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Alemu TG, Alemu NG, Gonete AT. Tinea capitis and its associated factors among school children in Gondar town northwest, Ethiopia. BMC Pediatr 2024; 24:448. [PMID: 38997660 PMCID: PMC11242016 DOI: 10.1186/s12887-024-04917-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 07/01/2024] [Indexed: 07/14/2024] Open
Abstract
INTRODUCTION Tinea capitis is a global public health concern with a unique therapeutic challenge and mostly affects children. The burden is double in developing countries. There is no study on school-going children from the urban residence in Ethiopia. OBJECTIVE To determine the prevalence of Tinea capitis and its associated factors among school children in Gondar town northwest, Ethiopia 2021. METHODS An institution-based cross-sectional study was conducted among school children in Gondar town from November 20 to December 20, 2021. Data was collected through an interviewer-administered structured questionnaire. A stratified simple random sampling technique was employed. Then data were entered into EPI Info version 7.22 and transferred to Statistical package for social science (SPSS) version 22 for further analysis. The binary logistic regression model was employed to identify factors associated with tinea capitis, and the strength of association and statistical significance was declared using the adjusted odds ratios with its corresponding 95% CI, and p-value ≤ 0.05 respectively. RESULT The prevalence of tinea capitis among school children in Gondar town was found to be 29.4%. Public school student (AOR = 2.79 95% CI: 1.34-5.87), widowed mother (AOR = 6.09, 95% CI: 1.83-11.23), students in the age group of 5-8 years (AOR = 3.79 95% CI: 1.68-8.55), animal contact (AOR = 2.61 95% CI: 1.15-5.90), and family similar illness category (AOR = 8.49 95% CI: 3.73-11.39) have risen the likelihood of tinea capitis among school children. CONCLUSIONS The prevalence of tinea capitis was higher. Young age, children from widowed marital status, illiterate mother, history of share blades, animal contact, a family similar illness, and lower number of living rooms are important factors contributing to tinea capitis among school children. Health education for the mother on the mode of transmission, prevention, and improve the low socioeconomic status of the parent is crucial. KEY TERMS Children, Ethiopia, Gondar, School age, Tinea capitis.
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Affiliation(s)
- Tewodros Getaneh Alemu
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, P.O.Box: 196, Gondar, Ethiopia.
| | - Nigus Getaneh Alemu
- School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Almaz Tefera Gonete
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, P.O.Box: 196, Gondar, Ethiopia
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2
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Giri M, Parida S. Phytochemical inhibitors from Leucas aspera against the target proteins induced by Trichophyton mentagrophytes using computational techniques. J Basic Microbiol 2024; 64:e2400112. [PMID: 38770635 DOI: 10.1002/jobm.202400112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 04/16/2024] [Accepted: 05/03/2024] [Indexed: 05/22/2024]
Abstract
Dermatophytosis is a cutaneous infection that is able to degrade the keratinized tissues of the animal/human body, like skin, nails, and hair, causing chronic or subacute infection with the contact of some specific fungal strains. Trichophyton mentagrophytes are the most potential fungal pathogen causing dermatophytoses. The present study focuses on computationally based in silico antifungal activity of selected phytocompounds of Leucas aspera (Willd.) Link. against dermatophytic fungus, T. mentagrophytes. Validation and screening of derived phytocompounds is performed using Lipinski rule of five and toxicity test through Protox-II. Five target genes involved in dermatophytosis, induced by T. mentagrophytes are retrieved from the UniProt Database, and the corresponding proteins such as glucan 1,3-beta-glucosidase ARB_02797, Probable class II chitinase ARB_00204, squalene monooxygenase, actin, and ubiquitin are selected for in silico study. Three-dimensional structures of the target protein were computationally determined and validated through modeling tools and techniques due to the lack of validated protein structures in the database. Then, these proteins are used for in silico molecular docking through the AutoDock Vina tool to find out the promising phytocompounds. This study could be utilized in designing more effective drugs against T. mentagrophytes. Based on this work, a plant-based natural alternative can be added to the treatment of dermatophytosis rather than synthetic supplements.
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Affiliation(s)
- Monalisha Giri
- Department of Botany, School of Applied Sciences, Centurion University of Technology and Management, Bhubaneswar, Odisha, India
| | - Sagarika Parida
- Department of Botany, School of Applied Sciences, Centurion University of Technology and Management, Bhubaneswar, Odisha, India
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3
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Joel MZ, Tripathi R, Bao A, Scott JF, Bibee KP. Sociodemographic trends and financial burden of emergency department visits due to dermatophytosis in the United States. Arch Dermatol Res 2024; 316:267. [PMID: 38795122 DOI: 10.1007/s00403-024-02980-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 04/22/2024] [Accepted: 04/26/2024] [Indexed: 05/27/2024]
Affiliation(s)
- Marina Z Joel
- Department of Dermatology, Johns Hopkins University School of Medicine, 601 N. Caroline St, Baltimore, MD, 21287, USA.
| | - Raghav Tripathi
- Department of Dermatology, Johns Hopkins University School of Medicine, 601 N. Caroline St, Baltimore, MD, 21287, USA
| | - Aaron Bao
- Department of Dermatology, Johns Hopkins University School of Medicine, 601 N. Caroline St, Baltimore, MD, 21287, USA
| | | | - Kristin P Bibee
- Department of Dermatology, Johns Hopkins University School of Medicine, 601 N. Caroline St, Baltimore, MD, 21287, USA
- Department of Oncology, Johns Hopkins University, Baltimore, MD, USA
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Hill RC, Caplan AS, Elewski B, Gold JAW, Lockhart SR, Smith DJ, Lipner SR. Expert Panel Review of Skin and Hair Dermatophytoses in an Era of Antifungal Resistance. Am J Clin Dermatol 2024; 25:359-389. [PMID: 38494575 PMCID: PMC11201321 DOI: 10.1007/s40257-024-00848-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2024] [Indexed: 03/19/2024]
Abstract
Dermatophytoses are fungal infections of the skin, hair, and nails that affect approximately 25% of the global population. Occlusive clothing, living in a hot humid environment, poor hygiene, proximity to animals, and crowded living conditions are important risk factors. Dermatophyte infections are named for the anatomic area they infect, and include tinea corporis, cruris, capitis, barbae, faciei, pedis, and manuum. Tinea incognito describes steroid-modified tinea. In some patients, especially those who are immunosuppressed or who have a history of corticosteroid use, dermatophyte infections may spread to involve extensive skin areas, and, in rare cases, may extend to the dermis and hair follicle. Over the past decade, dermatophytoses cases not responding to standard of care therapy have been increasingly reported. These cases are especially prevalent in the Indian subcontinent, and Trichophyton indotineae has been identified as the causative species, generating concern regarding resistance to available antifungal therapies. Antifungal-resistant dermatophyte infections have been recently recognized in the United States. Antifungal resistance is now a global health concern. When feasible, mycological confirmation before starting treatment is considered best practice. To curb antifungal-resistant infections, it is necessary for physicians to maintain a high index of suspicion for resistant dermatophyte infections coupled with antifungal stewardship efforts. Furthermore, by forging partnerships with federal agencies, state and local public health agencies, professional societies, and academic institutions, dermatologists can lead efforts to prevent the spread of antifungal-resistant dermatophytes.
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Affiliation(s)
| | - Avrom S Caplan
- Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, NY, USA
| | - Boni Elewski
- Department of Dermatology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jeremy A W Gold
- Centers for Disease Control and Prevention, Mycotic Diseases Branch, Atlanta, GA, USA
| | - Shawn R Lockhart
- Centers for Disease Control and Prevention, Mycotic Diseases Branch, Atlanta, GA, USA
| | - Dallas J Smith
- Centers for Disease Control and Prevention, Mycotic Diseases Branch, Atlanta, GA, USA
| | - Shari R Lipner
- Department of Dermatology, Weill Cornell Medicine, 1305 York Avenue, New York, NY, 10021, USA.
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5
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Zou K, Zhang S, Yin K, Ren S, Zhang M, Li X, Fan L, Zhang R, Li R. Studies on the in vitro mechanism and in vivo therapeutic effect of the antimicrobial peptide ACP5 against Trichophyton mentagrophytes. Peptides 2024; 175:171177. [PMID: 38354953 DOI: 10.1016/j.peptides.2024.171177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 02/07/2024] [Accepted: 02/07/2024] [Indexed: 02/16/2024]
Abstract
Trichophyton mentagrophytes is a zoophilic dermatophyte that can cause dermatophytosis in humans and animals. Antimicrobial peptides (AMPs) are considered as a promising agent to overcome the drug-resistance of T. mentagrophytes. Our findings suggest that cationic antimicrobial peptide (ACP5) not only possesses stronger activity against T. mentagrophytes than fluconazole, but also shows lower toxicity to L929 mouse fibroblast cells than terbinafine. Notably, its resistance development rate after resistance induction was lower than terbinafine. The present study aimed to evaluate the fungicidal mechanism of ACP5 in vitro and its potential to treat dermatophyte infections in vivo. ACP5 at 1 ×MIC completely inhibited T. mentagrophytes spore germination in vitro. ACP5 severely disrupts the mycelial morphology, leading to mycelial rupture. Mechanistically, ACP5 induces excessive ROS production, damaging the integrity of the cell membrane and decreasing the mitochondrial membrane potential, causing irreversible damage in T. mentagrophytes. Furthermore, 1% ACP5 showed similar efficacy to the commercially available drug 1% terbinafine in a guinea pig dermatophytosis model, and the complete eradication of T. mentagrophytes from the skin by ACP5 was verified by tissue section observation. These results indicate that ACP5 is a promising candidate for the development of new agent to combat dermatophyte resistance.
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Affiliation(s)
- Kuiming Zou
- Key Laboratory of Functional Molecules for Biomedical Research, Zhengzhou, Henan University of Technology, 450001 Zhengzhou, Henan, PR China; College of Biological Engineering, Henan University of Technology, 450001 Zhengzhou, Henan, PR China
| | - Shaojie Zhang
- Key Laboratory of Functional Molecules for Biomedical Research, Zhengzhou, Henan University of Technology, 450001 Zhengzhou, Henan, PR China; College of Biological Engineering, Henan University of Technology, 450001 Zhengzhou, Henan, PR China
| | - Kedong Yin
- Key Laboratory of Functional Molecules for Biomedical Research, Zhengzhou, Henan University of Technology, 450001 Zhengzhou, Henan, PR China; College of Information Science and Engineering, Henan University of Technology, 450001 Zhengzhou, Henan, PR China
| | - Shiming Ren
- Key Laboratory of Functional Molecules for Biomedical Research, Zhengzhou, Henan University of Technology, 450001 Zhengzhou, Henan, PR China; College of Biological Engineering, Henan University of Technology, 450001 Zhengzhou, Henan, PR China
| | - Mengjun Zhang
- Key Laboratory of Functional Molecules for Biomedical Research, Zhengzhou, Henan University of Technology, 450001 Zhengzhou, Henan, PR China; College of Biological Engineering, Henan University of Technology, 450001 Zhengzhou, Henan, PR China
| | - Xiatong Li
- Key Laboratory of Functional Molecules for Biomedical Research, Zhengzhou, Henan University of Technology, 450001 Zhengzhou, Henan, PR China; College of Biological Engineering, Henan University of Technology, 450001 Zhengzhou, Henan, PR China
| | - Lixin Fan
- Key Laboratory of Functional Molecules for Biomedical Research, Zhengzhou, Henan University of Technology, 450001 Zhengzhou, Henan, PR China; College of Biological Engineering, Henan University of Technology, 450001 Zhengzhou, Henan, PR China
| | - Ruiling Zhang
- Key Laboratory of Functional Molecules for Biomedical Research, Zhengzhou, Henan University of Technology, 450001 Zhengzhou, Henan, PR China; School of Economics and Trade, Henan University of Technology, 450001 Zhengzhou, Henan, PR China.
| | - Ruifang Li
- Key Laboratory of Functional Molecules for Biomedical Research, Zhengzhou, Henan University of Technology, 450001 Zhengzhou, Henan, PR China; College of Biological Engineering, Henan University of Technology, 450001 Zhengzhou, Henan, PR China.
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Herculano RD, Dos Reis CE, de Souza SMB, Pegorin Brasil GS, Scontri M, Kawakita S, Carvalho BG, Bebber CC, Su Y, de Sousa Abreu AP, Mecwan MM, Mandal K, Fusco Almeida AM, Mendes Giannini MJS, Guerra NB, Mussagy CU, Bosculo MRM, Gemeinder JLP, de Almeida BFM, Floriano JF, Farhadi N, Monirizad M, Khorsandi D, Nguyen HT, Gomez A, Tirpáková Z, Peirsman A, da Silva Sasaki JC, He S, Forster S, Burd BS, Dokmeci MR, Terra-Garcia M, Junqueira JC, de Mendonça RJ, Cardoso MR, Dos Santos LS, Silva GR, Barros NR, Jucaud V, Li B. Amphotericin B-loaded natural latex dressing for treating Candida albicans wound infections using Galleria mellonella model. J Control Release 2024; 365:744-758. [PMID: 38072085 DOI: 10.1016/j.jconrel.2023.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 11/19/2023] [Accepted: 12/03/2023] [Indexed: 12/17/2023]
Abstract
Amphotericin B (AmB) is the gold standard for antifungal drugs. However, AmB systemic administration is restricted because of its side effects. Here, we report AmB loaded in natural rubber latex (NRL), a sustained delivery system with low toxicity, which stimulates angiogenesis, cell adhesion and accelerates wound healing. Physicochemical characterizations showed that AmB did not bind chemically to the polymeric matrix. Electronic and topographical images showed small crystalline aggregates from AmB crystals on the polymer surface. About 56.6% of AmB was released by the NRL in 120 h. However, 33.6% of this antifungal was delivered in the first 24 h due to the presence of AmB on the polymer surface. The biomaterial's excellent hemo- and cytocompatibility with erythrocytes and human dermal fibroblasts (HDF) confirmed its safety for dermal wound application. Antifungal assay against Candida albicans showed that AmB-NRL presented a dose-dependent behavior with an inhibition halo of 30.0 ± 1.0 mm. Galleria mellonella was employed as an in vivo model for C. albicans infection. Survival rates of 60% were observed following the injection of AmB (0.5 mg.mL-1) in G. mellonella larvae infected by C. albicans. Likewise, AmB-NRL (0.5 mg.mL-1) presented survival rates of 40%, inferring antifungal activity against fungus. Thus, NRL adequately acts as an AmB-sustained release matrix, which is an exciting approach, since this antifungal is toxic at high concentrations. Our findings suggest that AmB-NRL is an efficient, safe, and reasonably priced ($0.15) dressing for the treatment of cutaneous fungal infections.
