Aspergillus citrinoterreus, a New Species of Section Terrei Isolated from Samples of Patients with Nonhematological Predisposing Conditions

Abstract

The use of molecular identification techniques has revealed an increasing number of new species withinAspergillussectionTerrei. We phenotyped a set of 26 clinical isolates that showed genetic differences fromAspergillus terreussensu strictoby analyzing sequences from PCR-amplified β-tubulin and calmodulin genes and the internal transcribed spacer region. Since the isolates were phylogenetically and morphologically different from all of the members ofAspergillussectionTerrei, they are described here as a new species,Aspergilluscitrinoterreus, so named because it produces a diffusible yellowish pigment in agar.A. citrinoterreusisolates were significantly more susceptible to itraconazole, voriconazole, and posaconazole thanA. terreussensu strictoisolates were; in contrast, the amphotericin B MICs for both species were high.A. citrinoterreuswas found in clinical samples from patients with proven or probable invasive aspergillosis and colonized patients, none of whom had hematological malignancies as predisposing conditions. However, they did have other underlying conditions such as chronic obstructive pulmonary disease, cirrhosis, and cancer or had received a solid organ transplants and presented not only with invasive pulmonary aspergillosis but also with mediastinitis.A. citrinoterreusisolates were detected for the first time in 2002. In all cases of invasive aspergillosis,A. citrinoterreuswas found to be a copathogen, mostly withA. fumigatus.