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Diniz BV, Ferreira SB, Negri M. Prevalence of psoriasis and cutaneous mycoses: A descriptive study in Paraná, Brazil. AN ACAD BRAS CIENC 2024; 96:e20230828. [PMID: 38808876 DOI: 10.1590/0001-3765202420230828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 03/17/2024] [Indexed: 05/30/2024] Open
Abstract
The epidemiology of psoriasis and cutaneous mycoses is scarce in Brazil. Thus, this cross-sectional study aimed to characterize the distribution of these diseases in Paraná. Data was obtained from the Outpatient Information System (SIA - Sistema de Informações Ambulatoriais), between 2016 and 2020. The procedures were filtered by the International Classification of Diseases (ICD). A total of 201,161 outpatient procedures were registered for psoriasis and psoriatic arthritis. The distribution concerning gender was similar (50.93% feminine; 49.07% masculine). The mean age was 51.55 years. The most frequent procedure was methotrexate dispensing (23.17%), followed by acitretin (14.29%) and adalimumab (12.55%). Adjusting to total population, the prevalence of procedures was 0.35%. Regarding cutaneous mycoses, 1,756 procedures were registered. 65% of them referred to females. White race/color was predominant (82.97%). The mean age was 37.6 years. The distribution concerning age varied according to the type of mycosis. Medical appointments (48.92%) and surgical pathology exam/biopsy (38.71%) were the most frequent procedures. The prevalence of procedures was 0.004%. This is the first epidemiological study using SIA about the population affected by psoriasis, psoriatic arthritis, and cutaneous mycoses in a Brazilian state. We believe that these findings allow relevant contribution to science and public policies in Brazil.
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Affiliation(s)
- Beatriz V Diniz
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Estadual de Maringá, Departamento de Análises Clínicas e Biomedicina, Av. Colombo, 5790, Bloco 126, 87020-900 Maringá, PR, Brazil
| | - Sineida B Ferreira
- Clínica de Dermatologia Dra. Sineida Berbert Ferreira, Av. Dr. Luiz Teixeira Mendes, 1500, 87015-000 Maringá, PR, Brazil
| | - Melyssa Negri
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Estadual de Maringá, Departamento de Análises Clínicas e Biomedicina, Av. Colombo, 5790, Bloco 126, 87020-900 Maringá, PR, Brazil
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Oliveira TF, Valeriano CAT, Buonafina-Paz MDS, Souza-Motta CM, Machado AR, Neves RP, Bezerra JDP, Arantes TD, de Hoog S, Magalhães OMC. Molecular Verification of Trichophyton in the Brazilian URM Culture Collection. Mycopathologia 2024; 189:2. [PMID: 38217794 DOI: 10.1007/s11046-023-00811-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 10/11/2023] [Indexed: 01/15/2024]
Abstract
Trichophyton species cause dermatophytosis in humans, with a high, worldwide frequency of reports and important public health relevance. We evaluated 61 Trichophyton strains from different sources deposited in the University Recife Mycology (URM) culture collection of the Universidade Federal de Pernambuco, Brazil. Strains were phenotypically identified and confirmed by sequencing Internal Transcribed Spacers rDNA and partial beta-tubulin 2-exon. Additionally, we evaluated their susceptibility to terbinafine and itraconazole. Physiological analyses included urease activity and growth in casein medium. Phenotypic methods allowed the reliable identification of T. rubrum only, whereas, for other species, molecular methods were mandatory. All Trichophyton species exhibited susceptibility profiles to itraconazole (0.04-5.33 μg/mL) and terbinafine (0.17-3.33 μg/mL). Our analyses revealed a heterogeneous distribution of T. mentagrophytes, which does not support the current distribution within the species complex of T. mentagrophytes and its genotypes.
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Affiliation(s)
- Tatiana F Oliveira
- Departamento de Micologia Prof. Chaves Batista, Universidade Federal de Pernambuco, Recife, PE, Brazil
| | - Carlos A T Valeriano
- Departamento de Micologia Prof. Chaves Batista, Universidade Federal de Pernambuco, Recife, PE, Brazil
| | - M Daniela S Buonafina-Paz
- Departamento de Micologia Prof. Chaves Batista, Universidade Federal de Pernambuco, Recife, PE, Brazil
| | - Cristina M Souza-Motta
- Departamento de Micologia Prof. Chaves Batista, Universidade Federal de Pernambuco, Recife, PE, Brazil
| | - Alexandre R Machado
- Departamento de Micologia Prof. Chaves Batista, Universidade Federal de Pernambuco, Recife, PE, Brazil
| | - Rejane P Neves
- Departamento de Micologia Prof. Chaves Batista, Universidade Federal de Pernambuco, Recife, PE, Brazil
| | - Jadson D P Bezerra
- Laboratório de Micologia (LabMicol), Departamento de Biociências e Tecnologia, Instituto de Patologia Tropical e Saúde Pública (IPTSP), Universidade Federal de Goiás (UFG), Goiânia, GO, Brazil.