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Affiliation(s)
- Rondinelli Donizetti Herculano
- São Paulo State University (UNESP), Bioengineering & Biomaterials Group, School of Pharmaceutical Sciences, 14800-903 Araraquara, SP, Brazil; Terasaki Institute for Biomedical Innovation (TIBI), 11507 W Olympic Blvd, Los Angeles, CA, USA; Autonomy Research Center for STEAHM (ARCS), California State University, Northridge, CA 91324, USA.
| | - Camila Eugênia Dos Reis
- Fundação Educacional do Município de Assis (FEMA), 1200 Getulio Vargas Avenue, 19807-130 Assis, SP, Brazil
| | | | - Giovana Sant'Ana Pegorin Brasil
- São Paulo State University (UNESP), Bioengineering & Biomaterials Group, School of Pharmaceutical Sciences, 14800-903 Araraquara, SP, Brazil
| | - Mateus Scontri
- São Paulo State University (UNESP), Bioengineering & Biomaterials Group, School of Pharmaceutical Sciences, 14800-903 Araraquara, SP, Brazil
| | - Satoru Kawakita
- Terasaki Institute for Biomedical Innovation (TIBI), 11507 W Olympic Blvd, Los Angeles, CA, USA
| | - Bruna Gregatti Carvalho
- Terasaki Institute for Biomedical Innovation (TIBI), 11507 W Olympic Blvd, Los Angeles, CA, USA; University of Campinas (UNICAMP), Department of Materials and Bioprocesses Engineering, School of Chemical Engineering, 13083-852 Campinas, SP, Brazil
| | - Camila Calderan Bebber
- São Paulo State University (UNESP), Bioengineering & Biomaterials Group, School of Pharmaceutical Sciences, 14800-903 Araraquara, SP, Brazil
| | - Yanjin Su
- São Paulo State University (UNESP), Bioengineering & Biomaterials Group, School of Pharmaceutical Sciences, 14800-903 Araraquara, SP, Brazil
| | - Ana Paula de Sousa Abreu
- São Paulo State University (UNESP), Bioengineering & Biomaterials Group, School of Pharmaceutical Sciences, 14800-903 Araraquara, SP, Brazil
| | - Marvin M Mecwan
- Terasaki Institute for Biomedical Innovation (TIBI), 11507 W Olympic Blvd, Los Angeles, CA, USA
| | - Kalpana Mandal
- Terasaki Institute for Biomedical Innovation (TIBI), 11507 W Olympic Blvd, Los Angeles, CA, USA
| | - Ana Marisa Fusco Almeida
- São Paulo State University (UNESP), Department of Clinical Analysis, School of Pharmaceutical Sciences, 14800-903 Araraquara, SP, Brazil
| | - Maria José Soares Mendes Giannini
- São Paulo State University (UNESP), Department of Clinical Analysis, School of Pharmaceutical Sciences, 14800-903 Araraquara, SP, Brazil
| | | | - Cassamo Ussemane Mussagy
- Escuela de Agronomía, Facultad de Ciencias Agronómicas y de los Alimentos, Pontificia Universidad Católica de Valparaíso, Chile
| | - Maria Rachel Melo Bosculo
- University Center of the Integrated Faculties of Ourinhos (UNIFIO), Km 338, BR-153, 19909-100 Ourinhos, SP, Brazil
| | - José Lúcio Pádua Gemeinder
- São Paulo State University (UNESP), Bioengineering & Biomaterials Group, School of Pharmaceutical Sciences, 14800-903 Araraquara, SP, Brazil; University Center of the Integrated Faculties of Ourinhos (UNIFIO), Km 338, BR-153, 19909-100 Ourinhos, SP, Brazil
| | | | - Juliana Ferreira Floriano
- São Paulo State University (UNESP), Bioengineering & Biomaterials Group, School of Pharmaceutical Sciences, 14800-903 Araraquara, SP, Brazil; São Paulo State University (UNESP), School of Sciences, 17033-360 Bauru, SP, Brazil
| | - Neda Farhadi
- Terasaki Institute for Biomedical Innovation (TIBI), 11507 W Olympic Blvd, Los Angeles, CA, USA
| | - Mahsa Monirizad
- Terasaki Institute for Biomedical Innovation (TIBI), 11507 W Olympic Blvd, Los Angeles, CA, USA
| | - Danial Khorsandi
- Terasaki Institute for Biomedical Innovation (TIBI), 11507 W Olympic Blvd, Los Angeles, CA, USA
| | - Huu Tuan Nguyen
- Terasaki Institute for Biomedical Innovation (TIBI), 11507 W Olympic Blvd, Los Angeles, CA, USA
| | - Alejandro Gomez
- Terasaki Institute for Biomedical Innovation (TIBI), 11507 W Olympic Blvd, Los Angeles, CA, USA; Autonomy Research Center for STEAHM (ARCS), California State University, Northridge, CA 91324, USA
| | - Zuzana Tirpáková
- Terasaki Institute for Biomedical Innovation (TIBI), 11507 W Olympic Blvd, Los Angeles, CA, USA; University of Veterinary Medicine and Pharmacy in Košice, Komenského 73, 041 81 Košice, Slovak Republic
| | - Arne Peirsman
- Terasaki Institute for Biomedical Innovation (TIBI), 11507 W Olympic Blvd, Los Angeles, CA, USA; Plastic, Reconstructive and Aesthetic Surgery, University Hospital Ghent, Ghent, Belgium
| | - Josana Carla da Silva Sasaki
- São Paulo State University (UNESP), Bioengineering & Biomaterials Group, School of Pharmaceutical Sciences, 14800-903 Araraquara, SP, Brazil
| | - Siqi He
- Terasaki Institute for Biomedical Innovation (TIBI), 11507 W Olympic Blvd, Los Angeles, CA, USA; Autonomy Research Center for STEAHM (ARCS), California State University, Northridge, CA 91324, USA
| | - Samuel Forster
- Terasaki Institute for Biomedical Innovation (TIBI), 11507 W Olympic Blvd, Los Angeles, CA, USA; Autonomy Research Center for STEAHM (ARCS), California State University, Northridge, CA 91324, USA
| | - Betina Sayeg Burd
- São Paulo State University (UNESP), Bioengineering & Biomaterials Group, School of Pharmaceutical Sciences, 14800-903 Araraquara, SP, Brazil
| | - Mehmet Remzi Dokmeci
- Terasaki Institute for Biomedical Innovation (TIBI), 11507 W Olympic Blvd, Los Angeles, CA, USA
| | - Maíra Terra-Garcia
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (UNESP), 12244-514 São José dos Campos, SP, Brazil
| | - Juliana Campos Junqueira
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (UNESP), 12244-514 São José dos Campos, SP, Brazil
| | - Ricardo José de Mendonça
- Department of Biochemistry, Pharmacology and Physiology, Federal University of Triangulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
| | - Marcos Roberto Cardoso
- São Carlos Institute of Physics, University of São Paulo, PO Box 369, 13561-970 São Carlos, SP, Brazil
| | - Lindomar Soares Dos Santos
- Faculty of Philosophy, Sciences and Languages of Ribeirão Preto, Universidade de São Paulo University (USP), 3900 Bandeirantes Avenue, 14, 040-901 Ribeirão Preto, SP, Brazil
| | - Gláucio Ribeiro Silva
- Federal Institute of Education, Science, and Technology of Minas Gerais, s/n São Luiz Gonzaga Street, 35577-010, Formiga, MG, Brazil
| | - Natan Roberto Barros
- Terasaki Institute for Biomedical Innovation (TIBI), 11507 W Olympic Blvd, Los Angeles, CA, USA
| | - Vadim Jucaud
- Terasaki Institute for Biomedical Innovation (TIBI), 11507 W Olympic Blvd, Los Angeles, CA, USA
| | - Bingbing Li
- Terasaki Institute for Biomedical Innovation (TIBI), 11507 W Olympic Blvd, Los Angeles, CA, USA; Autonomy Research Center for STEAHM (ARCS), California State University, Northridge, CA 91324, USA.
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Kruithoff C, Gamal A, McCormick TS, Ghannoum MA. Dermatophyte Infections Worldwide: Increase in Incidence and Associated Antifungal Resistance. Life (Basel) 2023; 14:1. [PMID: 38276250 PMCID: PMC10817648 DOI: 10.3390/life14010001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 12/15/2023] [Accepted: 12/15/2023] [Indexed: 01/27/2024] Open
Abstract
The increase in incidence of superficial fungal infections combined with the emergence of antifungal resistance represents both a global health challenge and a considerable economic burden. Recently, dermatophytes, the main culprit causing superficial fungal infections, have started to exhibit antifungal resistance. This can be observed in some of the most common species such as Trichophyton rubrum and Trichophyton mentagrophytes. Importantly, the new subspecies, known as Trichophyton indotineae, has been reported to show high resistance to terbinafine, a first-line treatment for dermatophyte infections. Compounding these issues is the realization that diagnosing the causative infectious agents requires using molecular analysis that goes beyond the conventional macroscopic and microscopic methods. These findings emphasize the importance of conducting antifungal susceptibility testing to select the appropriate antifungal necessary for successful treatment. Implementing these changes may improve clinical practices that combat resistant dermatophyte infections.
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Affiliation(s)
- Caroline Kruithoff
- Heritage College of Osteopathic Medicine, Ohio University, Cleveland, OH 44122, USA;
| | - Ahmed Gamal
- Center for Medical Mycology and Integrated Microbiome Core, Department of Dermatology, Case Western Reserve University, Cleveland, OH 44106, USA; (A.G.); (T.S.M.)
| | - Thomas S. McCormick
- Center for Medical Mycology and Integrated Microbiome Core, Department of Dermatology, Case Western Reserve University, Cleveland, OH 44106, USA; (A.G.); (T.S.M.)
| | - Mahmoud A. Ghannoum
- Center for Medical Mycology and Integrated Microbiome Core, Department of Dermatology, Case Western Reserve University, Cleveland, OH 44106, USA; (A.G.); (T.S.M.)
- Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, USA
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Fernandes JA, Conrado PCV, Perina BS, de Oliveira ACV, Arita GS, Capoci IRG, Gonçalves RS, Caetano W, Svidzinski TIE, Cotica ESK, Bonfim-Mendonça PDS. Photodynamic inactivation by hypericin-P123 on azole-resistant isolates of the Trichophyton rubrum complex as planktonic cells and biofilm. Photodiagnosis Photodyn Ther 2023; 44:103875. [PMID: 37923285 DOI: 10.1016/j.pdpdt.2023.103875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 10/30/2023] [Accepted: 10/31/2023] [Indexed: 11/07/2023]
Abstract
INTRODUCTION The Trichophyton rubrum complex comprises the majority of dermatophyte fungi (DM) responsible for chronic cases of onychomycosis, which is treated with oral or topical antifungals. However, owing to antifungal resistance, alternative therapies, such as photodynamic therapy (PDT), are needed. This study investigated the frequency of the T. rubrum species complex in onychomycosis cases in the northwestern region of Paraná state, Brazil, and evaluated the efficacy of (PDT) using P123-encapsulated hypericin (Hyp-P123) on clinical isolates of T. rubrum in the planktonic cell and biofilm forms. MATERIAL AND METHODS The frequency of the T. rubrum complex in onychomycosis cases from 2017 to 2021 was evaluated through a data survey of records from the Laboratory of Medical Mycology (LEPAC) of the State University of Maringa (UEM). To determine the effect of PDT-Hyp-P123 on planktonic cells of T. rubrum isolates, 1 × 105 conidia/mL were treated with ten different concentrations of Hyp-P123 and then irradiated with 37.8 J/cm2. Antibiofilm activity of PDT-Hyp-P123 was tested against T. rubrum biofilm in the adhesion phase (3 h), evaluated 72 h after irradiation (37.8 J/cm2), and the mature biofilm (72 h), evaluated immediately after irradiation. In this context, three different parameters were evaluated: cell viability, metabolic activity and total biomass. RESULTS The T. rubrum species complex was the most frequently isolated DM in onychomycosis cases (approximately 80 %). A significant reduction in fungal growth was observed for 75 % of the clinical isolates tested with a concentration from 0.19 μmol/L Hyp-P123, and 56.25 % had complete inhibition of fungal growth (fungicidal action); while all isolates were azole-resistant. The biofilm of T. rubrum isolates (TR0022 and TR0870) was inactivated in both the adhesion phase and the mature biofilm. CONCLUSION PDT-Hyp-P123 had antifungal and antibiofilm activity on T. rubrum, which is an important dermatophyte responsible for onychomycosis cases.
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Affiliation(s)
| | | | - Brenda Serenini Perina
- Department of Analysis Clinics & Biomedicine, State University of Maringá, Paraná, Brazil
| | | | - Glaucia Sayuri Arita
- Department of Analysis Clinics & Biomedicine, State University of Maringá, Paraná, Brazil
| | | | | | - Wilker Caetano
- Department of Chemistry, State University of Maringá, Paraná, Brazil
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9
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Keshwania P, Kaur N, Chauhan J, Sharma G, Afzal O, Alfawaz Altamimi AS, Almalki WH. Superficial Dermatophytosis across the World's Populations: Potential Benefits from Nanocarrier-Based Therapies and Rising Challenges. ACS OMEGA 2023; 8:31575-31599. [PMID: 37692246 PMCID: PMC10483660 DOI: 10.1021/acsomega.3c01988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 08/09/2023] [Indexed: 09/12/2023]
Abstract
The most prevalent infection in the world is dermatophytosis, which is a major issue with high recurrence and can affect the entire body including the skin, hair, and nails. The major goal of this Review is to acquire knowledge about cutting-edge approaches for treating dermatophytosis efficiently by adding antifungals to formulations based on nanocarriers in order to overcome the shortcomings of standard treatment methods. Updates on nanosystems and research developments on animal and clinical investigations are also presented. Along with the currently licensed formulations, the investigation also emphasizes novel therapies and existing therapeutic alternatives that can be used to control dermatophytosis. The Review also summarizes recent developments on the prevalence, management approaches, and disadvantages of standard dosage types. There are a number of therapeutic strategies for the treatment of dermatophytosis that have good clinical cure rates but also drawbacks such as antifungal drug resistance and unfavorable side effects. To improve therapeutic activity and get around the drawbacks of the traditional therapy approaches for dermatophytosis, efforts have been described in recent years to combine several antifungal drugs into new carriers. These formulations have been successful in providing improved antifungal activity, longer drug retention, improved effectiveness, higher skin penetration, and sustained drug release.
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Affiliation(s)
- Puja Keshwania
- Department
of Microbiology, Maharishi Markandeshwar
Institute of Medical Sciences and Research, Mullana, Ambala, Haryana 133207, India
| | - Narinder Kaur
- Department
of Microbiology, Maharishi Markandeshwar
Institute of Medical Sciences and Research, Mullana, Ambala, Haryana 133207, India
| | - Jyoti Chauhan
- Department
of Microbiology, Maharishi Markandeshwar
Institute of Medical Sciences and Research, Mullana, Ambala, Haryana 133207, India
| | - Gajanand Sharma
- University
Institute of Pharmaceutical Sciences, UGC-Centre of Advanced Studies, Panjab University, Chandigarh 160014, India
| | - Obaid Afzal
- Department
of Pharmaceutical Chemistry, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Alkharj 11942, Saudi Arabia
| | | | - Waleed H. Almalki
- Department
of Pharmacology and Toxicology, College of Pharmacy, Umm Al-Qura University, Makkah 21961, Saudi Arabia
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10
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Sinha SD, Rajamma A, Bandi MR, Sriramadasu SC, Sahu S, Kothiwala RK, Halder S, Sankerneni A, Panapakam M, Vemireddy VNR, Vattipalli R, Devireddy SR. Efficacy and Safety of Naftifine Hydrochloride 2% Gel in Interdigital Tinea Pedis: A Phase III Randomised, Double-Blind, Parallel-Group, Active-Controlled Study in Indian Adult Patients. Clin Drug Investig 2023; 43:565-574. [PMID: 37462803 DOI: 10.1007/s40261-023-01288-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND AND OBJECTIVE Naftifine, an allylamine, is highly effective against tinea pedis and exhibits relatively greater affinity to skin and nail beds, possibly due to its high lipophilicity. To study the efficacy and safety of naftifine 2% gel in an Indian population, a phase III multicentre double-blind, comparative, parallel-group study was conducted in comparison with miconazole 2% gel in patients with interdigital tinea pedis, with mild to moderate symptoms. PATIENTS AND METHODS Patients presenting with mild to moderate signs and symptoms of interdigital tinea pedis and mycologically confirmed tinea infection were randomised to either naftifine hydrochloride 2% gel (n = 112) or miconazole 2% gel (n = 112) in 1:1 ratio. All patients were treated for 2 weeks with a follow-up of up to 12 weeks. Study evaluations were done at the end of 2, 6, and 12 weeks. The primary efficacy endpoint was the proportion of patients achieving clinical cure at week 6 (± 4 days) and secondary endpoints were the mycological cure at week 6 and week 12 and complete cure at week 12. RESULTS At the end of week 6, clinical cure was 54.55% and 50.00% in the naftifine and miconazole groups (p = 0.4960), respectively, and it was increased to 78.18% and 76.36% in the naftifine and miconazole group (p = 0.7455) at the end of week 12. Mycological and clinical cure were similar in the naftifine and miconazole groups at week 6 and week 12. The safety and tolerability profiles of both treatments were similar. CONCLUSIONS Naftifine 2% gel was efficacious and safe for the treatment of mild to moderate interdigital tinea pedis. Its clinical effectiveness was comparable to that of miconazole 2% gel. TRIAL REGISTRATION Clinical Trials Registry of India: CTRI/2021/01/030753.
