Growth inhibition of Trichophyton species by Pseudomonas aeruginosa

OBJECTIVE

To assess the ability of Pseudomonas aeruginosa to inhibit the growth of Trichophyton mentagrophytes (TM) and Trichophyton rubrum (TR).

DESIGN

Pseudomonas aeruginosa, Escherichia coli, or Staphylococcus epidermidis were grown in co-culture with either TM or TR.

SETTING

An academic medical center.

MAIN OUTCOME MEASURES

The total fungal units and hyphal-spore ratio were measured at days 1, 5, 10, and 15.

RESULTS

There was a 73% and 46% reduction of total fungal units and a final hyphal-spore ratio of 0.16 and 0.04, respectively, when TM and TR were co-cultured with P aeruginosa. The number of fungal units increased when TM and TR were cultured with E coli (28% and 42%, respectively), S epidermidis (13% and 18%, respectively), and control media (44% and 62%, respectively), and the hyphal-spore ratio increased to above 30 in the presence of S epidermidis, E coli, and control media.

CONCLUSION

Pseudomonas aeruginosa exhibits growth inhibitory properties against TM and TR.

Isolation, characterization and antifungal activity of Streptomyces sampsonii GS 1322

For new antifungal antibiotics from actinomycetes, a strain of Streptomyces GS 1322 was isolated from a sample of garden soil. The strain was found to possess antagonistic activity against four fungi i.e., Candida albicans, Aspergillus niger, Microsporum gypseum and Trichophyton sp. The strain was identified as Streptomyces sampsonii and the antifungal compound produced by it was found to be the heptaene group of polyene antibiotics.

Five-hour diagnosis of dermatophyte nail infections with specific detection of Trichophyton rubrum

A rapid two-step DNA extraction method and a multiplex PCR for the detection of dermatophytes in general and Trichophyton rubrum specifically were developed and evaluated with DNA extracted from pure cultures and from clinically diseased nails. DNA from the following dermatophytes was used: Epidermophyton floccosum, Microsporum audouinii, Microsporum canis, Microsporum gypseum, Microsporum nanum, Trichophyton mentagrophytes, Trichophyton rubrum, Trichophyton schoenleinii, Trichophyton soudanense, Trichophyton terrestre, Trichophyton tonsurans, Trichophyton verrucosum, and Trichophyton violaceum. Human DNA and DNA from the following nondermatophyte fungi were included as controls: Alternaria, Aspergillus niger, Candida albicans, Candida glabrata, Candida krusei, Malassezia furfur, Saccharomyces cerevisiae, and Scopulariopsis brevicaulis. A total of 118 nail samples received for routine microscopy and culture for dermatophytes were subsequently tested by the two PCRs separately and in a multiplex format. Using DNA extracted from pure cultures and the pan-dermatophyte PCR, the T. rubrum-specific PCR sequentially and in a multiplex format correctly detected all dermatophytes and additionally correctly identified T. rubrum. Comparison of the traditional diagnostic evaluation (microscopy and culture) of nail samples with PCR on DNA directly extracted from the nails showed excellent agreement between PCR and microscopy, but the number of samples with dermatophyte species identification was increased considerably from 22.9% to 41.5%, mainly due to the identification of T. rubrum by PCR in microscopy-positive but culture-negative samples. In conclusion, this 5-hour diagnostic test was shown to increase not only the speed but also the sensitivity of investigation for nail dermatophytosis.

The pH signaling transcription factor PacC mediates the growth of Trichophyton rubrum on human nail in vitro

We report here the isolation, molecular cloning and initial characterization of the Trichophytonrubrum pacC gene, which encodes a putative protein that is homologous to the PacC/Rim101p family of pH signaling transcription regulators. The promoter region of the T. rubrumpacC gene contains four recognition sites 5'-GCCAAG-3' for the PacC protein, suggesting that the transcription of this gene itself could be induced under alkaline growth conditions. The enhanced expression profile of the T. rubrumpacC gene in an alkaline environment was confirmed by Northern blotting analysis. We also report that the disruption of pacC gene decreased both the secretion of keratinolytic proteases and the ability of the mutant pacC-1 to grow on human nail fragments as the sole source of nutrition, i.e., growth of the dermatophyte T. rubrum appear to be related to molecular events which depend on the action of protein PacC.