| | - Thales D Arantes
- Laboratório de Micologia (LabMicol), Departamento de Biociências e Tecnologia, Instituto de Patologia Tropical e Saúde Pública (IPTSP), Universidade Federal de Goiás (UFG), Goiânia, GO, Brazil
| | - Sybren de Hoog
- Center of Expertise in Mycology of Radboud University Medical Center, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
| | - Oliane M C Magalhães
- Departamento de Micologia Prof. Chaves Batista, Universidade Federal de Pernambuco, Recife, PE, Brazil
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Marin-Maldonado F, Pacheco-Torres AL, Gustafson E. Comparative analysis of onychomycosis in Puerto Rico using molecular and conventional approaches. J Mycol Med 2023; 33:101412. [PMID: 37451067 DOI: 10.1016/j.mycmed.2023.101412] [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: 03/03/2023] [Revised: 07/03/2023] [Accepted: 07/05/2023] [Indexed: 07/18/2023]
Abstract
Onychomycosis is the most prevalent nail ailment in adults, accounting for 50% of all nail infections. Dermatophyte fungi are the primary cause, but non-dermatophyte molds (NDM) and yeasts can also cause onychomycosis. It remains important to precisely determine the fungal cause of onychomycosis since the response to current treatments may vary between fungal classes. Real-time polymerase chain reaction (qPCR) has become a widespread tool for detecting fungal organisms for diagnosis due to its sensitivity and ability to detect down to the species level. This retrospective study aims to evaluate the qPCR Onycho+ test for dermatophyte detection using remnants of toenails from a cohort of patients from Puerto Rico. Two hundred forty-two toenail samples submitted for histological examination via Periodic acid Schiff (PAS) staining for suspected onychomycosis were analyzed by the Onycho+ test and Sanger sequencing of the internal transcribed spacer (ITS-2). Compared to the gold standard Sanger sequencing method, the Onycho+ test reported an agreement of 91.39%, a sensitivity of 100% and a specificity of 84.5% in detecting dermatophytes, superior to the histology method which had a 69.53% agreement, 85.1% sensitivity and 57.1% specificity. The distribution of fungal organisms detected in this cohort shows a dermatophyte majority but a higher-than-expected proportion of NDMs. Nails negative for the Onycho+ test and positive for histology were mostly NDMs. This study demonstrates that the clinical performance of the Onycho+ test is superior to histology in detecting dermatophytes and that a combination of Onycho+ and histology can result in a higher clinical accuracy.
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Affiliation(s)
| | | | - Erik Gustafson
- Research Department, CorePlus Servicios Clínicos y Patológicos LLC.
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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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Combining Essential Oils with Each Other and with Clotrimazole Prevents the Formation of Candida Biofilms and Eradicates Mature Biofilms. Pharmaceutics 2022; 14:pharmaceutics14091872. [PMID: 36145621 PMCID: PMC9503487 DOI: 10.3390/pharmaceutics14091872] [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: 07/05/2022] [Revised: 08/25/2022] [Accepted: 08/29/2022] [Indexed: 11/17/2022] Open
Abstract
Fungal infections by Candida spp. are opportunistic and most often occur in individuals with some predisposing factor. Essential oils (EO) have anti-Candida potential, being a therapeutic alternative to be explored, especially for superficial and mucosal candidiasis. The objective was to analyze the synergistic potential between the EO of Citrus limon, Cupressus sempervirens, Litsea cubeba and Melaleuca alternifolia, and each of them with clotrimazole, to inhibit in vitro the formation and eradication of Candida spp. biofilms. Added to this, the survival of Caenorhabditis elegans was evaluated after exposure to EO, clotrimazole and their synergistic combinations. Anti-Candida activity was determined by microdilution for the substances alone and in EO−EO and EO−clotrimazole combinations. The combinations were performed by the checkerboard method, and the reduction in the metabolic activity of biofilms was determined by the viability of MTT/menadione. C. elegans larvae survival was evaluated after 24 h of exposure to EO, clotrimazole and synergistic combinations. The minimum inhibitory concentration (MIC) of EO ranged from 500 to >4000 µg/mL. The lowest MIC (500 µg/mL) was for C. sempervirens and L. cubeba on a C. krusei isolate; for clotrimazole, the MIC ranged from 0.015 to 0.5 µg/mL. Biofilm inhibition and eradication both ranged from 1000 to >4000 µg/mL. The lethal concentration (LC50) of C. limon, L. cubeba and M. alternifolia was 2000 µg/mL for C. elegans, while for C. sempervirens and clotrimazole, it was not determined within the concentration limits tested. In combination, more than 85% of the larvae survived M. alternifolia−clotrimazole, M. alternifolia−L. cubeba, C. sempervirens−clotrimazole and C. sempervirens−C. limon combinations. This study is the first, to our knowledge, to present a synergistic relationship of EO−EO and EO−clotrimazole combinations on Candida spp. biofilms.