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Affiliation(s)
- Shubhadeep D Sinha
- Department of Clinical Development & Medical Affairs, Hetero Labs Limited, Hetero Corporate, 7-2-A2, Industrial Estates, Sanath Nagar, Hyderabad, Telangana, India
| | - Avula Rajamma
- Department of Dermatology and Venerology, ACSR Government Medical College, Nellore, Andhra Pradesh, India
| | - Mohan Reddy Bandi
- Department of Clinical Development & Medical Affairs, Hetero Labs Limited, Hetero Corporate, 7-2-A2, Industrial Estates, Sanath Nagar, Hyderabad, Telangana, India
| | - Sreenivasa Chary Sriramadasu
- Department of Clinical Development & Medical Affairs, Hetero Labs Limited, Hetero Corporate, 7-2-A2, Industrial Estates, Sanath Nagar, Hyderabad, Telangana, India
| | - Suvash Sahu
- Department of Dermatology, Maharani Laxmi Bai Medical College, Jhansi, Uttar Pradesh, India
| | - Raj Kumar Kothiwala
- Department of Dermatology, Venereology and Leprosy, Jawahar Lal Nehru Medical College, Kala Bagh, Ajmer, Rajasthan, India
| | - Saswati Halder
- Department of Dermatology, School of Tropical Medicine, Kolkata, West Bengal, India
| | - Abhilash Sankerneni
- Department of Clinical Development & Medical Affairs, Hetero Labs Limited, Hetero Corporate, 7-2-A2, Industrial Estates, Sanath Nagar, Hyderabad, Telangana, India
| | - Muralidhar Panapakam
- Department of Clinical Development & Medical Affairs, Hetero Labs Limited, Hetero Corporate, 7-2-A2, Industrial Estates, Sanath Nagar, Hyderabad, Telangana, India
| | - Venkata Narayana Reddy Vemireddy
- Department of Clinical Development & Medical Affairs, Hetero Labs Limited, Hetero Corporate, 7-2-A2, Industrial Estates, Sanath Nagar, Hyderabad, Telangana, India
| | - Ramya Vattipalli
- Department of Clinical Development & Medical Affairs, Hetero Labs Limited, Hetero Corporate, 7-2-A2, Industrial Estates, Sanath Nagar, Hyderabad, Telangana, India
| | - Srinivas Reddy Devireddy
- Department of Clinical Development & Medical Affairs, Hetero Labs Limited, Hetero Corporate, 7-2-A2, Industrial Estates, Sanath Nagar, Hyderabad, Telangana, India.
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11
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Chanyachailert P, Leeyaphan C, Bunyaratavej S. Cutaneous Fungal Infections Caused by Dermatophytes and Non-Dermatophytes: An Updated Comprehensive Review of Epidemiology, Clinical Presentations, and Diagnostic Testing. J Fungi (Basel) 2023; 9:669. [PMID: 37367605 DOI: 10.3390/jof9060669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 05/31/2023] [Accepted: 06/10/2023] [Indexed: 06/28/2023] Open
Abstract
Cutaneous fungal infection of the skin and nails poses a significant global public health challenge. Dermatophyte infection, mainly caused by Trichophyton spp., is the primary pathogenic agent responsible for skin, hair, and nail infections worldwide. The epidemiology of these infections varies depending on the geographic location and specific population. However, epidemiological pattern changes have occurred over the past decade. The widespread availability of antimicrobials has led to an increased risk of promoting resistant strains through inappropriate treatment. The escalating prevalence of resistant Trichophyton spp. infections in the past decade has raised serious healthcare concerns on a global scale. Non-dermatophyte infections, on the other hand, present even greater challenges in terms of treatment due to the high failure rate of antifungal therapy. These organisms primarily target the nails, feet, and hands. The diagnosis of cutaneous fungal infections relies on clinical presentation, laboratory investigations, and other ancillary tools available in an outpatient care setting. This review aims to present an updated and comprehensive analysis of the epidemiology, clinical manifestations, and diagnostic testing methods for cutaneous fungal infections caused by dermatophytes and non-dermatophytes. An accurate diagnosis is crucial for effective management and minimizing the risk of antifungal resistance.
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Affiliation(s)
- Pattriya Chanyachailert
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkok Noi, Bangkok 10700, Thailand
| | - Charussri Leeyaphan
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkok Noi, Bangkok 10700, Thailand
| | - Sumanas Bunyaratavej
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkok Noi, Bangkok 10700, Thailand
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12
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Brito SCP, Pinto MR, Alcântara LM, Reis NF, Durães TL, Bittar CTM, de Oliveira JC, da Rocha EMDS, Dantas Machado RL, Souza E Guimarães RJDP, Baptista ARDS. Spatio-temporal six-year retrospective study on dermatophytosis in Rio de Janeiro, Southeast Brazil: A tropical tourist locality tale. PLoS Negl Trop Dis 2023; 17:e0010865. [PMID: 37011092 PMCID: PMC10101643 DOI: 10.1371/journal.pntd.0010865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 04/13/2023] [Accepted: 03/13/2023] [Indexed: 04/05/2023] Open
Abstract
Trichophyton, Microsporum, Nannizzia and Epidermophyton genera cause dermatophytosis, the most common and highly contagious infectious skin disease. Rio de Janeiro is one of the most visited cities in the Southern Hemisphere, located in the most visited state of Brazil. This retrospective study investigated epidemiological and laboratorial aspects of dermatophytosis in Rio de Janeiro state, Brazil, by using spatiotemporal analysis. More than half of all individuals were infected by one or more dermatophytes. A variation between 18 and 106 years-old of the studied population was verified, and women more frequently affected. Patients were more frequently infected by Trichophyton spp., most of them T. rubrum, followed by T. mentagrophytes. M. canis and N. gypsea were more frequently isolated in the age group between 40 and 60 years old, while T. rubrum predominates among younger patients. All species presented homogeneous distribution while T. tonsurans appears to be restricted to the Rio de Janeiro capital while E. floccosum to the municipality of Macaé (190 Km apart from RJ). Rio de Janeiro state presented spatial clusters of dermatophytosis with high density in Guanabara Bay (E. floccosum, M. canis, N. gypsea, T. tonsurans) and Niterói (T. rubrum, T. mentagrophytes) but low density in Macaé (E. floccosum). Significant spatiotemporal clusters on dermatophytosis cases were detected in distinct municipalities (p-value ≤ 0.05). The Vulnerability Index (r = 0.293) and Demographic Density (r = 0.652) distributed according to neighborhoods in Niterói were direct related with dermatophytosis cases whereas Income (r = -0.306) was inversely correlated (p-value ≤ 0.05). The dermatophytosis spatiotemporal distinct distribution after two major international events in Rio de Janeiro, Brazil, highlight the pressing need for specific measures of its prevention and controlling. This is particularly relevant in touristic tropical localities which must consider both socio-economical and traveler's medicine variables.
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Affiliation(s)
- Simone Cristina Pereira Brito
- Center for Microorganisms' Investigation, Biomedical Institute, Department of Microbiology and Parasitology, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Márcia Ribeiro Pinto
- Laboratory of Biochemistry and Immunology of Mycoses, Biomedical Institute, Department of Microbiology and Parasitology, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Lucas Martins Alcântara
- Center for Microorganisms' Investigation, Biomedical Institute, Department of Microbiology and Parasitology, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Nathália Faria Reis
- Center for Microorganisms' Investigation, Biomedical Institute, Department of Microbiology and Parasitology, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | | | | | | | - Elisabeth Martins da Silva da Rocha
- Center for Microorganisms' Investigation, Biomedical Institute, Department of Microbiology and Parasitology, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Ricardo Luiz Dantas Machado
- Center for Microorganisms' Investigation, Biomedical Institute, Department of Microbiology and Parasitology, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | | | - Andréa Regina de Souza Baptista
- Center for Microorganisms' Investigation, Biomedical Institute, Department of Microbiology and Parasitology, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
- Rede Micologia RJ -Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ), Rio de Janeiro, Brazil
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13
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Bhat RM, Madhumita M, Jayaraman J. Dermatophytoses Severity Score - A novel point-of-care scoring tool to assess the severity of dermatophytosis. Mycoses 2023; 66:354-361. [PMID: 36564986 DOI: 10.1111/myc.13560] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 12/13/2022] [Accepted: 12/19/2022] [Indexed: 12/25/2022]
Abstract
The rising prevalence of dermatophytosis in tropical countries coupled with drug resistance necessitates an objective scoring system to define the severity, monitor therapeutic response and predict prognoses. We attempted to establish and validate a new scoring system - Dermatophytoses Severity Score (DSS), for dermatophytoses affecting non-glabrous skin. A consensus group was convened to develop an objective and reproducible scoring system to describe the extent and severity of dermatophytosis of 200 consecutive patients with dermatophytosis. A second assessment entailed independent DSS scoring of the same patients by dermatologists and residents who were not part of the consensus group. The main outcome measured was index reliability, assessed in two steps, between the observers. A two-step assessment and DSS grading of 200 consecutive patients with clinically diagnosed dermatophytoses showed high reliability (Cronbach's α test and intraclass correlation coefficient). The DSS has demonstrated high reliability, and it could serve as a novel, reproducible and objective scoring tool for dermatophytosis.
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Affiliation(s)
- Ramesh M Bhat
- Department of Dermatology and Venereology, Father Muller Medical College, Mangalore, India
| | - Monisha Madhumita
- Department of Dermatology and Venereology, Saveetha Medical College, Chennai, India
| | - Jyothi Jayaraman
- Department of Dermatology and Venereology, Father Muller Medical College, Mangalore, India
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14
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Kumar P, Ramachandran S, Das S, Bhattacharya SN, Taneja B. Insights into Changing Dermatophyte Spectrum in India Through Analysis of Cumulative 161,245 Cases Between 1939 and 2021. Mycopathologia 2023:10.1007/s11046-023-00720-6. [PMID: 36976442 DOI: 10.1007/s11046-023-00720-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 02/12/2023] [Indexed: 03/29/2023]
Abstract
Dermatophytosis is one of the most common superficial infections of the skin affecting nearly one-fifth of the world population at any given time. With nearly 30% of worldwide terbinafine-resistance cases in Trichophyton mentagrophytes/Trichophyton interdigitale and Trichophyton rubrum reported from India in recent years, there is a significant burden of the emerging drug resistance epidemic on India. Here, we carry out a comprehensive retrospective analysis of dermatophytosis in India using 1038 research articles pertaining to 161,245 cases reported from 1939 to 2021. We find that dermatophytosis is prevalent in all parts of the country despite variable climatic conditions in different regions. Our results show T. rubrum as the most prevalent until 2015, with a sudden change in dermatophyte spectrum towards T. mentagrophytes/T. interdigitale complex since then. We also carried out an 18S rRNA-based phylogenetics and an average nucleotide identity-and single nucleotide polymorphism-based analysis of available whole genomes and find very high relatedness among the prevalent dermatophytes, suggesting geographic specificity. The comprehensive epidemiological and phylogenomics analysis of dermatophytosis in India over the last 80 years, presented here, would help in region-specific prevention, control and treatment of dermatophyte infections, especially considering the large number of emerging resistance cases.
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Affiliation(s)
- Pawan Kumar
- CSIR-Institute of Genomics and Integrative Biology(CSIR-IGIB), New Delhi, 110025, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - S Ramachandran
- CSIR-Institute of Genomics and Integrative Biology(CSIR-IGIB), New Delhi, 110025, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - Shukla Das
- UCMS-GTB, Hospital, Dilshad Garden, Delhi, 110095, India
| | - S N Bhattacharya
- Dr. Babasaheb Ambedkar Medical College and Hospital, Delhi, 110085, India
| | - Bhupesh Taneja
- CSIR-Institute of Genomics and Integrative Biology(CSIR-IGIB), New Delhi, 110025, India.
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India.
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15
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Bhattacharyya A, Sadhasivam S, Sinha M, Gupta S, Saini S, Singh H, Khurana A, Sachdeva S, Sardana K, Ghosh S. Treatment of recalcitrant cases of tinea corporis/cruris caused by T. mentagrophytes - interdigitale complex with mutations in ERG11 ERG 3, ERG4, MDR1 MFS genes & SQLE and their potential implications. Int J Dermatol 2023; 62:637-648. [PMID: 36929499 DOI: 10.1111/ijd.16622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 01/10/2023] [Accepted: 02/07/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND Recalcitrant dermatophyte infections are being reported from various parts of the world due to varied causes including strain variation, steroid misuse, SQLE mutations, and variable quality of itraconazole pellet formulations. The oral drug preferred in endemic areas is itraconazole, to which MIC levels remain low, and clinical failures to itraconazole reported defy a sound scientific explanation. OBJECTIVES The objective of the study was to conduct a proteomic and genomic analysis on isolates from therapeutically recalcitrant case with isolation of gene mutations and enzymatic abnormalities to explain azole failures. METHODS Trichophyton mentagrophyte interdigitale complex strains were isolated from seven clinically non-responding tinea corporis/cruris patients, who had failed a sequential course of 6 weeks of terbinafine 250 mg QD and itraconazole 100 mg BID. After AFST 1 strain, KA01 with high MIC to most drugs was characterized using whole genome sequencing, comparative proteomic profiling, and total sterol quantification. RESULTS Sterol quantification showed that the standard strain of Trichophyton mentagrophytes (MTCC-7687) had half the ergosterol content than the resistant KA01 strain. Genomic analysis revealed mutations in SQLE, ERG4, ERG11, MDR1, MFS genes, and a novel ERG3 mutation. Proteomic analysis established the aberrant expression of acetyl Co-A transferase in the resistant strain and upregulation of thioredoxin reductase and peroxiredoxin. CONCLUSION Our findings demonstrate possible reasons for multidrug resistance in the prevalent strain with mutations in genes that predict terbinafine (SQLE) and azole actions (ERG4, ERG11, ERG3) apart from efflux pumps (MDR1, MFS) that can explain multidrug clinical failures.
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Affiliation(s)
| | | | - Mau Sinha
- Vyome Therapeutics Limited, New Delhi, India
| | - Swati Gupta
- Vyome Therapeutics Limited, New Delhi, India
| | | | | | - Ananta Khurana
- Department of Dermatology, Venereology and Leprosy, Dr. Ram Manohar Lohia Hospital, Atal Bihari Vajpayee Institute of Medical Sciences, New Delhi, India
| | - Soumya Sachdeva
- Saraswathi Institute of Medical Sciences, Anwarpur, Uttar Pradesh, India
| | - Kabir Sardana
- Department of Dermatology, Venereology and Leprosy, Dr. Ram Manohar Lohia Hospital, Atal Bihari Vajpayee Institute of Medical Sciences, New Delhi, India
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16
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Genome-wide identification and functional analysis of circRNAs in Trichophyton mentagrophytes spores and hyphae. Microb Pathog 2023; 176:106003. [PMID: 36702368 DOI: 10.1016/j.micpath.2023.106003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 01/19/2023] [Accepted: 01/20/2023] [Indexed: 01/24/2023]
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17
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Aggarwal N, Kitano S, Puah GRY, Kittelmann S, Hwang IY, Chang MW. Microbiome and Human Health: Current Understanding, Engineering, and Enabling Technologies. Chem Rev 2022; 123:31-72. [PMID: 36317983 PMCID: PMC9837825 DOI: 10.1021/acs.chemrev.2c00431] [Citation(s) in RCA: 54] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The human microbiome is composed of a collection of dynamic microbial communities that inhabit various anatomical locations in the body. Accordingly, the coevolution of the microbiome with the host has resulted in these communities playing a profound role in promoting human health. Consequently, perturbations in the human microbiome can cause or exacerbate several diseases. In this Review, we present our current understanding of the relationship between human health and disease development, focusing on the microbiomes found across the digestive, respiratory, urinary, and reproductive systems as well as the skin. We further discuss various strategies by which the composition and function of the human microbiome can be modulated to exert a therapeutic effect on the host. Finally, we examine technologies such as multiomics approaches and cellular reprogramming of microbes that can enable significant advancements in microbiome research and engineering.
