Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry.
    J Clin Microbiol 2017 Aug 7;55(8):2521-2528. Epub 2017 Jun 7.
    PHE Mycology Reference Laboratory, Bristol, United Kingdom.
    Eumycetoma, a chronic fungal infection endemic in India, Indonesia, and parts of Africa and South and Central America, follows traumatic implantation of saprophytic fungi and frequently requires radical surgery or amputation in the absence of appropriate treatment. Fungal species that can cause black-grain mycetomas include Madurella spp., Falciformispora spp., Trematosphaeria grisea, Nigrograna mackinnonii, Pseudochaetosphaeronema larense, Medicopsis romeroi, and Emarellia spp. Rhytidhysteron rufulum and Parathyridaria percutanea cause similar subcutaneous infections, but these infections lack the draining sinuses and fungal grains characteristic of eumycetoma. Accurate identification of the agents of subcutaneous fungal infection is essential to guide appropriate antifungal therapy. Since phenotypic identification of the causative fungi is often difficult, time-consuming molecular approaches are currently required. In the study described here we evaluated whether matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry might allow the accurate identification of eumycetoma agents and related fungi. A panel of 57 organisms corresponding to 10 different species from confirmed cases of eumycetoma and subcutaneous pedal masses, previously formally identified by PCR amplification and sequencing of internal transcribed spacer 1 (ITS1), was employed. Representative isolates of each species were used to create reference MALDI-TOF spectra, which were then used for the identification of the remaining isolates in a user-blinded manner. Here, we demonstrate that MALDI-TOF mass spectrometry accurately identified all of the test isolates, with 100%, 90.4%, and 67.3% of isolates achieving log scores greater than 1.8, 1.9, and 2.0, respectively.

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    PHE Mycology Reference Laboratory, Bristol, United Kingdom.
    Eumycetoma is a debilitating, chronic, fungal infection that is endemic in India, Indonesia, and parts of Africa and South and Central America. It remains a neglected tropical disease in need of international recognition. Infections follow traumatic implantation of saprophytic fungi and frequently require radical surgery or amputation in the absence of appropriate treatment. Read More
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    CBS-KNAW Fungal Biodiversity Centre, Uppsalalaan 8, 3584 CT Utrecht, The Netherlands. ; Institute for Biodiversity and Ecosystem Dynamics, University of Amsterdam, The Netherlands. ; Peking University Health Science Center, Research Center for Medical Mycology, Beijing, China; Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China; Shanghai Institute of Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China; Basic Pathology Department, Federal University of Paraná State, Curitiba, Paraná, Brazil; King Abdulassiz University, Jeddah, Saudi Arabia.
    Eumycetoma is a chronic fungal infection characterised by large subcutaneous masses and the presence of sinuses discharging coloured grains. The causative agents of black-grain eumycetoma mostly belong to the orders Sordariales and Pleosporales. The aim of the present study was to clarify the phylogeny and taxonomy of pleosporalean agents, viz. Read More
    Rapid Identification of Clinically Relevant Members of the Genus Exophiala by Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry and Description of Two Novel Species, Exophiala campbellii and Exophiala lavatrina.
    J Clin Microbiol 2017 Apr 25;55(4):1162-1176. Epub 2017 Jan 25.
    PHE UK National Mycology Reference Laboratory, Bristol, United Kingdom.
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    PLoS Negl Trop Dis 2014 Dec 4;8(12):e3368. Epub 2014 Dec 4.
    Peking University Health Science Center, Research Center for Medical Mycology, Beijing, China; Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China; Shanghai Institute of Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China; Basic Pathology Department, Federal University of Paraná State, Curitiba, Brazil; King Abdulaziz University, Jeddah, Saudi Arabia.
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