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Pathogen Analysis of Superficial Mucocutaneous Mycosis in a Tertiary A-level Hospital from 2007 to 2018. Curr Med Sci 2022; 42:434-438. [PMID: 35403954 DOI: 10.1007/s11596-022-2576-7] [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: 05/14/2020] [Accepted: 03/11/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVE This study aimed to analyze the fungal species of pathogens isolated from patients with superficial mucocutaneous mycosis from May 2007 to December 2018. METHODS A retrospective analysis was carried out to determine the pathogenic fungi isolated from patients with superficial fungal infections in the Medical Mycology Clinical Laboratory, Department of Dermatology and Venereology, Union Hospital, from May 2007 to December 2018. RESULTS A total of 7639 strains were obtained, belonging to 21 genera and 36 species. They mainly consisted of Candida (3707/7639, 48.53%) and dermatophytes (3594/7639, 47.05%). The specimens were skin scales, nail shavings, secretions on the nail grooves, broken or diseased hair and dandruff, secretions or pseudomembrane of the external genitalia, and the oral mucosa. A total of 7300 patients were enrolled in this study, including 3301 males and 3999 females aged 2 months to 92 years old with a median age of 46.04 years old except for 633 patients whose ages were unknown. Two strains of different species were isolated from each of 339 patients at different body sites. The most frequent species were Trichophyton rubrum complex (2906/7639, 38.04%), Candida albicans (2619/7639, 34.28%), and unclassified Candida spp. Dermatophytes were mostly isolated from glabrous skin (2138/3594, 59.49%), with T. rubrum complex being the predominant species. Candida strains were most commonly isolated from mucosal sites (1979/3707, 53.39%), and C. albicans was the most prevalent causative agent. CONCLUSION The main distribution of pathogenic fungal species isolated from patients with superficial mycosis from 2007 to 2018 in Wuhan, Hubei province and the surrounding areas was that Candida slightly outnumbered dermatophytes. Among all of the isolated strains, T. rubrum complex was the most abundant.
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Correia NS, Balbinot RTS, Bonacorsi C, Donofrio FC. Epidemiology of dermatomycoses in children in Northern Mato Grosso 2015-2020. Mycoses 2022; 65:560-566. [PMID: 35315158 DOI: 10.1111/myc.13439] [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: 11/16/2021] [Revised: 03/01/2022] [Accepted: 03/15/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Dermatomycoses, fungal diseases that affect the superficial layers of skin, hair, or nails, are a public health concern due to their high prevalence. In Brazil, dermatomycoses are not notifiable diseases, so only fragmented epidemiological studies have been reported in the national literature. To evaluate the epidemiological profile of dermatomycoses in preschoolers and school children in Sinop, Mato Grosso (MT), Brazil. METHODS Classic methods were used to perform 782 mycological examinations to identify dermatophytosis, cutaneous candidosis, and pityriasis versicolor in preschoolers and school children aged between 6 months and 12 years in 11 educational institutions in Sinop - MT. RESULTS Among the evaluated clinical specimens, 5.2% tested positive for dermatophytosis, with 58.45% of these cases corresponding to tinea capitis, followed by skin (tinea corporis and tinea pedis) and toenail (tinea unguium) lesions; zoophilic fungi predominated. Microsporum canis and Trichophyton mentagrophytes complex were isolated in 53.66% and 24.39% of the cases, respectively. Regarding cutaneous candidosis, 9.1% of the specimens tested positive for this disease, with 59.16% and 12.7% of the cases corresponding to toenails and interdigitoplantar lesions, respectively. Candida albicans caused 70.43% of the lesions. The remaining specimens (85.7%) tested positive for pityriasis versicolor; children aged between 6 and 12 were the most affected (71.79%). CONCLUSION Our results agree with most epidemiological studies carried out in Brazil and demonstrate the high frequency of mycoses in preschoolers and school children, a result of poor personal hygiene and favorable weather conditions in Northern Mato Grosso, Brazil.