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Affiliation(s)
- Nikhil Aggarwal
- NUS
Synthetic Biology for Clinical and Technological Innovation (SynCTI), National University of Singapore, Singapore 117456, Singapore,Synthetic
Biology Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117456, Singapore
| | - Shohei Kitano
- NUS
Synthetic Biology for Clinical and Technological Innovation (SynCTI), National University of Singapore, Singapore 117456, Singapore,Synthetic
Biology Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117456, Singapore
| | - Ginette Ru Ying Puah
- NUS
Synthetic Biology for Clinical and Technological Innovation (SynCTI), National University of Singapore, Singapore 117456, Singapore,Synthetic
Biology Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117456, Singapore,Wilmar-NUS
(WIL@NUS) Corporate Laboratory, National
University of Singapore, Singapore 117599, Singapore,Wilmar
International Limited, Singapore 138568, Singapore
| | - Sandra Kittelmann
- Wilmar-NUS
(WIL@NUS) Corporate Laboratory, National
University of Singapore, Singapore 117599, Singapore,Wilmar
International Limited, Singapore 138568, Singapore
| | - In Young Hwang
- NUS
Synthetic Biology for Clinical and Technological Innovation (SynCTI), National University of Singapore, Singapore 117456, Singapore,Synthetic
Biology Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117456, Singapore,Department
of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117596, Singapore,Singapore
Institute of Technology, Singapore 138683, Singapore
| | - Matthew Wook Chang
- NUS
Synthetic Biology for Clinical and Technological Innovation (SynCTI), National University of Singapore, Singapore 117456, Singapore,Synthetic
Biology Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117456, Singapore,Wilmar-NUS
(WIL@NUS) Corporate Laboratory, National
University of Singapore, Singapore 117599, Singapore,Department
of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117596, Singapore,E-mail:
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18
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Sharma A, Gupta S. Protective manifestation of herbonanoceuticals as antifungals: A possible drug candidate for dermatophytic infection. Health Sci Rep 2022; 5:e775. [PMID: 35957972 PMCID: PMC9364328 DOI: 10.1002/hsr2.775] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 07/15/2022] [Accepted: 07/17/2022] [Indexed: 11/08/2022] Open
Abstract
Background and Aims Methods Results Conclusion
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Affiliation(s)
- Anusha Sharma
- Department of Bioscience and Biotechnology Banasthali Vidyapith Banasthali Rajasthan India
| | - Sarika Gupta
- Department of Bioscience and Biotechnology Banasthali Vidyapith Banasthali Rajasthan India
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19
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Moskaluk AE, VandeWoude S. Current Topics in Dermatophyte Classification and Clinical Diagnosis. Pathogens 2022; 11:pathogens11090957. [PMID: 36145389 PMCID: PMC9502385 DOI: 10.3390/pathogens11090957] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/18/2022] [Accepted: 08/19/2022] [Indexed: 11/28/2022] Open
Abstract
Dermatophytes are highly infectious fungi that cause superficial infections in keratinized tissues in humans and animals. This group of fungi is defined by their ability to digest keratin and encompasses a wide range of species. Classification of many of these species has recently changed due to genetic analysis, potentially affecting clinical diagnosis and disease management. In this review, we discuss dermatophyte classification including name changes for medically important species, current and potential diagnostic techniques for detecting dermatophytes, and an in-depth review of Microsporum canis, a prevalent zoonotic dermatophyte. Fungal culture is still considered the “gold standard” for diagnosing dermatophytosis; however, modern molecular assays have overcome the main disadvantages of culture, allowing for tandem use with cultures. Further investigation into novel molecular assays for dermatophytosis is critical, especially for high-density populations where rapid diagnosis is essential for outbreak prevention. A frequently encountered dermatophyte in clinical settings is M. canis, which causes dermatophytosis in humans and cats. M. canis is adapting to its primary host (cats) as one of its mating types (MAT1-2) appears to be going extinct, leading to a loss of sexual reproduction. Investigating M. canis strains around the world can help elucidate the evolutionary trajectory of this fungi.
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20
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Son JH, Doh JY, Han K, Kim YH, Han JH, Bang CH, Park YM, Lee JH. Risk factors of dermatophytosis among Korean adults. Sci Rep 2022; 12:13444. [PMID: 35927302 PMCID: PMC9352717 DOI: 10.1038/s41598-022-17744-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 07/29/2022] [Indexed: 11/11/2022] Open
Abstract
Dermatophytosis includes all fungal infections caused by dermatophytes in humans. Some risk factors for the development of subtypes of dermatophytosis have been studied; however, large-scale epidemiologic studies on risk factors for total dermatophytosis are scarce. We investigated the risk factors of dermatophytosis using a nationwide study. Total 4,532,655 subjects with dermatophytosis aged between 20 and 40 years were examined using data from the Korean National Health Insurance Service from 2009 to 2018. Women showed a lower risk of development of dermatophytosis compared to men [hazard ratio (HR) 0.848; 95% confidence interval (CI) 0.843–0.853]. Subjects with elevated waist circumference (HR 1.057; 95% CI 1.048–1.065), heavy drinking (HR 1.053; 95% CI 1044–1.061), engaging in mild-to-heavy exercise (HR 1.071; 95% CI 1.064–1.077) had a higher risk of dermatophytosis. In addition, subjects with body mass index (BMI) of more than 30 kg/m2 exhibited a higher risk of dermatophytosis (HR 1.36; 95% CI 1.342–1.378) compared to those with BMIs in the range of 18.5–23 kg/m2. In this study, the risk of developing dermatophytosis significantly increased in individuals with elevated waist circumference or high BMI. Lifestyle modifications, including weight management, are suggested to be important in preventing dermatophytosis.
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Affiliation(s)
- Joon Ho Son
- Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Jee Yun Doh
- Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Yeong Ho Kim
- Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Ju Hee Han
- Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Chul Hwan Bang
- Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Young Min Park
- Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Ji Hyun Lee
- Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
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21
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Song G, Zhang M, Liu W, Liang G. Epidemiology of Onychomycosis in Chinese Mainland: A 30-year Retrospective Study. Mycopathologia 2022; 187:323-331. [PMID: 35819711 DOI: 10.1007/s11046-022-00647-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 06/18/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Onychomycosis was a common nail disease caused by dermatophytes, yeasts or molds. The prevalence of onychomycosis varied in different counties and it was necessary to understand the epidemiology in China. OBJECTIVES This study was conducted to investigate the epidemiology of onychomycosis in Chinese mainland in the past 30 years. METHODS A 30-year systemic review was carried out by searching publications investigating the prevalence of onychomycosis in Chinese mainland from 1991 to 2020. RESULTS A total of 90 articles involving more than 40,000 onychomycosis patients were enrolled in this study. The ratio of males to females was 1:1.32. Fingernail onychomycosis was found in 36.12% cases, toenail onychomycosis in 48.31%, and both fingernail and toenail onychomycosis in 15.57%. The most common clinical type of onychomycosis was distal lateral subungual onychomycosis (60.99%), followed by total dystrophic onychomycosis (18.91%), proximal subungual onychomycosis (10.19%) and superficial white onychomycosis (9.92%). Dermatophytes (60.59%) were the most frequently isolated pathogens, followed by yeasts (30.09%), molds (7.91%) and mixed infection (1.41%). The primary pathogens in dermatophytes, yeasts and molds were Trichophyton rubrum (49.93%), Candida albicans (10.99%) and Aspergillus (3.11%), respectively. Additionally, dermatophytes were more commonly affected males than females (63.69% vs. 51.57%), and mostly involved in toenail onychomycosis (75.63%). The infection of yeasts was higher in females than males (40.97% vs. 29.52%), often causing onychomycosis in fingernail than toenail (41.03% vs. 17.08%), and it was more common in warm and humid southern regions than northern area (34.07% vs. 24.41%). CONCLUSION The proportion of the causative agents changed over time, dermatophytes, especially T. rubrum had always been the predominant pathogen, followed by yeasts and molds. The distribution of fungal pathogens varied among clinical types, gender, infection sites and geography gender.
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Affiliation(s)
- Ge Song
- Department of Medical Mycology, Institute of Dermatology and Hospital for Skin Diseases, Chinese Academy of Medical Science and Peking Union Medical College, Nanjing, 210042, China.,Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.,CAMS Collection Center of Pathogen Microorganisms-D (CAMS-CCPM-D), Nanjing, 210042, China.,Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, 210042, China
| | - Meijie Zhang
- Department of Medical Mycology, Institute of Dermatology and Hospital for Skin Diseases, Chinese Academy of Medical Science and Peking Union Medical College, Nanjing, 210042, China.,Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.,CAMS Collection Center of Pathogen Microorganisms-D (CAMS-CCPM-D), Nanjing, 210042, China.,Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, 210042, China
| | - Weida Liu
- Department of Medical Mycology, Institute of Dermatology and Hospital for Skin Diseases, Chinese Academy of Medical Science and Peking Union Medical College, Nanjing, 210042, China. .,Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China. .,CAMS Collection Center of Pathogen Microorganisms-D (CAMS-CCPM-D), Nanjing, 210042, China. .,Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, 210042, China.
| | - Guanzhao Liang
- Department of Medical Mycology, Institute of Dermatology and Hospital for Skin Diseases, Chinese Academy of Medical Science and Peking Union Medical College, Nanjing, 210042, China. .,Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China. .,CAMS Collection Center of Pathogen Microorganisms-D (CAMS-CCPM-D), Nanjing, 210042, China. .,Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, 210042, China.
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22
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Carmo PHF, Freitas GJC, Dornelas JCM, Almeida BCT, Baltazar LM, Ferreira GF, Peres NTA, Santos DA. Reactive oxygen and nitrogen species are crucial for the antifungal activity of amorolfine and ciclopirox olamine against the dermatophyte Trichophyton interdigitale. Med Mycol 2022; 60:6650890. [PMID: 35896502 DOI: 10.1093/mmy/myac058] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/24/2022] [Accepted: 07/25/2022] [Indexed: 11/12/2022] Open
Abstract
Onychomycosis is a nail infection caused by Trichophyton interdigitale and other fungi, which can be treated with topical amorolfine (AMR) and ciclopirox olamine (CPX). Although these drugs are widely used, little is known about the role of reactive oxygen (ROS) and nitrogen (RNS) in their mechanism of action. Aiming to better understand the effects of AMR and CPX in dermatophytes, we evaluated whether they act through the production of ROS and peroxynitrite (PRN). We tested a set of strains, all susceptible to AMR and CPX, and these antifungals significantly reduced T. interdigitale viability within 24 hours. This effect occurred concomitantly with reduced ergosterol, increased production of ROS and PRN, and consequently increased lipid peroxidation. Together, these mechanisms lead to cell damage and fungal death. These fungicidal effects were abolished when PRN and superoxide scavengers were used in the assays, demonstrating the role of these species in the mechanism of action. We also studied the antioxidant system when T. interdigitale was exposed to AMR and CPX. Interestingly, superoxide dismutase and catalase inhibition lead to altered ROS and PRN production, lipid peroxidation, and ergosterol levels. In fact, the combination of AMR or CPX with a superoxide dismutase inhibitor was antagonistic. Together, these data demonstrate the importance of ROS and PRN in the antifungal action of AMR and CPX against the evaluated T. interdigitale strains.
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Affiliation(s)
- Paulo H F Carmo
- Laboratório de Micologia, Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, 6627, Pampulha, CEP: 31270-901, Belo Horizonte, MG, Brazil
| | - Gustavo J C Freitas
- Laboratório de Micologia, Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, 6627, Pampulha, CEP: 31270-901, Belo Horizonte, MG, Brazil
| | - João C M Dornelas
- Laboratório de Micologia, Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, 6627, Pampulha, CEP: 31270-901, Belo Horizonte, MG, Brazil
| | - Bruna C T Almeida
- Laboratório de Micologia, Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, 6627, Pampulha, CEP: 31270-901, Belo Horizonte, MG, Brazil
| | - Ludmila M Baltazar
- Laboratório de Micologia, Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, 6627, Pampulha, CEP: 31270-901, Belo Horizonte, MG, Brazil
| | - Gabriella F Ferreira
- Programa Multicêntrico de Pós Graduação em Bioquímica e Biologia Molecular, Universidade Federal de Juiz de Fora, Rua São Paulo, 745, Centro, 35010-180, Governador Valadares, MG, Brazil
| | - Nalu T A Peres
- Laboratório de Micologia, Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, 6627, Pampulha, CEP: 31270-901, Belo Horizonte, MG, Brazil
| | - Daniel A Santos
- Laboratório de Micologia, Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, 6627, Pampulha, CEP: 31270-901, Belo Horizonte, MG, Brazil
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23
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Trichophyton indotineae—An Emerging Pathogen Causing Recalcitrant Dermatophytoses in India and Worldwide—A Multidimensional Perspective. J Fungi (Basel) 2022; 8:jof8070757. [PMID: 35887512 PMCID: PMC9323571 DOI: 10.3390/jof8070757] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/17/2022] [Accepted: 07/18/2022] [Indexed: 12/22/2022] Open
Abstract
Trichophyton (T.) indotineae is a newly identified dermatophyte species that has been found in a near-epidemic form on the Indian subcontinent. There is evidence of its spread from the Indian subcontinent to a number of countries worldwide. The fungus is identical to genotype VIII within the T. mentagrophytes/T. interdigitale species complex, which was described in 2019 by sequencing the Internal Transcribed Spacer (ITS) region of ribosomal DNA of the dermatophyte. More than 10 ITS genotypes of T. interdigitale and T. mentagrophytes can now be identified. T. indotineae causes inflammatory and itchy, often widespread, dermatophytosis affecting the groins, gluteal region, trunk, and face. Patients of all ages and genders are affected. The new species has largely displaced other previously prevalent dermatophytes on the Indian subcontinent. T. indotineae has become a problematic dermatophyte due to its predominantly in vitro genetic resistance to terbinafine owing to point mutations of the squalene epoxidase gene. It also displays in vivo resistance to terbinafine. The most efficacious drug currently available for this terbinafine-resistant dermatophytoses, based on sound evidence, is itraconazole.
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24
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Akhoundi M, Nasrallah J, Marteau A, Chebbah D, Izri A, Brun S. Effect of Household Laundering, Heat Drying, and Freezing on the Survival of Dermatophyte Conidia. J Fungi (Basel) 2022; 8:jof8050546. [PMID: 35628801 PMCID: PMC9143173 DOI: 10.3390/jof8050546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/12/2022] [Accepted: 05/19/2022] [Indexed: 12/10/2022] Open
Abstract
Dermatomycoses are one of the most common dermatological infectious diseases. Dermatophytoses, such as tinea pedis (athlete’s foot) in adults and tinea capitis in children, are the most prevalent fungal diseases caused by dermatophytes. The transmission of anthropophilic dermatophytoses occurs almost exclusively through indirect contact with patient-contaminated belongings or environments and, subsequently, facilitates the spread of the infection to others. Hygienic measures were demonstrated to have an important role in removing or reducing the fungal burden. Herein, we evaluated the effectiveness of physical-based methods of laundering, heat drying, and freezing in the elimination of Trichophyton tonsurans, T. rubrum, and T. interdigitale conidia in diverse temperatures and time spectra. Based on our findings, laundering at 60 °C was effective for removing the dermatophyte conidia from contaminated linens. On the contrary, heat drying using domestic or laundromat machines; freezing at −20 °C for 24 h, 48 h, or one week; and direct heat exposure at 60 °C for 10, 30, or 90 min were unable to kill the dermatophytes. These results can be helpful for clinicians, staff of children’s communities, and hygiene practitioners for implementing control management strategies against dermatophytoses caused by mentioned dermatophyte species.
