ABSTRACT Rare emerging pathogens such as Saprochaete clavata are associated with invasive
fungal diseases, high
morbidity,
mortality, rapidly fatal
infections, and
outbreaks. However, little is known about S. clavata
infections,
epidemiology,
risk factors,
treatment,
biofilms, and
disease outcomes. The objective of this study was to describe a new case of severe S. clavata
infection in a
patient diagnosed at a
referral children's
hospital in
Brazil, including antifungal minimal inhibitory concentration, S. clavata
biofilm characterization, and molecular characterization. The S. clavata isolated from an immunocompromised 11-year-old
male patient was characterized using
MALDI-TOF, Gram
staining,
scanning electron microscopy (SEM), and
next generation sequencing (NGS) of genomic
DNA.
Biofilm production was also evaluated in parallel with determining minimal inhibitory concentration (MIC) and
biofilm sensitivity to antifungal
treatment. We observed small to medium, whitish, farinose, dry, filamentous margin colonies,
yeast-like
cells with bacillary features, and
biofilm formation. The
MALDI-TOF system yielded a score of ≥ 2,000, while NGS confirmed S. clavata presence at the
nucleotide level. The MIC values (in mg L-1) for tested
drugs were as follows
fluconazole = 2,
voriconazole ≤ 2,
caspofungin ≥ 8,
micafungin = 2,
amphotericin B = 4,
flucytosine ≤ 1, and
anidulafungin = 1.
Amphotericin B can be active against S. clavata
biofilm and the
fungus can be susceptible to new
azoles. These findings were helpful for
understanding the development of novel
treatments for S. clavata-induced
disease, including combined
therapy for
biofilm-associated
infections.