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Affiliation(s)
- Neocimar Saraiva Correia
- Instituto de Ciências da Saúde, Universidade Federal de Mato Grosso - Campus Sinop, Sinop, Brazil
| | | | - Cibele Bonacorsi
- Instituto de Ciências da Saúde, Universidade Federal de Mato Grosso - Campus Sinop, Sinop, Brazil
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Koehler A, Ribeiro AC, Pagani DM, Vettorato R, Magagnin CM, Stopiglia CDO, Heidrich D, Scroferneker ML. Molecular identification and antifungal susceptibility of 75 clinical isolates of Trichophyton spp. from southern Brazil. J Mycol Med 2021; 31:101201. [PMID: 34474264 DOI: 10.1016/j.mycmed.2021.101201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 08/08/2021] [Accepted: 08/23/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Dermatophytoses affect more than 20% of the world's population and is caused by filamentous fungi, mainly of the genus Trichophyton. The species identification through microscopic direct examination and culture methods is challenging, with molecular presenting high sensitivity and specificity. Although there are several therapy options for dermatophyte infections, treatment failures and antifungal resistance are growing concerns. OBJECTIVE This study aimed to identify clinical isolates of Trichophyton spp. from southern Brazil using molecular methods and determine their in-vitro antifungal susceptibility. MATERIAL AND METHODS Seventy-five isolates were identified through sequencing of the ITS region. The exposure to seven antifungals drugs was performed according to protocol M28-A2 of the Clinical and Laboratory Standards Institute (CLSI). RESULTS Sixty-one isolates (81%) were identified as T. interdigitale, which differs from the epidemiological data present in the literature. Thirteen isolates were identified as T. rubrum and one as T. tonsurans. Terbinafine was the most effective antifungal, followed by itraconazole and voriconazole, which is in accordance with the results reported in previous studies. CONCLUSIONS The use of molecular methods to identify Trichophyton spp. clinical isolates and the performance of susceptibility tests are relevant to epidemiological data, identification of the emergence of antifungal resistance, and to help to translate the in-vitro antifungal susceptibility results into clinical practice.
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Affiliation(s)
- Alessandra Koehler
- Postgraduate Program in Medicine: Medical Sciences, Universidade Federal do Rio Grande do Sul. Rua Ramiro Barcelos, 2400 - CEP, 90035-003, Porto Alegre - RS, Brasil
| | - Amanda Carvalho Ribeiro
- Graduate Program in Pharmacy Universdade Federal do Rio Grande do Sul. Avenida Ipiranga, 2752 - CEP, 90610-000, Porto Alegre RS, Brasil
| | - Danielle Machado Pagani
- Postgraduate Program in Agricultural and Environmental Microbiology, Universidade do Rio Grande do Sul. Universidade Federal do Rio Grande do Sul. Rua Sarmento Leite, 500 - CEP 90050-170, Porto Alegre RS, Brasil
| | - Rodrigo Vettorato
- Postgraduate Program in Medicine: Medical Sciences, Universidade Federal do Rio Grande do Sul. Rua Ramiro Barcelos, 2400 - CEP, 90035-003, Porto Alegre - RS, Brasil
| | - Cibele Massotti Magagnin
- Postgraduate Program in Medicine: Medical Sciences, Universidade Federal do Rio Grande do Sul. Rua Ramiro Barcelos, 2400 - CEP, 90035-003, Porto Alegre - RS, Brasil
| | - Cheila Denise Ottonelli Stopiglia
- Postgraduate Program in Medicine: Medical Sciences, Universidade Federal do Rio Grande do Sul. Rua Ramiro Barcelos, 2400 - CEP, 90035-003, Porto Alegre - RS, Brasil
| | - Daiane Heidrich
- Postgraduate Program in Medicine: Medical Sciences, Universidade Federal do Rio Grande do Sul. Rua Ramiro Barcelos, 2400 - CEP, 90035-003, Porto Alegre - RS, Brasil
| | - Maria Lúcia Scroferneker
- Postgraduate Program in Medicine: Medical Sciences, Universidade Federal do Rio Grande do Sul. Rua Ramiro Barcelos, 2400 - CEP, 90035-003, Porto Alegre - RS, Brasil; Department of Microbiology, Immunology and Parasitology, ICBS, Universidade Federal do Rio Grande do Sul. Rua Sarmento Leite, 500 - CEP 90050-170, Porto Alegre RS, Brasil.