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Affiliation(s)
- Mohammad Akhoundi
- Parasitology-Mycology Department, Avicenne Hospital, AP-HP, Sorbonne Paris Nord University, 93009 Bobigny, France; (J.N.); (A.M.); (D.C.); (A.I.)
- Correspondence: (M.A.); (S.B.)
| | - Jade Nasrallah
- Parasitology-Mycology Department, Avicenne Hospital, AP-HP, Sorbonne Paris Nord University, 93009 Bobigny, France; (J.N.); (A.M.); (D.C.); (A.I.)
| | - Anthony Marteau
- Parasitology-Mycology Department, Avicenne Hospital, AP-HP, Sorbonne Paris Nord University, 93009 Bobigny, France; (J.N.); (A.M.); (D.C.); (A.I.)
| | - Dahlia Chebbah
- Parasitology-Mycology Department, Avicenne Hospital, AP-HP, Sorbonne Paris Nord University, 93009 Bobigny, France; (J.N.); (A.M.); (D.C.); (A.I.)
| | - Arezki Izri
- Parasitology-Mycology Department, Avicenne Hospital, AP-HP, Sorbonne Paris Nord University, 93009 Bobigny, France; (J.N.); (A.M.); (D.C.); (A.I.)
- Unité des Virus Émergents (UVE: Aix-Marseille Université-IRD 190-Inserm 1207-IHU Méditerranée Infection), 13005 Marseille, France
| | - Sophie Brun
- Parasitology-Mycology Department, Avicenne Hospital, AP-HP, Sorbonne Paris Nord University, 93009 Bobigny, France; (J.N.); (A.M.); (D.C.); (A.I.)
- Correspondence: (M.A.); (S.B.)
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25
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Augmenting Azoles with Drug Synergy to Expand the Antifungal Toolbox. Pharmaceuticals (Basel) 2022; 15:ph15040482. [PMID: 35455479 PMCID: PMC9027798 DOI: 10.3390/ph15040482] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 03/25/2022] [Accepted: 03/26/2022] [Indexed: 12/23/2022] Open
Abstract
Fungal infections impact the lives of at least 12 million people every year, killing over 1.5 million. Wide-spread use of fungicides and prophylactic antifungal therapy have driven resistance in many serious fungal pathogens, and there is an urgent need to expand the current antifungal arsenal. Recent research has focused on improving azoles, our most successful class of antifungals, by looking for synergistic interactions with secondary compounds. Synergists can co-operate with azoles by targeting steps in related pathways, or they may act on mechanisms related to resistance such as active efflux or on totally disparate pathways or processes. A variety of sources of potential synergists have been explored, including pre-existing antimicrobials, pharmaceuticals approved for other uses, bioactive natural compounds and phytochemicals, and novel synthetic compounds. Synergy can successfully widen the antifungal spectrum, decrease inhibitory dosages, reduce toxicity, and prevent the development of resistance. This review highlights the diversity of mechanisms that have been exploited for the purposes of azole synergy and demonstrates that synergy remains a promising approach for meeting the urgent need for novel antifungal strategies.
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26
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Trovato L, Domina M, Calvo M, De Pasquale R, Scalia G, Oliveri S. Use of Real Time Multiplex PCR for the diagnosis of dermatophytes onychomycosis in patients with empirical antifungal treatments. J Infect Public Health 2022; 15:539-544. [DOI: 10.1016/j.jiph.2022.03.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 03/12/2022] [Accepted: 03/31/2022] [Indexed: 12/22/2022] Open
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27
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Fink S, Burmester A, Hipler U, Neumeister C, Götz MR, Wiegand C. Efficacy of antifungal agents against fungal spores: An in vitro study using microplate laser nephelometry and an artificially infected 3D skin model. Microbiologyopen 2022; 11:e1257. [PMID: 35212482 PMCID: PMC8756736 DOI: 10.1002/mbo3.1257] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 09/09/1999] [Accepted: 12/01/2021] [Indexed: 12/13/2022] Open
Abstract
Dermal fungal infections seem to have increased over recent years. There is further a shift from anthropophilic dermatophytes to a growing prevalence of zoophilic species and the emergence of resistant strains. New antifungals are needed to combat these fungi and their resting spores. This study aimed to investigate the sporicidal effects of sertaconazole nitrate using microplate laser nephelometry against the microconidia of Trichophyton, chlamydospores of Epidermophyton, blastospores of Candida, and conidia of the mold Scopulariopsis brevicaulis. The results obtained were compared with those from ciclopirox olamine and terbinafine. The sporicidal activity was further determined using infected three-dimensional full skin models to determine the antifungal effects in the presence of human cells. Sertaconazole nitrate inhibited the growth of dermatophytes, molds, and yeasts. Ciclopirox olamine also had good antifungal activity, although higher concentrations were needed compared to sertaconazole nitrate. Terbinafine was highly effective against most dermatophytes, but higher concentrations were required to kill the resistant strain Trichophyton indotineae. Sertaconazole nitrate, ciclopirox olamine, and terbinafine had no negative effects on full skin models. Sertaconazole nitrate reduced the growth of fungal and yeast spores over 72 h. Ciclopirox olamine and terbinafine also inhibited the growth of dermatophytes and molds but had significantly lower effects on the yeast. Sertaconazole nitrate might have advantages over the commonly used antifungals ciclopirox olamine and terbinafine in combating resting spores, which persist in the tissues, and thus in the therapy of recurring dermatomycoses.
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Affiliation(s)
- Sarah Fink
- Department of DermatologyUniversity Hospital JenaJenaGermany
| | - Anke Burmester
- Department of DermatologyUniversity Hospital JenaJenaGermany
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28
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Song G, Zhang M, Liu W, Liang G. The Changing Face of Epidemiology of Dermatophytoses in Chinese Mainland: A 30 years Nationwide Retrospective Study from 1991 to 2020. Mycoses 2022; 65:440-448. [PMID: 35102623 DOI: 10.1111/myc.13425] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 01/06/2022] [Accepted: 01/25/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Dermatophytoses are the most common infectious skin disease. Its epidemiology varies in different countries and regions, and its prevalence in China is still unknown. OBJECTIVES We aimed to reveal the epidemiological features of dermatophytoses in Chinese mainland in the past thirty years. METHODS From 1991 to 2020, a 30-year retrospective epidemiological study was carried out. All published literatures containing dermatophytoses and dermatophytes were collected and analyzed. RESULTS A total of more than 180,000 cases in 124 articles from more than 100 hospitals were included and analyzed. Among dermatophytoses, tinea cruris (24.92%) was the predominant clinical type, followed by tinea pedis (22.97%) and tinea corporis (18.12%). In recent 10 years, tinea pedis (25.40%) was more common than tinea cruris (22.39%) and became the most common infection. Among dermatophytes, T. rubrum (69.48%) has always been the most common isolates, followed by T. mentagrophytes (16.45%) and M. canis (8.09%). Other species were found below 3%. In superficial mycoses, dermatophytes accounted for 75.52%, higher than that of yeasts/yeast-like (21.83%) and molds (2.65%). The prevalence of tinea capitis was lower in economically developed eastern region than that in central and western regions. Tinea cruris was more common in warm zones than cold zones. CONCLUSIONS The top three dermatophytoses are tinea cruris, tinea pedis and tinea corporis, while the top three dermatophytes are T. rubrum, T. mentagrophytes and M. canis. The distribution of dermatophytoses may be influenced by socioeconomic status and geographical-meteorological conditions.
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Affiliation(s)
- Ge Song
- Department of Medical Mycology, Institute of Dermatology, Chinese Academy of Medical Science and Peking Union Medical College, Nanjing, 210042, China.,Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, 210042, China
| | - Meijie Zhang
- Department of Medical Mycology, Institute of Dermatology, Chinese Academy of Medical Science and Peking Union Medical College, Nanjing, 210042, China.,Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, 210042, China
| | - Weida Liu
- Department of Medical Mycology, Institute of Dermatology, Chinese Academy of Medical Science and Peking Union Medical College, Nanjing, 210042, China.,Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, 210042, China.,Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Guanzhao Liang
- Department of Medical Mycology, Institute of Dermatology, Chinese Academy of Medical Science and Peking Union Medical College, Nanjing, 210042, China.,Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, 210042, China
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29
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Jabet A, Normand AC, Moreno-Sabater A, Guillot J, Risco-Castillo V, Brun S, Demar M, Blaizot R, Nabet C, Packeu A, Piarroux R. Investigations upon the Improvement of Dermatophyte Identification Using an Online Mass Spectrometry Application. J Fungi (Basel) 2022; 8:jof8010073. [PMID: 35050013 PMCID: PMC8780538 DOI: 10.3390/jof8010073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 12/31/2021] [Accepted: 01/07/2022] [Indexed: 12/10/2022] Open
Abstract
Online MALDI-TOF mass spectrometry applications, such as MSI-2, have been shown to help identify dermatophytes, but recurrent errors are still observed between phylogenetically close species. The objective of this study was to assess different approaches to reduce the occurrence of such errors by adding new reference spectra to the MSI-2 application. Nine libraries were set up, comprising an increasing number of spectra obtained from reference strains that were submitted to various culture durations on two distinct culture media: Sabouraud gentamicin chloramphenicol medium and IDFP Conidia medium. The final library included spectra from 111 strains of 20 species obtained from cultures on both media collected every three days after the appearance of the colony. The performance of each library was then analyzed using a cross-validation approach. The spectra acquisitions were carried out using a Microflex Bruker spectrometer. Diversifying the references and adding spectra from various culture media and culture durations improved identification performance. The percentage of correct identification at the species level rose from 63.4 to 91.7% when combining all approaches. Nevertheless, residual confusion between close species, such as Trichophyton rubrum, Trichophyton violaceum and Trichophyton soudanense, remained. To distinguish between these species, mass spectrometry identification should take into account basic morphological and/or clinico-epidemiological features.
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Affiliation(s)
- Arnaud Jabet
- AP-HP (Assistance Publique-Hôpitaux de Paris), Service de Parasitologie Mycologie, Hôpital La Pitié-Salpêtrière, 75013 Paris, France; (A.J.); (C.N.); (R.P.)
- AP-HP, Hôpital Saint-Antoine, Service de Parasitologie Mycologie, Sorbonne Université, 75012 Paris, France;
| | - Anne-Cécile Normand
- AP-HP (Assistance Publique-Hôpitaux de Paris), Service de Parasitologie Mycologie, Hôpital La Pitié-Salpêtrière, 75013 Paris, France; (A.J.); (C.N.); (R.P.)
- Correspondence:
| | - Alicia Moreno-Sabater
- AP-HP, Hôpital Saint-Antoine, Service de Parasitologie Mycologie, Sorbonne Université, 75012 Paris, France;
- Inserm, Centre d’Immunologie et des Maladies Infectieuses (CIMI-Paris), AP-HP, Hôpital Pitié-Salpêtrière, 75013 Paris, France
| | - Jacques Guillot
- Dynamic Research Group, Ecole Nationale Vétérinaire d’Alfort, UPEC, USC ANSES, 94700 Maisons-Alfort, France; (J.G.); (V.R.-C.)
- Department of Parasitology-Mycology, Ecole Nationale Vétérinaire, Agroalimentaire et de L’alimentation, Oniris, 44307 Nantes, France
| | - Veronica Risco-Castillo
- Dynamic Research Group, Ecole Nationale Vétérinaire d’Alfort, UPEC, USC ANSES, 94700 Maisons-Alfort, France; (J.G.); (V.R.-C.)
- Service de Parasitologie-Mycologie, Ecole Nationale Vétérinaire d’Alfort, Biopole Alfort, 94700 Maisons-Alfort, France
- Centre Hospitalier Universitaire Vétérinaire de la Faune Sauvage (Chuv-FS), Ecole nationale vétérinaire d’Alfort, 94700 Maisons-Alfort, France
| | - Sophie Brun
- AP-HP, Hôpital Avicenne, Service de Parasitologie-Mycologie, 93000 Bobigny, France;
| | - Magalie Demar
- EA3593 Ecosystèmes Amazoniens et Pathologie Tropicale, Université de Guyane, 97300 Cayenne, French Guiana; (M.D.); (R.B.)
- Hôpital Andrée Rosemon, Laboratoire Hospitalo-Universitaire de Parasitologie-Mycologie, 97300 Cayenne, French Guiana
| | - Romain Blaizot
- EA3593 Ecosystèmes Amazoniens et Pathologie Tropicale, Université de Guyane, 97300 Cayenne, French Guiana; (M.D.); (R.B.)
- Service de Dermatologie, Cayenne Hospital, CEDEX 97300 Cayenne, French Guiana
| | - Cécile Nabet
- AP-HP (Assistance Publique-Hôpitaux de Paris), Service de Parasitologie Mycologie, Hôpital La Pitié-Salpêtrière, 75013 Paris, France; (A.J.); (C.N.); (R.P.)
- Inserm, Institut Pierre Louis d’Epidemiologie et de Santé Publique, Sorbonne Université, 75571 Paris, France
| | - Ann Packeu
- Sciensano, BCCM/IHEM Collection, Mycology and Aerobiology Unit, 1000 Brussels, Belgium;
| | - Renaud Piarroux
- AP-HP (Assistance Publique-Hôpitaux de Paris), Service de Parasitologie Mycologie, Hôpital La Pitié-Salpêtrière, 75013 Paris, France; (A.J.); (C.N.); (R.P.)
- Inserm, Institut Pierre Louis d’Epidemiologie et de Santé Publique, Sorbonne Université, 75571 Paris, France
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30
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Geng Y, Wu W, Li R, Xu J, Gu R, Lu J, Zheng W, Zhao F, Zhang J, Gong J. Founder Effects Contribute to the Population Genetic Structure of the Major Dermatophytosis Pathogen Trichophyton rubrum on Hainan Island, China. Clin Cosmet Investig Dermatol 2021; 14:1569-1577. [PMID: 34737596 PMCID: PMC8558103 DOI: 10.2147/ccid.s329569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 10/12/2021] [Indexed: 11/23/2022]
Abstract
Background Founder events have been observed among numerous plants and animal species living on oceanic islands due to the geographic separation of these islands and the small amount of original life they harbor. However, there has been little research on the ecological characteristics of pathogenic microorganisms on islands. Trichophyton rubrum ranks the most common isolated dermatophyte causing dermatophytosis in clinic and has become an epidemic strain worldwide in recent decades. Objective To study the phylogenetic characteristics and the distribution pattern of genetic polymorphism of T. rubrum in China, which further provide theoretical basis for the prevention and control of T. rubrum. Methods In the present study, we sequenced and analyzed the genetic characteristics of 204 T. rubrum isolates from Hainan Island and other sites in China. Phylogenetic analysis and genetic polymorphisms were studied based on a total of 41,409 high-quality whole-genome SNPs. Results The majority of the isolates from Hainan Island clustered together. Mixed T. rubrum population differentiation was observed among the strains of different geographical origins. In addition, the genetic diversity (π) of the Hainan isolates was low and showed no significant difference from that of isolates from other sites. Conclusion This study is the first to discuss general ecological and evolutionary principles related to pathogenic fungi. Our findings reveal a founder effect during the origination of T. rubrum on Hainan Island and provide guidance regarding prevention and treatment strategies.