[A study of the growth and enzymatic activity of Microsporum gypseum and Trichophyton ajelloi isolates from sewage sludge]

The study was to compare growth and enzymatic activity of Microsporum gypseum and Trichophyton ajelloi isolates from sewage sludge. Agar media and the API-ZYM test were used. The isolates showed weak gelatinase, catalase and urease activities and did not produce cellulase, pectate lyase and polygalacturonase. In some strains poor amylase and DNA-se activities were observed. No strain was able to hydrolyze casein. The strains were found to hydrolyze tributyrin, rapeseed oil and Biodiesel oil and to grow on Diesel oil medium. On the medium containing tributyrin and on the media with rapeseed oil and Biodiesel oil additions, inhibition and stimulation of fungal growth was observed, respectively. Diesel oil did not affect the growth of these fungi. The growth and enzymatic activity of M. gypseum was found to be better than the growth and activity of T. ajelloi. Higher enzymatic activity can be associated with the pathogenicity of M. gypseum.

Trichophyton violaceum: a rare isolate in 18-day-old neonate

Trichophyton violaceum, a less common and geographically restricted infection is reported in a 18-day-old neonate. The diagnosis was made by potassium hydroxide of skin scraping examination and confirmed by culture. The patient was treated successfully with miconazole nitrate application. A large family with crowded living was considered the main predisposing factor.

Arthroconidia production in Trichophyton rubrum and a new ex vivo model of onychomycosis

The dermatophyte fungus Trichophyton rubrum often produces arthroconidia in vivo, and these cells are thought to be involved in pathogenesis, and, in shed skin scales, to act as a source of infection. The purpose of this study was (i) to examine the environmental and iatrogenic factors which affect arthroconidiation in T. rubrum in vitro, (ii) to look at arthroconidia formation in a large number of clinical isolates of T. rubrum and (iii) to develop a new model for the study of arthroconidia formation in nail tissue. Arthroconidia production was studied in T. rubrum grown on a number of media and under conditions of varying pH, temperature and CO(2) concentration. The effect of the presence of antifungals and steroids on arthroconidia formation was also examined. Nail powder from the healthy toenails of volunteers was used as a substrate for arthroconidial production. On Sabouraud dextrose agar in the presence of 10 % CO(2) plus air, arthroconidial formation occurred optimally at 37 degrees C and pH 7.5, and was maximal at 10 days. Most isolates of T. rubrum showed a similar level of arthroconidial production, and only two out of 50 strains were unable to produce arthroconidia. Subinhibitory levels of some antifungals and betamethasone resulted in the stimulation of arthroconidia formation. Arthroconidial production in ground nail material also occurred under the same optimal conditions, but took longer to reach maximal levels (14 days). These in vitro and ex vivo results provide a useful basis for the understanding of arthroconidium formation in vivo in infected tissues such as nails.

Canine dermatophytosis caused by an anthropophilic species: molecular and phenotypical characterization of Trichophyton tonsurans

Microsporum canis is the most common species isolated from canine and feline dermatophytosis in the world. However, this study reports a rare case of canine dermatophytosis caused by the anthropophilic dermatophyte Trichophyton tonsurans in the city of Fortaleza, Ceará, Brazil. The fungal characterization was performed by classical mycological examination and by genotypical analysis using the restriction enzymes Sau3A, RsaI, DdeI and EcoRI. The phenotypical characteristics were compatible with T. tonsurans. The results obtained in the genotypical analysis were similar to the digestion pattern of the ITS sequences for T. tonsurans strains. In addition, an antifungal susceptibility test was performed with griseofulvin, ketoconazole and itraconazole. The MICs were 0.5 microg ml(-1) for griseofulvin, 0.25 microg ml(-1) for ketoconazole and 1 microg ml(-1) for itraconazole. This study emphasizes the adaptability of anthropophilic fungi such as T. tonsurans to animal conditions.