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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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Souza AMS, Ribeiro RCA, Pinheiro GKLO, Pinheiro FI, Oliveira WN, Souza LBFC, Silva AL, Amaral-Machado L, Alencar ÉN, Chaves GM, Egito EST. Polishing the Therapy of Onychomycosis Induced by Candida spp.: Amphotericin B-Loaded Nail Lacquer. Pharmaceutics 2021; 13:pharmaceutics13060784. [PMID: 34073997 PMCID: PMC8225016 DOI: 10.3390/pharmaceutics13060784] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/20/2021] [Accepted: 05/21/2021] [Indexed: 11/16/2022] Open
Abstract
Onychomycosis induced by Candida spp. has several limitations regarding its treatment. Nail lacquers display the potential to overcome these drawbacks by providing therapeutic compliance and increasing local drug bioavailability. Thus, this work aimed to produce a nail lacquer loaded with Amphotericin B (AmB) and evaluate its performance. The AmB-loaded nail lacquer was produced and preliminarily characterized. An AmB quantification method was developed. Stability, drug release, permeability and anti-Candida activity assays were conducted. The analytical method validation met the acceptance criteria. The drug loading efficiency was 100% (0.02 mg/g of total product), whereas the AmB stability was limited to ≅7 days (≅90% remaining). The nail lacquer displayed a drying time of 187 s, non-volatile content of around 20%w/w, water-resistance of approximately 2%w/w of weight loss and satisfactory in vitro adhesion. Moreover, the in vitro antifungal activity against different Candida spp. strains was confirmed. The AmB release and the ex vivo permeability studies revealed that AmB leaves the lacquer and permeates the nail matrix in 47.76 ± 0.07% over 24 h. In conclusion, AmB-loaded nail lacquer shows itself as a promising extemporaneous dosage form with remarkable anti-Candida activity related to onychomycosis.
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Affiliation(s)
- Aleph M. S. Souza
- Graduate Program in Pharmaceutical Sciences, Federal University of Rio Grande do Norte (UFRN), Natal 59012-570, Brazil; (A.M.S.S.); (L.B.F.C.S.); (G.M.C.)
| | - Renato C. A. Ribeiro
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte (UFRN), Natal 59012-570, Brazil; (R.C.A.R.); (W.N.O.); (L.A.-M.)
| | - Gleyse K. L. O. Pinheiro
- Graduate Program in Biotechnology, School of Health, Potiguar University (UnP)–Laureate International Universities, Natal 59056-000, Brazil; (G.K.L.O.P.); (F.I.P.)
| | - Francisco I. Pinheiro
- Graduate Program in Biotechnology, School of Health, Potiguar University (UnP)–Laureate International Universities, Natal 59056-000, Brazil; (G.K.L.O.P.); (F.I.P.)
| | - Wógenes N. Oliveira
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte (UFRN), Natal 59012-570, Brazil; (R.C.A.R.); (W.N.O.); (L.A.-M.)
| | - Luanda B. F. C. Souza
- Graduate Program in Pharmaceutical Sciences, Federal University of Rio Grande do Norte (UFRN), Natal 59012-570, Brazil; (A.M.S.S.); (L.B.F.C.S.); (G.M.C.)
| | - André L. Silva
- Center for Biological Sciences and Health, Federal University of Western Bahia (UFOB), Barreiras 47800-000, Brazil;
| | - Lucas Amaral-Machado
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte (UFRN), Natal 59012-570, Brazil; (R.C.A.R.); (W.N.O.); (L.A.-M.)
| | - Éverton N. Alencar
- Graduate Program in Pharmaceutical Nanotechnology, Federal University of Rio Grande do Norte (UFRN), Natal 59012-570, Brazil;
| | - Guilherme M. Chaves
- Graduate Program in Pharmaceutical Sciences, Federal University of Rio Grande do Norte (UFRN), Natal 59012-570, Brazil; (A.M.S.S.); (L.B.F.C.S.); (G.M.C.)
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte (UFRN), Natal 59012-570, Brazil; (R.C.A.R.); (W.N.O.); (L.A.-M.)
| | - Eryvaldo S. T. Egito
- Graduate Program in Pharmaceutical Sciences, Federal University of Rio Grande do Norte (UFRN), Natal 59012-570, Brazil; (A.M.S.S.); (L.B.F.C.S.); (G.M.C.)
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte (UFRN), Natal 59012-570, Brazil; (R.C.A.R.); (W.N.O.); (L.A.-M.)