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Affiliation(s)
- Yuanyuan Geng
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Weiwei Wu
- Department of Dermatology, The Fifth People's Hospital of Hainan Province, Haikou, People's Republic of China.,National Clinical Research Center for Skin and Immune Disease, Beijing, People's Republic of China
| | - Rouyu Li
- Department of Dermatology, Peking University First Hospital, Beijing, People's Republic of China.,Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, People's Republic of China.,Research Center for Medical Mycology, Peking University, Beijing, People's Republic of China
| | - Juan Xu
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Ruixue Gu
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Jiejie Lu
- Department of Dermatology, The Fifth People's Hospital of Hainan Province, Haikou, People's Republic of China
| | - Wenai Zheng
- Department of Laboratory Medicine, The Fifth People's Hospital of Hainan Province, Haikou, People's Republic of China
| | - Fei Zhao
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Jianzhong Zhang
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Jie Gong
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
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31
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Castellanos J, Guillén-Flórez A, Valencia-Herrera A, Toledo-Bahena M, Ramírez-Cortés E, Toussaint-Caire S, Mena-Cedillos C, Salazar-García M, Bonifaz A. Unusual Inflammatory Tinea Infections: Majocchi's Granuloma and Deep/Systemic Dermatophytosis. J Fungi (Basel) 2021; 7:929. [PMID: 34829218 PMCID: PMC8617809 DOI: 10.3390/jof7110929] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 10/24/2021] [Accepted: 10/29/2021] [Indexed: 11/17/2022] Open
Abstract
PURPOSE OF REVIEW Inflammatory tinea is an uncommon group of dermatophyte entities that predominantly cause fungal infection of the skin and hair. This review intends to present all of the available evidence regarding its epidemiology, etiopathogenesis, clinical features, and diagnostic methods as well as treatments recommended for various inflammatory tinea infections. This article provides a review of Majocchi's granuloma and dermatophytic or Hadida's disease. RECENT FINDINGS The new phylogenetic classification of dermatophytes includes nine genera, and those that affect humans are Trichophyton, Microsporum, Epidermophyton, and Nannizzia. Furthermore, molecular advancements have revealed impaired antifungal immune responses caused by inflammatory tinea, which are detailed in this article. SUMMARY The common denominator in these pathologies is the presence of impaired immune responses and, consequently, an impaired inflammatory response by the host. It is necessary to be familiar with these immunological characteristics in order to use the appropriate diagnostic methods and to provide adequate treatment.
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Affiliation(s)
- Jade Castellanos
- Dermatology Department, Hospital Infantil de México Federico Gómez, Mexico City 06720, Mexico; (J.C.); (A.G.-F.); (M.T.-B.); (C.M.-C.)
| | - Andrea Guillén-Flórez
- Dermatology Department, Hospital Infantil de México Federico Gómez, Mexico City 06720, Mexico; (J.C.); (A.G.-F.); (M.T.-B.); (C.M.-C.)
| | - Adriana Valencia-Herrera
- Dermatology Department, Hospital Infantil de México Federico Gómez, Mexico City 06720, Mexico; (J.C.); (A.G.-F.); (M.T.-B.); (C.M.-C.)
| | - Mirna Toledo-Bahena
- Dermatology Department, Hospital Infantil de México Federico Gómez, Mexico City 06720, Mexico; (J.C.); (A.G.-F.); (M.T.-B.); (C.M.-C.)
| | | | - Sonia Toussaint-Caire
- Dermatology Division, Hospital General Dr. Manuel Gea González, Mexico City 14080, Mexico;
| | - Carlos Mena-Cedillos
- Dermatology Department, Hospital Infantil de México Federico Gómez, Mexico City 06720, Mexico; (J.C.); (A.G.-F.); (M.T.-B.); (C.M.-C.)
| | - Marcela Salazar-García
- Biomedical Research Department, Hospital Infantil de México Federico Gómez, Mexico City 06720, Mexico;
| | - Alexandro Bonifaz
- Dermatology & Mycology Service, Hospital General de México Dr. Eduardo Liceaga, Mexico City 06720, Mexico;
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32
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Mishra K, Bukavina L, Ghannoum M. Symbiosis and Dysbiosis of the Human Mycobiome. Front Microbiol 2021; 12:636131. [PMID: 34630340 PMCID: PMC8493257 DOI: 10.3389/fmicb.2021.636131] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 08/04/2021] [Indexed: 12/13/2022] Open
Abstract
The influence of microbiological species has gained increased visibility and traction in the medical domain with major revelations about the role of bacteria on symbiosis and dysbiosis. A large reason for these revelations can be attributed to advances in deep-sequencing technologies. However, the research on the role of fungi has lagged. With the continued utilization of sequencing technologies in conjunction with traditional culture assays, we have the opportunity to shed light on the complex interplay between the bacteriome and the mycobiome as they relate to human health. In this review, we aim to offer a comprehensive overview of the human mycobiome in healthy and diseased states in a systematic way. The authors hope that the reader will utilize this review as a scaffolding to formulate their understanding of the mycobiome and pursue further research.
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Affiliation(s)
- Kirtishri Mishra
- University Hospitals Cleveland Medical Center, Urology Institute, Cleveland, OH, United States.,Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center, Cleveland, OH, United States
| | - Laura Bukavina
- University Hospitals Cleveland Medical Center, Urology Institute, Cleveland, OH, United States.,Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center, Cleveland, OH, United States
| | - Mahmoud Ghannoum
- Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center, Cleveland, OH, United States.,Center for Medical Mycology, and Integrated Microbiome Core, Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center, Cleveland, OH, United States.,Department of Dermatology, Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center, Cleveland, OH, United States
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33
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Jain N, Jansone I, Obidenova T, Sīmanis R, Meisters J, Straupmane D, Reinis A. Epidemiological Characterization of Clinical Fungal Isolates from Pauls Stradinš Clinical University Hospital, Latvia: A 4-Year Surveillance Report. Life (Basel) 2021; 11:1002. [PMID: 34685374 PMCID: PMC8537438 DOI: 10.3390/life11101002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 09/21/2021] [Accepted: 09/21/2021] [Indexed: 12/12/2022] Open
Abstract
Nosocomial fungal infections are an emerging global public health threat that requires urgent attention and proper management. With the limited availability of treatment options, it has become necessary to understand the emerging epidemiological trends, mechanisms, and risk factors. However, very limited surveillance reports are available in the Latvian and broader European context. We therefore conducted a retrospective analysis of laboratory data (2017-2020) from Pauls Stradinš Clinical University Hospital (PSCUH), Riga, Latvia, which is one of the largest public multispecialty hospitals in Latvia. A total of 2278 fungal isolates were analyzed during the study period, with Candida spp. comprising 95% of the isolates, followed by Aspergillus spp. and Geotrichum spp. Amongst the Candida spp., C. albicans and C. glabrata made up about 75% of the isolates. The Department of Lung Diseases and Thoracic Surgery had the highest caseload followed by Intensive Care Department. Majority of the fungal isolates were collected from the bronchoalveolar lavage (37%), followed by urine (19%) and sputum (18%) samples. A total of 34 cases of candidemia were noted during the study period with C. albicans being the most common candidemia pathogen. Proper surveillance of emerging epidemiological trends serve as the most reliable and powerful cornerstone towards tackling this emerging threat.
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Affiliation(s)
- Nityanand Jain
- Department of Biology and Microbiology, Faculty of Medicine, Riga Stradiņš University, Dzirciema Street 16, LV-1007 Riga, Latvia;
| | - Inese Jansone
- Joint Laboratory, Pauls Stradiņš Clinical University Hospital, LV-1002 Riga, Latvia; (I.J.); (T.O.); (J.M.); (D.S.)
| | - Tatjana Obidenova
- Joint Laboratory, Pauls Stradiņš Clinical University Hospital, LV-1002 Riga, Latvia; (I.J.); (T.O.); (J.M.); (D.S.)
| | - Raimonds Sīmanis
- Department of Infectology, Faculty of Medicine, Riga Stradiņš University, Dzirciema Street 16, LV-1007 Riga, Latvia;
| | - Jānis Meisters
- Joint Laboratory, Pauls Stradiņš Clinical University Hospital, LV-1002 Riga, Latvia; (I.J.); (T.O.); (J.M.); (D.S.)
| | - Dagnija Straupmane
- Joint Laboratory, Pauls Stradiņš Clinical University Hospital, LV-1002 Riga, Latvia; (I.J.); (T.O.); (J.M.); (D.S.)
| | - Aigars Reinis
- Department of Biology and Microbiology, Faculty of Medicine, Riga Stradiņš University, Dzirciema Street 16, LV-1007 Riga, Latvia;
- Joint Laboratory, Pauls Stradiņš Clinical University Hospital, LV-1002 Riga, Latvia; (I.J.); (T.O.); (J.M.); (D.S.)
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Appelt L, Nenoff P, Uhrlaß S, Krüger C, Kühn P, Eichhorn K, Buder S, Beissert S, Abraham S, Aschoff R, Bauer A. [Terbinafine-resistant dermatophytoses and onychomycosis due to Trichophyton rubrum]. Hautarzt 2021; 72:868-877. [PMID: 34459941 DOI: 10.1007/s00105-021-04879-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND In recent years, therapy-refractory courses of dermatophytoses have increasingly become the focus of attention. The most frequent pathogens are Trichophyton (T.) rubrum and T. mentagrophytes. In addition to local therapy, first-line treatment includes terbinafine, an allylamine antifungal agent that acts by inhibiting squalene epoxidase and thus interfering with ergosterol synthesis. In refractory cases, terbinafine resistance due to point mutation in the squalene epoxidase gene has been frequently detected. OBJECTIVES The aim is to present specific aspects in the epidemiology of dermatophytoses with terbinafine resistance and to illustrate them on the basis of four patient cases including diagnostic procedures. MATERIALS AND METHODS A review of handbook knowledge, a selective literature search, and a review of four patient cases were performed. RESULTS Detection of the terbinafine resistance was performed by in vitro testing using the breakpoint method as well as sequencing of the Trichophyton isolate and detection of the point mutation with amino acid substitution at position L393F or F397L of squalene epoxidase. CONCLUSION In refractory and recurrent dermatophytoses, terbinafine resistance should be considered, especially in T. mentagrophytes and T. rubrum, and in vitro resistance testing of the dermatophyte and point mutation analysis of squalene epoxidase (SQLE) should be performed. Therapeutically, intermittent administration of itraconazole in combination with antifungal local therapy is recommended. Nevertheless, a recurrent course is to be expected and long-term therapy with itraconazole is usually necessary.
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Affiliation(s)
- L Appelt
- Klinik und Poliklinik für Dermatologie, Universitätsklinikum Carl Gustav Carus, Technische Universität, Fetscherstr. 74, 01307, Dresden, Deutschland.
| | - P Nenoff
- Labor für medizinische Mikrobiologie, Mölbis, Deutschland
| | - S Uhrlaß
- Labor für medizinische Mikrobiologie, Mölbis, Deutschland
| | - C Krüger
- Labor für medizinische Mikrobiologie, Mölbis, Deutschland
| | - P Kühn
- Praxis für Podologie Penelope Kühn, Rheinstr. 32, 56355, Nastätten, Deutschland
| | - K Eichhorn
- Privatpraxis für Venen & Haut, München, Deutschland
| | - S Buder
- Konsiliarlabor für Gonokokken, Klinik für Dermatologie und Venerologie, Vivantes Klinikum Neukölln, Rudower Str. 48, 12351, Berlin, Deutschland
| | - S Beissert
- Klinik und Poliklinik für Dermatologie, Universitätsklinikum Carl Gustav Carus, Technische Universität, Fetscherstr. 74, 01307, Dresden, Deutschland
| | - S Abraham
- Klinik und Poliklinik für Dermatologie, Universitätsklinikum Carl Gustav Carus, Technische Universität, Fetscherstr. 74, 01307, Dresden, Deutschland
| | - R Aschoff
- Klinik und Poliklinik für Dermatologie, Universitätsklinikum Carl Gustav Carus, Technische Universität, Fetscherstr. 74, 01307, Dresden, Deutschland
| | - A Bauer
- Klinik und Poliklinik für Dermatologie, Universitätsklinikum Carl Gustav Carus, Technische Universität, Fetscherstr. 74, 01307, Dresden, Deutschland
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Segal E, Elad D. Human and Zoonotic Dermatophytoses: Epidemiological Aspects. Front Microbiol 2021; 12:713532. [PMID: 34421872 PMCID: PMC8378940 DOI: 10.3389/fmicb.2021.713532] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 07/09/2021] [Indexed: 12/30/2022] Open
Abstract
Introduction Dermatophytes are a group of molds characterized by the ability to produce keratinases, thereby carving out for themselves specific ecological niches. Their traditional division into three genera, Trichophyton, Microsporum, and Epidermophyton has been expanded to nine and the species in each genus were modified. Dermatophytes are among the most prevalent causes of human and animal mycoses. Their epidemiology is influenced by various factors. These factors may be evolutive such as the predilected environment of the fungus, namely, humans (anthropophilic), animals (zoophilic), or environment (geophilic), is evolutionary and thus may require centuries to develop. Many other factors, however, result from a variety of causes, affecting the epidemiology of dermatophytoses within a shorter time frame. Objective This review aims at summarizing the factors that have modified the epidemiology of dermatophytoses during the last decades. Results Geographic and climatic conditions, demography such as age and gender, migration, socio-economic conditions, lifestyle, and the environment have had an impact on changes in the epidemiology of dermatophytoses, as have changes in the pattern of human interaction with animals, including pets, farm, and wild animals. A typical example of such changes is the increased prevalence of Trichophyton tonsurans, which spread from Latin America to the United States and subsequently becoming a frequent etiological agent of tinea capitis in Africa, Middle East, and other areas. Conclusion The comprehension of the epidemiology of dermatophytoses has a major bearing on their prevention and treatment. Since it is undergoing continuous changes, periodic assessments of the most recent developments of this topic are required. This article aims at providing such an overview.
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Affiliation(s)
- Esther Segal
- Sackler School of Medicine, Department of Clinical Microbiology and Immunology, Tel Aviv University, Tel Aviv, Israel
| | - Daniel Elad
- Department of Clinical Bacteriology and Mycology, Kimron Veterinary Institute, Bet Dagan, Israel
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36
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Yanyun C, Ying T, Wei K, Hua F, Haijun Z, Ping Z, Shunming X, Jian W. Preliminary Study on Antifungal Mechanism of Aqueous Extract of Cnidium monnieri Against Trichophyton rubrum. Front Microbiol 2021; 12:707174. [PMID: 34489895 PMCID: PMC8417377 DOI: 10.3389/fmicb.2021.707174] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 07/21/2021] [Indexed: 11/13/2022] Open
Abstract
Trichoderma rubrum (T. rubrum) is one of the important pathogens because it is the cause of most dermatomycosis. The treatment of Trichophyton rubrum infection is time-consuming and very expensive; it is easy for the infections to reoccur, leading to therapeutic failures, persistence, and chronic infection. These issues have inspired researchers to study natural alternative therapies instead. Cnidium monnieri (L.), as a kind of traditional Chinese medicine, has a variety of pharmacological activities and a wide range of applications, so it has a high potential for researching and economic value. We detected the effect of aqueous extract of C. monnieri (L.) on the activity of T. rubrum by Cell Count Kit-8 assay (CCK-8), and we found that 128 and 256 μg/ml of aqueous extracts of C. monnieri (L.) co-cultured with T. rubrum for 24 h showed the inhibitory effect on T. rubrum. The results of scanning electron microscopy (SEM) and transmission electron microscopy (TEM) confirmed that aqueous extract of C. monnieri (L.) damaged the T. rubrum. At the same time, mass spectrometry screening with T. rubrum before and after the treatment of 256 μg/ml of aqueous extracts of C. monnieri (L.) showed that 966 differentially expressed proteins were detected, including 524 upregulated differentially expressed genes (DEGs) and 442 downregulated DEGs. The most significantly downregulated protein was chitin synthase (CHS); and the results of qRT-PCR and Western blotting demonstrated that the expression level of CHS was downregulated in the 256 μg/ml group compared with the control group. The study showed that the aqueous extract of C. monnieri (L.) could destroy the morphology of mycelia and the internal structure of T. rubrum, and it could inhibit the growth of T. rubrum. The antifungal effect of aqueous extract of C. monnieri (L.) may be related to the downregulation of the expression of CHS in T. rubrum, and CHS may be one of the potential targets of its antifungal mechanism. We concluded that aqueous extract from C. monnieri (L.) may be a potential candidate for antifungal agents.