In vitro methods for antifungal susceptibility testing of Trichophyton spp

In general, methods to test the susceptibility of fungi to antifungal drugs require standardized techniques, but so far there is no methodology that is widely applicable to dermatophytes. Here we introduced modifications to the protocols from documents of the National Committee for Clinical Laboratory Standards (CLSI) M38-A and the Antifungal Susceptibility Testing Subcommittee of the European Committee on Antimicrobial Susceptibility Testing (EUCAST) that are usually applied to moulds and fermentative yeasts, in order to adjust the conditions for the growth of dermatophytes. The modifications included: growth on potato dextrose agar supplemented with 2% in-house rice flour to encourage sporulation, the addition of 2% glucose to the culture media (RPMI-1640), and an incubation temperature of 28 degrees C. In addition, the incubation period was 7d, the minimum inhibitory concentration (MIC) was defined as 80% growth inhibition endpoints for azole agents, and the inocula only contained microconidia. Results obtained by both tested methodologies were very similar to the ones reported by other researchers. MIC90 (MIC at which 90% of isolates tested were inhibited) values were identical for four out of five antifungal drugs tested and there was only a difference of one or two dilutions when MIC50 values were compared. Although the modifications introduced did not interfere with the results, more studies are necessary to establish a standard technique to test susceptibility of dermatophytes to antifungal drugs.

Analysis of the dermatophyte Trichophyton rubrum expressed sequence tags

Background

Dermatophytes are the primary causative agent of dermatophytoses, a disease that affects billions of individuals worldwide. Trichophyton rubrum is the most common of the superficial fungi. Although T. rubrum is a recognized pathogen for humans, little is known about how its transcriptional pattern is related to development of the fungus and establishment of disease. It is therefore necessary to identify genes whose expression is relevant to growth, metabolism and virulence of T. rubrum.

Results

We generated 10 cDNA libraries covering nearly the entire growth phase and used them to isolate 11,085 unique expressed sequence tags (ESTs), including 3,816 contigs and 7,269 singletons. Comparisons with the GenBank non-redundant (NR) protein database revealed putative functions or matched homologs from other organisms for 7,764 (70%) of the ESTs. The remaining 3,321 (30%) of ESTs were only weakly similar or not similar to known sequences, suggesting that these ESTs represent novel genes.

Conclusion

The present data provide a comprehensive view of fungal physiological processes including metabolism, sexual and asexual growth cycles, signal transduction and pathogenic mechanisms.

Photodynamic treatment of the dermatophyte Trichophyton rubrum and its microconidia with porphyrin photosensitizers

The application of photosensitizers for the treatment of fungal infections is a new and promising development within the field of photodynamic treatment (PDT). Dermatophytes, fungi that can cause infections of the skin, hair and nails, are able to feed on keratin. Superficial mycoses are probably the most prevalent of infectious diseases in all parts of the world. One of the most important restrictions of the current therapeutic options is the return of the infection and the duration of the treatment. This is especially true in the case of infections of the nail (tinea unguium) caused by Trichophyton rubrum, an anthropophilic dermatophyte with a worldwide distribution. Recently, we demonstrated that 5,10,15-tris(4-methylpyridinium)-20-phenyl-[21H,23H]-porphine trichloride (Sylsens B) and deuteroporphyrin monomethylester were excellent photosensitizers toward T. rubrum when using broadband white light. This study demonstrates the photodynamic activity of these photosensitizers with red light toward both a suspension culture of T. rubrum and its isolated microconidia. The higher penetration depth of red light is important for the PDT of nail infections. In addition, we tested the photodynamic activity of a newly synthesized porphyrin, quinolino-[4,5,6,7-efg]-7-demethyl-8-deethylmesoporphyrin dimethylester, displaying a distinct peak in the red part of the spectrum. However, its photodynamic activity with red light toward a suspension culture of T. rubrum appeared to be only fungistatic. Sylsens B was the best photosensitizer toward both T. rubrum and its microconidia. A complete inactivation of the fungal spores and destruction of the fungal hyphae was found. In studies into the photostability, Sylsens B appeared to be photostable under the conditions used for fungal PDT. A promising result of this study is the demonstration of the complete degradation of the fungal hyphae in the time after the PDT and the inactivation of fungal spores, both with red light. These results offer the ingredients for a future treatment of fungal infections, including those of the nail.