- Graduate Program in Pharmaceutical Nanotechnology, Federal University of Rio Grande do Norte (UFRN), Natal 59012-570, Brazil;
- Correspondence: ; Tel.: +55-(84)-3342–9817
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Ordiales H, Vázquez-López F, Pevida M, Vázquez-Losada B, Vázquez F, Quirós LM, Martín C. Glycosaminoglycans Are Involved in the Adhesion of Candida albicans and Malassezia Species to Keratinocytes But Not to Dermal Fibroblasts. ACTAS DERMO-SIFILIOGRAFICAS 2021:S1578-2190(21)00161-X. [PMID: 34052141 DOI: 10.1016/j.adengl.2021.05.002] [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: 11/18/2020] [Accepted: 02/08/2021] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Superficial mycoses are some of the most common diseases worldwide. The usual culprits-yeasts belonging to the genera Malassezia and Candida-are commensal species in the skin that can cause opportunistic infections. We aimed to determine whether these yeasts use glycosaminoglycans (GAGs) as adhesion receptors to mediate binding to epithelial cells. MATERIAL AND METHODS In keratinocyte and dermal fibroblast cultures, we used rhodamine B and genistein to inhibit GAG synthesis to study the role these molecules play in the adhesion of Candida albicans and Malassezia species to cells. We also analyzed GAG involvement by means of enzyme digestion, using specific lyases. RESULTS Rhodamine B partially inhibited the adhesion of both fungi to keratinocytes but not to fibroblasts. Selective digestion of heparan sulfate enhanced the binding of Malassezia species to keratinocytes and of both fungi to fibroblasts. Chondroitin sulfate digestion decreased Calbicans adhesion to keratinocytes, but increased the adhesion of the filamentous forms of this species to fibroblasts. CONCLUSIONS Cell surface GAGs appear to play a role in the adhesion of Calbicans and Malasezzia species to keratinocytes. In contrast, their adhesion to fibroblasts appears to be enhanced by GAG inhibition, suggesting that some other type of receptor is the mediator.
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Affiliation(s)
- H Ordiales
- Instituto Universitario Fernández-Vega (IUFV), Universidad de Oviedo, Oviedo, Asturias, Spain; Departamento de Biología Funcional, Universidad de Oviedo, Oviedo, Asturias, Spain
| | - F Vázquez-López
- Servicio de Dermatología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain; Departamento de Medicina, Universidad de Oviedo, Oviedo, Asturias, Spain
| | - M Pevida
- Centro Comunitario de Sangre y Tejidos del Principado de Asturias y CIBERER, U714, Oviedo, Asturias, Spain
| | - B Vázquez-Losada
- Servicio de Dermatología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - F Vázquez
- Instituto Universitario Fernández-Vega (IUFV), Universidad de Oviedo, Oviedo, Asturias, Spain; Departamento de Biología Funcional, Universidad de Oviedo, Oviedo, Asturias, Spain; Servicio de Microbiología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - L M Quirós
- Instituto Universitario Fernández-Vega (IUFV), Universidad de Oviedo, Oviedo, Asturias, Spain; Departamento de Biología Funcional, Universidad de Oviedo, Oviedo, Asturias, Spain
| | - C Martín
- Instituto Universitario Fernández-Vega (IUFV), Universidad de Oviedo, Oviedo, Asturias, Spain; Departamento de Biología Funcional, Universidad de Oviedo, Oviedo, Asturias, Spain.
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12
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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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13
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Ordiales H, Vázquez-López F, Pevida M, Vázquez-Losada B, Vázquez F, Quirós LM, Martín C. Glycosaminoglycans Are Involved in the Adhesion of Candida albicans and Malassezia Species to Keratinocytes But Not to Dermal Fibroblasts. ACTAS DERMO-SIFILIOGRAFICAS 2021; 112:S0001-7310(21)00086-7. [PMID: 33609451 DOI: 10.1016/j.ad.2021.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 01/12/2021] [Accepted: 02/08/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Superficial mycoses are some of the most common diseases worldwide. The usual culprits - yeasts belonging to the genera Malassezia and Candida - are commensal species in the skin that can cause opportunistic infections. We aimed to determine whether these yeasts use glycosaminoglycans (GAGs) as adhesion receptors to mediate binding to epithelial cells. MATERIAL AND METHODS In keratinocyte and dermal fibroblast cultures, we used rhodamine B and genistein to inhibit GAG synthesis to study the role these molecules play in the adhesion of Candida albicans (C. albicans) and Malassezia species to cells. We also analyzed GAG involvement by means of enzyme digestion, using specific lyases. RESULTS Rhodamine B partially inhibited the adhesion of both fungi to keratinocytes but not to fibroblasts. Selective digestion of heparan sulfate enhanced the binding of Malassezia species to keratinocytes and of both fungi to fibroblasts. Chondroitin sulfate digestion decreased C. albicans adhesion to keratinocytes, but increased the adhesion of the filamentous forms of this species to fibroblasts. CONCLUSIONS Cell surface GAGs appear to play a role in the adhesion of C albicans and Malasezzia species to keratinocytes. In contrast, their adhesion to fibroblasts appears to be enhanced by GAG inhibition, suggesting that some other type of receptor is the mediator.