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Affiliation(s)
- Cao Yanyun
- Department of Dermatology, Pudong New Area People's Hospital, Shanghai, China
| | - Tang Ying
- Department of Dermatology, Pudong New Area People's Hospital, Shanghai, China
| | - Kong Wei
- Department of Dermatology, Pudong New Area People's Hospital, Shanghai, China
| | - Fang Hua
- Department of Clinical Laboratory, Pudong New Area People's Hospital, Shanghai, China
| | - Zhu Haijun
- Department of Emergency and Critical Care Medicine, Pudong New Area People' s Hospital, Shanghai, China
| | - Zheng Ping
- Department of Clinical Laboratory, Pudong New Area People's Hospital, Shanghai, China
| | - Xu Shunming
- Department of Dermatology, Pudong New Area People's Hospital, Shanghai, China
| | - Wan Jian
- Department of Emergency and Critical Care Medicine, Pudong New Area People' s Hospital, Shanghai, China
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Kromer C, Celis D, Hipler UC, Zampeli VA, Mößner R, Lippert U. Dermatophyten-Infektionen bei Kindern und Erwachsenen in Deutschland - eine retrospektive multizentrische Studie. J Dtsch Dermatol Ges 2021; 19:993-1002. [PMID: 34288468 DOI: 10.1111/ddg.14432_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 01/07/2021] [Indexed: 12/01/2022]
Affiliation(s)
- Christian Kromer
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Göttingen
| | - Daniel Celis
- Fakultät für Wirtschaftswissenschaften, Georg-August-Universität Göttingen
| | | | - Vasiliki A Zampeli
- Hochschulklinik für Dermatologie, Venerologie und Allergologie, Immunologisches Zentrum, Städtisches Klinikum Dessau
| | - Rotraut Mößner
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Göttingen
| | - Undine Lippert
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Göttingen
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Nowicka D, Nawrot U. Tinea pedis-An embarrassing problem for health and beauty-A narrative review. Mycoses 2021; 64:1140-1150. [PMID: 34145648 DOI: 10.1111/myc.13340] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 05/31/2021] [Indexed: 12/19/2022]
Abstract
Fungal infections present with a broad spectrum of diseases in humans (from relatively mild superficial infections of the skin and mucous membranes to the invasive or chronic infections of internal organs, which have a high mortality rate). Globally, up to 1.6 million people die each year as a result of various types of mycoses. Currently, many scientific studies focus on the best possible understanding of the aspects of the epidemiology and pathogenesis of invasive mycoses and effective methods to combat them. However, mycoses of the skin and its appendages remain a relatively less explored area. In some communities, superficial mycoses are a frequent problem as they affect nearly 70% of the population, an example of which is the athlete's foot. It involves the nails (onychomycosis) and skin (tinea pedis). It is mainly caused by keratin-decomposing dermatophyte fungi. Less often, infections are caused by non-dermatophyte moulds (Fusarium, Aspergillus, Scopulariopsis) or yeasts. Several factors have been listed as having substantial influence on the development of dermatophytosis, including those related to climate, season, geographical region, as well as to demography, socioeconomic and cultural customs, professions or contact with animals. In this review, we summarise the current knowledge about aetiology, epidemiology, diagnostics and therapy of tinea pedis with a special focus to the role of podologic management in spreading, prevention and therapy of mycoses. The article presents up-to-date knowledge on the management of the patient from the diagnosis, treatment and skincare, to counselling on how to prevent fungal skin infections in the long term.
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Affiliation(s)
- Danuta Nowicka
- Department of Dermatology, Venereology and Allergology, Wrocław Medical University, Wrocław, Poland
| | - Urszula Nawrot
- Department of Pharmaceutical Microbiology and Parasitology, Wroclaw Medical University, Wrocław, Poland
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39
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Quality of life and therapeutic regimen management in onychomycosis patients and in vitro study of antiseptic solutions. Sci Rep 2021; 11:12789. [PMID: 34140577 PMCID: PMC8211768 DOI: 10.1038/s41598-021-92111-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 06/04/2021] [Indexed: 12/02/2022] Open
Abstract
Onychomycosis or tinea unguium (EE12.1) and Onychomycosis due to non-dermatophyte moulds (1F2D.5) (OM) is a fungal infection of the nail plates with a high prevalence that often affects vulnerable people with co-existing health problems. Gold standard pharmacological treatments for onychomycosis have been associated with low success rates and increasing antifungal resistance, suggesting that treatment outcome is dependent on multiple variables. Here, the prevalence of OM and quality of life were characterized in two vulnerable populations—Hospital patients and Homeless people. Comparing both groups, the most prevalent fungal species were identified in Hospital patients. Then, the in vitro fungicidal properties of the antiseptics povidone-iodine, polyhexamethylene biguanide-betaine, octenidine dihydrochloride, and a super-oxidized solution against two ATCC strains (Candida albicans and Aspergillus niger) and three clinical fungal isolates from Hospital patients (Candida parapsilosis, Trichophyton interdigitale, and Trichophyton rubrum) were tested. OM prevalence was high in both patient groups studied, who also reported a reduction in quality of life and concerns about the state of their feet. In addition, Hospital patients had a non-negligent therapeutic regimen management style. Antiseptics tested in vitro revealed antifungal properties. As antiseptics are low-cost and easy to apply and have few iatrogenic effects, the demonstration of fungicidal properties of these solutions suggests that they may constitute potential supportive therapeutics for OM.
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Bitencourt TA, Neves-da-Rocha J, Martins MP, Sanches PR, Lang EAS, Bortolossi JC, Rossi A, Martinez-Rossi NM. StuA-Regulated Processes in the Dermatophyte Trichophyton rubrum: Transcription Profile, Cell-Cell Adhesion, and Immunomodulation. Front Cell Infect Microbiol 2021; 11:643659. [PMID: 34169004 PMCID: PMC8218993 DOI: 10.3389/fcimb.2021.643659] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 05/06/2021] [Indexed: 12/19/2022] Open
Abstract
Fungal infections represent a significant concern worldwide, contributing to human morbidity and mortality. Dermatophyte infections are among the most significant mycoses, and Trichophyton rubrum appears to be the principal causative agent. Thus, an understanding of its pathophysiology is urgently required. Several lines of evidence have demonstrated that the APSES family of transcription factors (Asm1p, Phd1p, Sok2p, Efg1p, and StuA) is an important point of vulnerability in fungal pathogens and a potential therapeutic target. These transcription factors are unique to fungi, contributing to cell differentiation and adaptation to environmental cues and virulence. It has recently been demonstrated that StuA plays a pleiotropic role in dermatophyte pathophysiology. It was suggested that it functions as a mediator of crosstalk between different pathways that ultimately contribute to adaptive responses and fungal-host interactions. The complex regulation of StuA and its interaction pathways are yet to be unveiled. Thus, this study aimed to gain a deeper understanding of StuA-regulated processes in T. rubrum by assessing global gene expression following growth on keratin or glucose sources. The data showed the involvement of StuA in biological processes related to central carbon metabolism and glycerol catabolism, reactive oxygen species metabolism, and cell wall construction. Changes in carbohydrate metabolism may be responsible for the significant alteration in cell wall pattern and consequently in cell-cell interaction and adhesion. Loss of StuA led to impaired biofilm production and promoted proinflammatory cytokine secretion in a human keratinocyte cell line. We also observed the StuA-dependent regulation of catalase genes. Altogether, these data demonstrate the multitude of regulatory targets of StuA with a critical role in central metabolism that may ultimately trigger a cascade of secondary effects with substantial impact on fungal physiology and virulence traits.
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Affiliation(s)
- Tamires A Bitencourt
- Department of Genetics, Ribeirão Preto Medical School, University of São Paulo, USP, Ribeirão Preto, Brazil
| | - João Neves-da-Rocha
- Department of Genetics, Ribeirão Preto Medical School, University of São Paulo, USP, Ribeirão Preto, Brazil
| | - Maira P Martins
- Department of Genetics, Ribeirão Preto Medical School, University of São Paulo, USP, Ribeirão Preto, Brazil
| | - Pablo R Sanches
- Department of Genetics, Ribeirão Preto Medical School, University of São Paulo, USP, Ribeirão Preto, Brazil
| | - Elza A S Lang
- Department of Genetics, Ribeirão Preto Medical School, University of São Paulo, USP, Ribeirão Preto, Brazil
| | - Julio C Bortolossi
- Department of Genetics, Ribeirão Preto Medical School, University of São Paulo, USP, Ribeirão Preto, Brazil
| | - Antonio Rossi
- Department of Genetics, Ribeirão Preto Medical School, University of São Paulo, USP, Ribeirão Preto, Brazil
| | - Nilce M Martinez-Rossi
- Department of Genetics, Ribeirão Preto Medical School, University of São Paulo, USP, Ribeirão Preto, Brazil
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Tahiliani S, Saraswat A, Lahiri AK, Shah A, Hawelia D, Shah GK, Girdhar M, Rao PN, Raghav PA, Agarwal P, Kharkar RD, Gupta RP, Udare S, Hegde S, Haldar S. Etiological prevalence and antifungal sensitivity patterns of dermatophytosis in India - A multicentric study. Indian J Dermatol Venereol Leprol 2021; 87:800-806. [PMID: 34160163 DOI: 10.25259/ijdvl_1025_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 12/01/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND The prevalence of dermatophytes varies with season, geographical area, socio-economic factors and effective management strategies. AIMS The aim of the study was to assess the prevalence of pathogenic dermatophytes, clinical types of dermatophyte fungal infection, and in vitro antifungal drug susceptibility testing against dermatophytes. METHODS Three hundred and ninety five patients with dermatophytosis were enrolled from five cities (Mumbai, Delhi, Lucknow, Kolkata and Hyderabad) across India. All patients were subjected to clinical examination and investigations, including potassium hydroxide microscopy, fungal culture and antifungal drug susceptibility testing. RESULTS Trichophyton rubrum was the most common species identified (68.4%), followed by T. mentagrophytes (29.3%). Within species, T. mentagrophytes was prevalent in humid environmental conditions (Mumbai and Kolkata), whereas T. rubrum was prevalent in noncoastal areas (Delhi, Lucknow and Hyderabad). Tinea corporis (71.4%) and tinea cruris (62.0%) were the common clinical types observed. antifungal drug susceptibility testing data indicated that minimum inhibitory concentration required to inhibit the growth of 90% of organisms (MIC-90) was lowest for griseofulvin (0.25-3.0 μg/mL). Among oral antifungals, the mean MIC of itraconazole was within the range (0.84 [0.252] μg/ mL), whereas high mean MIC values were reported for terbinafine (0.05 [0.043] μg/mL). Among topical agents, lowest mean MIC values were reported for luliconazole (0.29 [0.286] μg/mL), eberconazole (0.32 [0.251]) μg/mL and amorolfine (0.60 [0.306]) μg/mL. LIMITATIONS Lack of correlation between in vitro antifungal susceptibility and clinical outcome and absence of defined MIC breakpoints. CONCLUSION T. rubrum was the most common, followed by T. mentagrophytes as an emerging/codominant fungal isolate in India. Tinea corporis was the most common clinical type of dermatophytosis. Mean MIC of terbinafine was above the reference range, while it was within the range for itraconazole; griseofulvin had the lowest mean MIC. Luliconazole presented the lowest mean MIC values across cities.
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Affiliation(s)
- Sushil Tahiliani
- Dr. Tahiliani's Clinic, A 201/202, Gasper Enclave Ambedkar Road, Pali Market, Next to Gold's Gym, Bandra West, Mumbai, Maharashtra, India
| | - Abir Saraswat
- Indushree Skin Clinic, Near Hotel Bandhan, Faizabad Road, Indiranagar Colony, Lucknow, Uttar Pradesh, India
| | - A K Lahiri
- Skin and Laser Clinic, 204, Amsri Plaza, Sarojini Devi Road, Near to Domino's Pizza, Secunderabad, Telangana, India
| | - Avani Shah
- Dr. Miskeen's Central Clinical Microbiology Laboratory, Nirmal, 1st Floor, Behind Amrapali Hotel, Near Gadkari Rangayatan, Old Mumbai-Pune Road, Thane (West), Thane, Maharashtra, India
| | - Dinesh Hawelia
- Dr.Hawelia's Skin Clinic, 1st Floor, 245A, Chittaranjan Avenue, Kolkata, West Bengal, India
| | - G K Shah
- Skin Zone, No. 404, Vini Elegance, Above Tanishq Jewellers, L. T. Road, Borivali (West), Mumbai, Maharashtra, India
| | - Mukesh Girdhar
- Dr Mukesh Girdhar's Skin Clinic, 101, 1st Floor, Rishab Tower, Community Centre, Karkardooma, Anand Vihar, Delhi, India
| | - P Narasimha Rao
- Comprehensive Dermatology Clinic, Plot No 4, Satya Apartment, Masab Tank, Opposite Polytechnic College, Beside Golconda Hotel, Hyderabad, Telangana, India
| | - Potharaju Arun Raghav
- Comprehensive Dermatology Clinic, Plot No 4, Satya Apartment, Masab Tank, Opposite Polytechnic College, Beside Golconda Hotel, Hyderabad, Telangana, India
| | - Pramod Agarwal
- Yuva Skin and Laser Center, A-1031, A-Block, Indira Nagar, Lucknow, Uttar Pradesh, India
| | - R D Kharkar
- Dr. Kharkar's Skin Clinic, Room No 55 , 5th Floor, Dattani Chambers, S V Road, Opposite Shantinath Shopping Centre, Malad West, Mumbai, Maharashtra, India
| | - R P Gupta
- GNH Excel Medical Centre, BN-56, Jhulelal Mandir Marg, Shalimar Bagh, Block BN, Poorbi Shalimar Bag, Shalimar Bagh, Delhi, India
| | - Satish Udare
- Sparkle Skin and Aesthetic Centre, Shanti Center Building, Sector 17, Vashi, Navi Mumbai, India
| | - Sudha Hegde
- Dr. Sudha Hegade Clinic, 101, 1st Floor, Eknath Apartment, Near Paanch Rasta, Above Real Pharmacy, M G Road, Mulund (West), Mumbai, Maharashtra, India
| | - Susmit Haldar
- Calcutta Skin Institute, 169, Scheme 6 M, C I T Road, Kankurgachi, Kolkata, West Bengal, India
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Lopes AI, Tavaria FK, Pintado ME. Conventional and natural compounds for the treatment of dermatophytosis. Med Mycol 2021; 58:707-720. [PMID: 31773153 DOI: 10.1093/mmy/myz116] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 09/16/2019] [Accepted: 10/31/2019] [Indexed: 01/22/2023] Open
Abstract
Dermatophytes are a group of pathogenic fungi that exclusively infect the stratum corneum of the skin, nails, and hair, causing dermatophytosis. Superficial skin infections caused by dermatophytes have increased in the last decades. There are conventional antifungals that treat these infections, such as terbinafine, fluconazole, and others. However, the limitations of these treatments (resistance, side effects and toxicity) along with the increasing over-prescription, the misuse of these antifungals and the high treatment costs led to the search for new, alternative, natural-based antifungal drugs. These have multiple mechanisms of action, which works to their advantage, making it difficult for a fungus to create resistance mechanisms against all of them at the same time. The main objective of this work is to provide a state-of-the-art review on dermatophytes, dermatophytosis, and the existing treatments, both conventional and natural, such as chitosan and essential oils.