Forty-eight-hour diagnosis of onychomycosis with subtyping of Trichophyton rubrum strains

A novel strategy for the molecular identification of fungal agents of onychomycosis (including Trichophyton rubrum) has been designed based on the use of species-specific and universal primers in conjunction with a commercial kit that allows the extraction of DNA directly from the nail specimens. The microsatellite marker T1, which is based on a (GT)n repeat, was applied for the species-specific identification of Trichophyton rubrum. To evaluate how often Scopulariopsis spp. are detected in nail specimens, a second primer pair was designed to amplify specifically a 336-bp DNA fragment of the 28S region of the nuclear rRNA gene of S. brevicaulis and closely related species. Other fungal species were identified using amplification of the internal transcribed spacer (ITS) region of the rRNA gene, followed by restriction fragment length polymorphism analysis or sequencing. In addition, polyacrylamide gel separation of the T1-PCR product allowed subtyping of T. rubrum strains. We studied 195 nail specimens (the "nail sample") and 66 previously collected etiologic strains (the "strain sample") from 261 onychomycosis patients from Bulgaria and Greece. Of the etiologic agents obtained from both samples, T. rubrum was the most common organism, confirmed to be present in 76% of all cases and serving as the sole or (rarely) mixed etiologic agent in 199 of 218 cases (91%) where the identity of the causal organism(s) was confirmed. Other agents seen included molds (6% of cases with identified etiologic agents; mainly S. brevicaulis) and other dermatophyte species (4%; most frequently Trichophyton interdigitale). Simultaneous infections with two fungal species were confirmed in a small percentage of cases (below 1%). The proportion of morphologically identified cultures revealed by molecular study to have been misidentified was 6%. Subtyping revealed that all but five T. rubrum isolates were of the common type B that is prevalent in Europe. In comparison to microscopy and culture, the molecular approach was superior. The PCR was more sensitive (84%) than culture (22%) in the nail sample and was more frequently correct in specifically identifying etiologic agents (100%) than microscopy plus routine culture in either the nail or the strain samples (correct culture identifications in 96% and 94% of cases, respectively). Using the molecular approach, the time for diagnosing the identity of fungi causing onychomycosis could be reduced to 48 h, whereas culture techniques generally require 2 to 4 weeks. The early detection and identification of the infecting species in nails will facilitate prompt and appropriate treatment and may be an aid for the development of new antifungal agents.

Establishing a method of inoculum preparation for susceptibility testing of Trichophyton rubrum and Trichophyton mentagrophytes

A total of 92 clinical isolates of dermatophytes (52 of Trichophyton rubrum and 40 of Trichophyton mentagrophytes) were selected for testing with six antifungal drugs (terbinafine, griseofulvin, clotrimazole, miconazole, isoconazole, and fluconazole) and two pairs of drug combinations (ketoconazole-cyclopiroxolamine and itraconazole-cyclopiroxolamine). Two methods of inoculum preparation for susceptibility testing were evaluated that used (i) inocula consisting only of microconidia of dermatophytes filtered in Whatman filter model 40 and (ii) unfiltered inocula consisting of hyphae and microconidia. We followed the recommendations of approved document M38-A of CLSI (formerly NCCLS) with some adaptations, including an incubation period of 7 days and an incubation temperature of 28 degrees C. Reference strains of Candida parapsilosis, Candida krusei, Trichophyton rubrum, and Trichophyton mentagrophytes were included as quality-control strains. MICs were consistently higher (usually 1 to 2 dilutions for drugs tested individually) when nonfiltered inocula were tested (P < 0.01) except for terbinafine. Larger MICs were seen when testing drugs with nonfiltered inocula. The curves of drug interaction were used to analyze the reproducibility of the test, and it was shown that high levels of reproducibility were achieved using the methodology that included the filtration step. The standardization of methodologies is the first step to yield reliability of susceptibility testing and to proceed with clinical laboratory studies to correlate MICs with clinical outcomes.