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Affiliation(s)
- H Ordiales
- Instituto Universitario Fernández-Vega (IUFV), Universidad de Oviedo, Oviedo, Asturias, España; Departamento de Biología Funcional, Universidad de Oviedo, Oviedo, Asturias, España
| | - F Vázquez-López
- Servicio de Dermatología, Hospital Universitario Central de Asturias, Oviedo, Asturias, España; Departamento de Medicina, Universidad de Oviedo, Oviedo, Asturias, España
| | - M Pevida
- Centro Comunitario de Sangre y Tejidos del Principado de Asturias y CIBERER, U714, Oviedo, Asturias, España
| | - B Vázquez-Losada
- Servicio de Dermatología, Hospital Universitario Central de Asturias, Oviedo, Asturias, España
| | - F Vázquez
- Instituto Universitario Fernández-Vega (IUFV), Universidad de Oviedo, Oviedo, Asturias, España; Departamento de Biología Funcional, Universidad de Oviedo, Oviedo, Asturias, España; Servicio de Microbiología, Hospital Universitario Central de Asturias, Oviedo, Asturias, España
| | - L M Quirós
- Instituto Universitario Fernández-Vega (IUFV), Universidad de Oviedo, Oviedo, Asturias, España; Departamento de Biología Funcional, Universidad de Oviedo, Oviedo, Asturias, España
| | - C Martín
- Instituto Universitario Fernández-Vega (IUFV), Universidad de Oviedo, Oviedo, Asturias, España; Departamento de Biología Funcional, Universidad de Oviedo, Oviedo, Asturias, España.
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Santos Júnior CJD, Melo ARDL, Nascimento JMDD, Silva SMTD, Araújo MADS, Souza AKP. Evaluation of susceptibility and response in the surface of agents of surface mycoses (Trichophyton mentagrophytes; T. tonsurans) to antifungal drugs of interest in a medical clinic. ABCS HEALTH SCIENCES 2021. [DOI: 10.7322/abcshs.2019162.1431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Introduction: The resistance of fungal species to drugs usually used in clinics is of great interest in the medical field. Objective: To evaluate susceptibility and in vitro response of species of Trichophyton spp. to antifungal drugs of interest in clinical medicine. Methods: 12 samples of clinical isolates from humans were used, nine of T. mentagrophytes and three of T. tonsurans. Susceptibility tests were performed according to the agar diffusion (AD) and broth microdilution (BM) methods. Results: In the AD method, the species T. tonsurans presented a percentage of sensitivity of 33% in relation to amphotericin B and 66% to itraconazole, with 100% resistance to ketoconazole and fluconazole. T. mentagrophytes also showed 100% resistance to ketoconazole in this technique, with 11% sensitivity to ketoconazole, 22% to itraconazole and 22% of samples classified as sensitive dose dependent. In the MC method, the species T. tonsurans presented a sensitivity percentage of 66%, 55% and 33% in relation to ketoconazole, fluconazole and itraconazole, respectively. The T. mentagrophytes species presented sensitivity percentages of 11%, 11%, 33% and 55% for amphotericin B, itraconazole, ketoconazole and fluconazole, respectively. Conclusion: There was resistance in vitro of the species of T. mentagrophytes and T. tonsurans against the antifungal fluconazole and relative resistance against ketoconazole in the AD method. In BM, however, important percentages of sensitivity were observed for the two species analyzed in relation to the antifungals fluconazole and ketoconazole when compared to itraconazole and amphotericin B.