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Affiliation(s)
- Ana I Lopes
- Centro de Biotecnologia e Química Fina - Laboratório Associado, Escola Superior de Biotecnologia, Universidade Católica Portuguesa/Porto, Rua de Diogo Botelho, 1327, 4169-005 Porto, Portugal
| | - Freni K Tavaria
- Centro de Biotecnologia e Química Fina - Laboratório Associado, Escola Superior de Biotecnologia, Universidade Católica Portuguesa/Porto, Rua de Diogo Botelho, 1327, 4169-005 Porto, Portugal
| | - Manuela E Pintado
- Centro de Biotecnologia e Química Fina - Laboratório Associado, Escola Superior de Biotecnologia, Universidade Católica Portuguesa/Porto, Rua de Diogo Botelho, 1327, 4169-005 Porto, Portugal
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Boero E, Mnich ME, Manetti AGO, Soldaini E, Grimaldi L, Bagnoli F. Human Three-Dimensional Models for Studying Skin Pathogens. Curr Top Microbiol Immunol 2021; 430:3-27. [PMID: 32601967 DOI: 10.1007/82_2020_219] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Skin is the most exposed surface of the human body, separating the microbe-rich external environment, from the sterile inner part. When skin is breached or its homeostasis is perturbed, bacterial, fungal and viral pathogens can cause local infections or use the skin as an entry site to spread to other organs. In the last decades, it has become clear that skin provides niches for permanent microbial colonization, and it actively interacts with microorganisms. This crosstalk promotes skin homeostasis and immune maturation, preventing expansion of harmful organisms. Skin commensals, however, are often found to be skin most prevalent and dangerous pathogens. Despite the medical interest, mechanisms of colonization and invasion for most skin pathogens are poorly understood. This limitation is due to the lack of reliable skin models. Indeed, animal models do not adequately mimic neither the anatomy nor the immune response of human skin. Human 3D skin models overcome these limitations and can provide new insights into the molecular mechanisms of microbial pathogenesis. Herein, we address the strengths and weaknesses of different types of human skin models and we review the main findings obtained using these models to study skin pathogens.
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Affiliation(s)
| | | | | | | | - Luca Grimaldi
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
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Kromer C, Celis D, Hipler UC, Zampeli VA, Mößner R, Lippert U. Dermatophyte infections in children compared to adults in Germany: a retrospective multicenter study in Germany. J Dtsch Dermatol Ges 2021; 19:993-1001. [PMID: 33973357 DOI: 10.1111/ddg.14432] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 01/07/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND AND OBJECTIVE Dermatophyte infections of the skin and nails are common worldwide and vary between geographical areas and over time. The aim of this study was to determine the epidemiological profile of dermatophytes in Germany with a focus on comparing children with adults. PATIENTS AND METHODS In this retrospective multicenter study, mycological dermatophyte culture results in the period 01/2014 to 12/2016 were analyzed according to identified pathogen, age and gender of patients, and type of disease. RESULTS Of 1,136 infections (children: n = 88, adults: n = 1,048), 50.8 % were clinically classified as onychomycosis, followed by tinea pedis (34.6 %), tinea corporis (16.2 %), tinea manus (16.2 %), tinea capitis (2.5 %), and tinea faciei (1.2 %). The most frequent pathogen was Trichophyton (T.) rubrum (78.6 %), followed by T. interdigitale (14.3 %), T. benhamiae (3.2 %), T. mentagrophytes (2.1 %), and Microsporum canis (1.7 %). The fungal spectrum differed particularly in tinea corporis and tinea capitis between children and adults with a more diverse pathogen spectrum in children. Trichophyton tonsurans was rarely identified as cause for tinea corporis (2.7 %) or tinea capitis (3.3 %). CONCLUSIONS Differences in pathogens and frequency of fungal infections between age groups should be considered for optimal selection of the appropriate therapeutic regimen.
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Affiliation(s)
- Christian Kromer
- Department of Dermatology, Venereology, and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Daniel Celis
- Faculty of Economic Sciences, Georg August University Göttingen, Göttingen, Germany
| | | | - Vasiliki A Zampeli
- Department of Dermatology, Venereology, Allergology, and Immunology, Dessau Medical Center, Dessau, Germany
| | - Rotraut Mößner
- Department of Dermatology, Venereology, and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Undine Lippert
- Department of Dermatology, Venereology, and Allergology, University Medical Center Göttingen, Göttingen, Germany
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Pham CVA, Rademacher F, Hinrichs H, Beck-Jendroschek V, Harder M, Brasch J, Gläser R, Harder J. Expression of epidermal antimicrobial peptides is increased in tinea pedis. Mycoses 2021; 64:763-770. [PMID: 33797129 DOI: 10.1111/myc.13279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/23/2021] [Accepted: 03/25/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Tinea pedis is often chronic or recurrent, but not all individuals are equally susceptible to this infection. Dermatophytes are able to induce the expression of antimicrobial peptides and proteins (AMPs) in human keratinocytes and certain AMPs can inhibit the growth of dermatophytes. OBJECTIVE The focus of this study was to analyse the secretion of relevant AMPs, especially RNase 7, human beta-defensin-2 (hBD-2) and the S-100 protein psoriasin (S100A7), in patients with confirmed tinea pedis. METHODS To verify the diagnosis, skin scales were obtained from all patients (n = 13) and the dermatophytes were identified by potassium hydroxide mount, culture and molecular analysis. To determine the AMP concentrations, the lesional skin area of the foot was rinsed with a buffer that was subsequently analysed by ELISA. The corresponding area of the other unaffected foot as well as defined healthy skin areas of the forearm and forehead and samples from age and gender-matched healthy volunteers served as controls. RESULTS In tinea pedis patients the AMP concentrations were higher in lesional skin than in non-lesional skin and in healthy skin of controls. In particular, concentrations of hBD-2 and psoriasin were significantly elevated. CONCLUSIONS The induction of AMPs in tinea pedis might be triggered directly by the dermatophytes; furthermore, attendant inflammation and/or differentiation processes may play a role. Our results indicate that there is no defect in the constitutive expression and induction of the analysed AMPs by dermatophytes in the epidermis of affected patients. However, it is not known why the elevated AMP concentrations fail to efficiently combat dermatophyte growth.
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Affiliation(s)
- Christina Van Anh Pham
- Department of Dermatology, Venerology and Allergology, Quincke Research Center, University-Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Franziska Rademacher
- Department of Dermatology, Venerology and Allergology, Quincke Research Center, University-Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Heilwig Hinrichs
- Department of Dermatology, Venerology and Allergology, Quincke Research Center, University-Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Vera Beck-Jendroschek
- Department of Dermatology, Venerology and Allergology, Mycological Laboratory, University Hospitals of Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Melanie Harder
- EUROIMMUN Medical Laboratory Diagnostic AG, Lübeck, Germany
| | - Jochen Brasch
- Department of Dermatology, Venerology and Allergology, Mycological Laboratory, University Hospitals of Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Regine Gläser
- Department of Dermatology, Venerology and Allergology, Quincke Research Center, University-Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Jürgen Harder
- Department of Dermatology, Venerology and Allergology, Quincke Research Center, University-Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
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Gnat S, Dyląg M, Łagowski D, Zielinski J. Therapeutic efficacy of topically used luliconazole vs. terbinafine 1% creams. Mycoses 2021; 64:967-975. [PMID: 33884673 DOI: 10.1111/myc.13289] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/12/2021] [Accepted: 04/13/2021] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Dermatomycoses of zoophilic origin, especially those caused by Trichophyton mentagrophytes, often pose considerable therapeutic problems. This is reflected in the growing number of strains of this species with resistance to terbinafine caused by a mutation in the squalene epoxidase (SQLE) gene. Therefore, it is reasonable to look for alternative therapies to the commonly used terbinafine. The aim of the present study was to assess the in vivo effectiveness of topical therapy with luliconazole or terbinafine 1% cream. METHODS Therapeutic efficacy was assessed using direct examination in KOH with DMSO, qPCR analysis with pan-dermatophyte primers and culturing. Moreover, in vitro susceptibility tests for luliconazole and terbinafine were performed. RESULTS The results demonstrated significantly higher antifungal activity of luliconazole than terbinafine against dermatomycoses caused by T. mentagrophytes. The geometric mean of the MIC value for luliconazole against all T. mentagrophytes strains was 0.002 μg/ml, while this value for terbinafine was 0.004 μg/ml. In all studied cases, 28-day local therapy with luliconazole contributed to complete eradication of the aetiological agent of infection. CONCLUSIONS Given the increasingly frequent reports of difficult-to-treat dermatophytoses caused by zoophilic terbinafine-resistant strains, the 1% luliconazole cream can be alternative solution in topical therapy.
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Affiliation(s)
- Sebastian Gnat
- Department of Veterinary Microbiology, Institute of Preclinical Veterinary Sciences, Faculty of Veterinary Medicine, University of Life Sciences, Akademicka 12, Lublin, 20-033, Poland
| | - Mariusz Dyląg
- Department of Mycology and Genetics, Institute of Genetics and Microbiology, Faculty of Biological Sciences, University of Wroclaw, Wroclaw, Poland
| | - Dominik Łagowski
- Department of Veterinary Microbiology, Institute of Preclinical Veterinary Sciences, Faculty of Veterinary Medicine, University of Life Sciences, Akademicka 12, Lublin, 20-033, Poland
| | - Jessica Zielinski
- Hollings Cancer Center, Medical University of South Carolina (MUSC), Charleston, SC, USA
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Rosalie S, Lize C, Laurence S, Rajae D, Caroline A, Katrien L, Marie-Pierre H. Epidemiology of Dermatophytes in Belgium: A 5 Years' Survey. Mycopathologia 2021; 186:399-409. [PMID: 33900539 DOI: 10.1007/s11046-021-00542-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 03/15/2021] [Indexed: 01/01/2023]
Abstract
Dermatophytes are among the most common fungal agents causing superficial skin infections worldwide. Epidemiology of these infections is evolving and variable in every country. This report presents the Belgian epidemiological data regarding the distribution of dermatophytes species isolated by the two national reference centers for mycosis during a period of 5 years (2012-2016). Trichophyton rubrum was the most frequently isolated species, considering all sampling sites (60.3% on average between 2012 and 2016). More precisely, this dermatophyte was the major agent of Tinea unguium and Tinea corporis during this period, followed by species of the Trichophyton mentagrophytes complex. Moreover, Microsporum audouinii was the main etiological agent of Tinea capitis (TC) with a frequency of 52.5% on average between 2012 and 2016. Other African dermatophytes species such as Trichophyton soudanense and Trichophyton violaceum were also agents of TC with a respective prevalence of 11.6% and 11.5% on average. This study highlights a different dermatophyte distribution in Belgium in comparison with other European countries.
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Affiliation(s)
- Sacheli Rosalie
- Department of Clinical Microbiology, Belgian National Reference Center, University Hospital of Liege, Liège, Belgium.
| | - Cuypers Lize
- Laboratory of Clinical Bacteriology and Mycology, Belgian National Reference Center, University Hospital of Leuven, Leuven, Belgium
| | - Seidel Laurence
- Department of Biostatistics, University Hospital of Liege, Liege, Belgium
| | - Darfouf Rajae
- Department of Clinical Microbiology, Belgian National Reference Center, University Hospital of Liege, Liège, Belgium
| | - Adjetey Caroline
- Department of Clinical Microbiology, Belgian National Reference Center, University Hospital of Liege, Liège, Belgium
| | - Lagrou Katrien
- Laboratory of Clinical Bacteriology and Mycology, Belgian National Reference Center, University Hospital of Leuven, Leuven, Belgium
| | - Hayette Marie-Pierre
- Department of Clinical Microbiology, Belgian National Reference Center, University Hospital of Liege, Liège, Belgium
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Pablo T, Mzabi A, Meo M, Decruyenaere F, Perrin M. Routine laboratory test enabling the detection of dermatophytes and the identification of Trichophyton rubrum by means of in-house duplex real-time PCR. J Microbiol Methods 2021; 185:106229. [PMID: 33887312 DOI: 10.1016/j.mimet.2021.106229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 04/15/2021] [Accepted: 04/16/2021] [Indexed: 10/21/2022]
Abstract
Dermatophytes are responsible, in majority, for fungal infections of skin, hair and nails, and Trichophyton rubrum is the most frequently isolated dermatophyte in humans. The time for dermatophyte growth in culture requires a total of two to four weeks. Molecular methods were developed to improve time to diagnosis and initiation of treatment. We present here an in-house duplex real-time PCR enabling detection of dermatophytes and simultaneous identification of T. rubrum from mycological samples and cultures. The objective of this work was to optimize the fungal DNA extraction method, the detection of dermatophytes and the identification of T. rubrum on a CFX96® (Real-Time PCR Detection System). In addition, the method comparison showed that this new method is more sensitive than the culture and microscopic observations. To conclude, this routinely used method has been accredited ISO 15189 since January 2020 in our laboratory.
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Affiliation(s)
- Thomas Pablo
- Bacteriology, Mycology, Antibiotic Resistance and Hospital Hygiene Service, Department of Microbiology, Laboratoire National de Santé, Dudelange, Luxembourg
| | - Alexandre Mzabi
- Bacteriology, Mycology, Antibiotic Resistance and Hospital Hygiene Service, Department of Microbiology, Laboratoire National de Santé, Dudelange, Luxembourg.
| | - Marie Meo
- Bacteriology, Mycology, Antibiotic Resistance and Hospital Hygiene Service, Department of Microbiology, Laboratoire National de Santé, Dudelange, Luxembourg
| | - Frédéric Decruyenaere
- Bacteriology, Mycology, Antibiotic Resistance and Hospital Hygiene Service, Department of Microbiology, Laboratoire National de Santé, Dudelange, Luxembourg
| | - Monique Perrin
- Bacteriology, Mycology, Antibiotic Resistance and Hospital Hygiene Service, Department of Microbiology, Laboratoire National de Santé, Dudelange, Luxembourg
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Mechanism of streptomyces albidoflavus STV1572a derived 1-heneicosanol as an inhibitor against squalene epoxidase of Trichophyton mentagrophytes. Microb Pathog 2021; 154:104853. [PMID: 33811987 DOI: 10.1016/j.micpath.2021.104853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/05/2021] [Accepted: 03/05/2021] [Indexed: 11/20/2022]
Abstract
An increase in incidences of tinea infections paves the way to discover the novel antifungal drugs from unexplored natural resources. The quality of life in patients with tinea infection may be affected by different factors, including morbidity, length of illness, social and demographic factors. The present investigation explores the functional principle of a bioactive compound isolated from actinomycetes, S. albidoflavus STV1572a by in-silico and in-vitro studies. In continuation of our previous reports on the antidermatophytic potential of S. albidoflavus STV1572a, this study progresses with the in-silico molecular docking study of the seven GC-MS discovered ligands, and six dermatophytic modelled targets. Through virtual screening, it was revealed that a docking score -8.8 between 1-heneicosanol and squalene epoxidase favored partially in understanding the mode of action. Further validation of in-silico study was performed by a sterol quantification assay which confirmed the antidermatophytic mechanism of 1-heneicosanol. Taken together, the evidence from this study suggests that 1-heneicosanol has a potential antidermatophytic compound and can be considered for dermatophytic treatment.
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Sharma B, Nonzom S. Superficial mycoses, a matter of concern: Global and Indian scenario-an updated analysis. Mycoses 2021; 64:890-908. [PMID: 33665915 DOI: 10.1111/myc.13264] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 02/25/2021] [Accepted: 02/26/2021] [Indexed: 01/19/2023]
Abstract
Superficial mycoses of skin, nails and hair are among the common fungal infections. They are caused by dermatophytes, non-dermatophyte moulds, yeasts and yeast-like fungi. Such fungal infections are widespread all over the world and are predominant in tropical as well as subtropical regions. Environmental factors, such as warm, humid and pitiable hygienic conditions, are conducive for their growth and proliferation. Although it does not cause mortality, it is known to be associated with excessive morbidity which may be psychological or physical. This affects the quality of life of the infected individuals which leads to a negative impact on their occupational, emotional and social status. Such infections are increasing on a global scale and, therefore, are of serious concern worldwide. This review article covers the global and Indian scenario of superficial mycoses taking into account the historical background, aetiological agents, prevalence, cultural and environmental factors, risk factors, pathogenesis and hygienic practices for the prevention of superficial mycoses.
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Affiliation(s)
- Bharti Sharma
- Department of Botany, University of Jammu, Jammu, Jammu and Kashmir, India
| | - Skarma Nonzom
- Department of Botany, University of Jammu, Jammu, Jammu and Kashmir, India
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