Clinico-mycological Profile of Dermatophytosis in a Reference Centre for Leprosy and Dermatological Diseases in Addis Ababa

To assess the clinical and fungal species spectrum of dermatophyte infection in a reference centre in Addis Ababa, 539 dermatological patients with signs of dermatophytosis were investigated. Seventy-one percent were female and 29% male, aged 2-66 years (median 9). Four hundred-fifteen (77%) had at least one skin lesion. Tinea capitis was diagnosed in 138/155 males (89%) as compared to 214/384 females (40%) (p < 0.05). T. capitis was diagnosed in 69% of the 374 children. Fingernails were affected in 132/145 (91%) of onychomycosis, 118 (90%) of these patients were females and 14 males (p < 0.05). Tinea corporis was observed in 45, and other types of tinea in 12 patients. Thirty-six percent of all patients had also other skin lesions, mostly impetigo. Of 490 cultured samples 364 (74%) grew dermatophytes: Trichophyton violaceum in 84%, Trichophyton verrucosum in 9.6%, Trichophyton tonsurans in 1.4% and T. rubrum in 0.5%. Additionally, 15 isolates were identified as white variants of T. violaceum, in 3 cases confirmed by sequencing of the rDNA ITS 2 region. T. capitis in young males and T. unguium of fingernails in females were the most common manifestations of dermatophytosis in Addis Ababa, usually caused by T.violaceum.

Stimulation, inhibition and death of macrophages infected with Trichophyton rubrum

Trichophyton rubrum is the most common pathogen causing dermatophytosis, accounting for approximately 80% of the reported cases of onychomycosis. Since 90% of the chronic dermatophyte infections are caused by T. rubrum, it is likely that this pathogen must have evolved mechanisms that evade or suppress cell-mediated immunity. Several reports have highlighted the participation of phagocytes in the immune defense against fungi; however, few studies have addressed the role of these cells in dermatophytosis. In this study, we investigated the interactions of resident and peritoneal macrophages with T. rubrum. We show here that the interaction of T. rubrum conidia with resident macrophages results in the production of TNF-alpha and IL-10 but not IL-12 and nitric oxide. Infected macrophages down-regulated the expression of co-stimulatory molecules (CD80 and CD54). We also show that phagocytosis of T. rubrum conidia is inhibited by the addition of fungal exoantigens or mannan. Cytotoxicity assays indicated that after 8 h of conidia ingestion macrophage viability decreased drastically. Electron microscopy revealed that the ingested conidia grow and differentiate into hyphae inside macrophages leading to rupture of the macrophage membrane.

Real-time PCR TaqMan assay for detectingTrichophyton tonsurans, a causative agent of tinea capitis, from hairbrushes

Tinea capitis caused by Trichophyton tonsurans is currently an epidemic in the United States, Europe, and Japan, and the cultivation of this microorganism is necessary for a definitive diagnosis. We recently developed a real-time PCR TaqMan assay as a culture-independent method for the rapid detection of T. tonsurans from hairbrushes.

A Novel Method to Estimate the Contribution of the Vapor Activity of Essential Oils in Agar Diffusion Assay

By the combined use of agar diffusion, agar vapor and agar vapor-inhibitory assays, contribution of the vapor activity of essential oils was quantitatively estimated. The test organisms were Trichophyton mentagrophytes and Aspergillus fumigatus. Agar vapor assay was used to confirm the vapor activity of the oils. The parameter delta defined as a contribution index of the vapor activity was calculated by (1 - b-c/a-c) x 100, where a is inhibitory diameter in the diffusion assay, b is inhibitory diameter in the vapor-inhibitory assay and c is diameter of the sealed ring in the vapor-inhibitory assay (21 mm). Many of the essential oils examined showed a delta value near 100, thus providing the major contribution of the vapor activity to the inhibitory diameter. Essential oils containing aldehyde as major constituent showed low delta value, indicating the major inhibition was due to agar diffusion. Major essential oil components behaved similarly; the delta value was increased in the following order: aldehyde < phenol < alcohol < ester, oxide, hydrocarbon, indicating the enhanced contribution of the vapor activity in that order.

Role of Chrysosporium keratinophillum in the parasitic evolution of dermatophytes

Anti-dermatophytic activity of Chrysosporium keratinophillum against species of the genera Trichophyton, Microsporum and Epidermophyton floccosum was tested in vitro. When C. keratinophillum and different species of dermatophytes were inoculated on Sabouraud's dextrose agar plates 2 cm apart, no antagonistic effect of C. keratinophillum on the mycelial growth of dermatophytes was observed. However, conidia production was not observed on the hyphae of Trichophyton rubrum, Trichophyton tonsurans and E. floccosum grown near C. keratinophillum. The secretory substances released by C. keratinophillum inhibited the growth of T. rubrum, T. tonsurans, Trichophyton mentagrophytes var. interdigitale and E. floccosum at a concentration of 2,000 microg ml(-1) when tested by broth dilution technique. No inhibition of the growth was observed for Microsporum gypseum and Microsporum nanum. The anti-fungal activity of secretory substances released by C. keratinophillum was recorded to be heat stable. Results of the present study suggest that the anti-dermatophytic activity of the secretory substances of C. keratinophillum on T. rubrum, T. mentagrophytes var. interdigitale, T. tonsurans and E. floccosum may be responsible in part, for the absence of these dermatophyte species in soil. Considering the global prevalence of C. keratinophillum in soil one may speculate that the anti-dermatophytic activity of C. keratinophillum is one of the early events for the evolutionary divergence of saprophytic archi-dermatophytes to obligate parasitic dermatophyte species.

Dermatophytes growth curve and in vitro susceptibility test: a broth micro-titration method

The introduction of systemic antifungal drugs which act upon different targets is the main issue of the in vivo antifungal resistance control. Different factors, such as growth curve phase, quality of the specimen, quantity of the inoculum, temperature, pH, culture medium composition, incubation duration and solvent, are believed important factors affecting minimum inhibitory concentration (MIC) value to most of the antifungal agents. We assayed an in vitro susceptibility test with 40 isolates of dermatophytes: Microsporum canis, Trichophyton rubrum, Trichophyton mentagrophytes and Epidermophyton floccosum against griseofulvin, fluconazole, itraconazole and terbinafine, using the guidelines of the M38-P document approved by the NCCLS. We determined the growth curves, to estimate the specific growth rate (mu max) and the generation time (G) of each dermatophyte, using dry weight and spectrophotometry methods. We demonstrate that, at 192 h, all fungi tested had a constant growth curve and we considered this as the optimal time for MIC determination. Terbinafine, griseofulvin and itraconazole possessed the highest antifungal activity against the four groups of dermatophytes studied. Fluconazole demonstrated no efficacy. Our MIC results differ from other authors and this difference is due to the timing of the MIC determination based on the growth curve of each fungi tested.

Dermatophyte growth and degradation of human stratum corneum in vitro (pathogenesis of dermatophytosis)

BACKGROUND

This study was carried out to determine growth of dermatophytes using human stratum corneum in vitro and the degrading effect of Keratinases (Proteinases) on stratum corneum for a complete understanding of the host parasite relationship.

METHOD

Trichophyton rubrum isolates derived from patients with tinea cruris infections were obtained from the Department of Medical Microbiology, University Hospital of Wales, U.K. Human stratum corneum sterilized with ethylene oxide was used as a nitrogen source in agar culture medium plates.

RESULT

Fungal growth took place in plates which contained human stratum corneum particles while there was no growth in the plates without stratum corneum at three weeks after initiation. There was a gradual disappearance of the particles of stratum corneum from the plates at the end of the third week

CONCLUSION

The growth of organisms in plates with human stratum corneum and their disappearance at third week suggested that stratum corneum was not only source of nutrition for the dermatophytes, but also the growing fungal mycelia and the proteinases induced by them were playing a part in the digestion of granules and thus may have an important role in the pathogenesis of dermatophyte infections.