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Petrucelli MF, de Abreu MH, Cantelli BAM, Segura GG, Nishimura FG, Bitencourt TA, Marins M, Fachin AL. Epidemiology and Diagnostic Perspectives of Dermatophytoses. J Fungi (Basel) 2020; 6:E310. [PMID: 33238603 PMCID: PMC7712040 DOI: 10.3390/jof6040310] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 10/27/2020] [Accepted: 11/02/2020] [Indexed: 12/12/2022] Open
Abstract
Dermatophytoses affect about 25% of the world population, and the filamentous fungus Trichophyton rubrum is the main causative agent of this group of diseases. Dermatomycoses are caused by pathogenic fungi that generally trigger superficial infections and that feed on keratinized substrates such as skin, hair, and nails. However, there are an increasing number of reports describing dermatophytes that invade deep layers such as the dermis and hypodermis and that can cause deep infections in diabetic and immunocompromised patients, as well as in individuals with immunodeficiency. Despite the high incidence and importance of dermatophytes in clinical mycology, the diagnosis of this type of infection is not always accurate. The conventional methods most commonly used for mycological diagnosis are based on the identification of microbiological and biochemical features. However, in view of the limitations of these conventional methods, molecular diagnostic techniques are increasingly being used because of their higher sensitivity, specificity and rapidity and have become more accessible. The most widely used molecular techniques are conventional PCR, quantitative PCR, multiplex PCR, nested, PCR, PCR-RFLP, and PCR-ELISA. Another promising technique for the identification of microorganisms is the analysis of protein profiles by MALDI-TOF MS. Molecular techniques are promising but it is necessary to improve the quality and availability of the information in genomic and proteomic databases in order to streamline the use of bioinformatics in the identification of dermatophytes of clinical interest.
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Affiliation(s)
- Monise Fazolin Petrucelli
- Biotechnology Unit, Unaerp, Av. Costábile Romano, 2201, Ribeirão Preto SP 14096-900, Brazil; (M.F.P.); (M.H.d.A.); (B.A.M.C.); (G.G.S.); (F.G.N.); (T.A.B.); (M.M.)
| | - Mariana Heinzen de Abreu
- Biotechnology Unit, Unaerp, Av. Costábile Romano, 2201, Ribeirão Preto SP 14096-900, Brazil; (M.F.P.); (M.H.d.A.); (B.A.M.C.); (G.G.S.); (F.G.N.); (T.A.B.); (M.M.)
| | - Bruna Aline Michelotto Cantelli
- Biotechnology Unit, Unaerp, Av. Costábile Romano, 2201, Ribeirão Preto SP 14096-900, Brazil; (M.F.P.); (M.H.d.A.); (B.A.M.C.); (G.G.S.); (F.G.N.); (T.A.B.); (M.M.)
| | - Gabriela Gonzalez Segura
- Biotechnology Unit, Unaerp, Av. Costábile Romano, 2201, Ribeirão Preto SP 14096-900, Brazil; (M.F.P.); (M.H.d.A.); (B.A.M.C.); (G.G.S.); (F.G.N.); (T.A.B.); (M.M.)
| | - Felipe Garcia Nishimura
- Biotechnology Unit, Unaerp, Av. Costábile Romano, 2201, Ribeirão Preto SP 14096-900, Brazil; (M.F.P.); (M.H.d.A.); (B.A.M.C.); (G.G.S.); (F.G.N.); (T.A.B.); (M.M.)
| | - Tamires Aparecida Bitencourt
- Biotechnology Unit, Unaerp, Av. Costábile Romano, 2201, Ribeirão Preto SP 14096-900, Brazil; (M.F.P.); (M.H.d.A.); (B.A.M.C.); (G.G.S.); (F.G.N.); (T.A.B.); (M.M.)
- Department of Genetics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto SP 14049-900, Brazil
- Department of Biochemistry and Immunology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto SP 14049-900, Brazil
| | - Mozart Marins
- Biotechnology Unit, Unaerp, Av. Costábile Romano, 2201, Ribeirão Preto SP 14096-900, Brazil; (M.F.P.); (M.H.d.A.); (B.A.M.C.); (G.G.S.); (F.G.N.); (T.A.B.); (M.M.)
| | - Ana Lúcia Fachin
- Biotechnology Unit, Unaerp, Av. Costábile Romano, 2201, Ribeirão Preto SP 14096-900, Brazil; (M.F.P.); (M.H.d.A.); (B.A.M.C.); (G.G.S.); (F.G.N.); (T.A.B.); (M.M.)
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Evaluation of Zinc and Copper Levels in Superficial Fungal Infections. JOURNAL OF CONTEMPORARY MEDICINE 2020. [DOI: 10.16899/jcm.794824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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17
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Antifungal activity of aminoalcohols and diamines against dermatophytes and yeast. Med Chem Res 2020. [DOI: 10.1007/s00044-020-02636-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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18
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Colosi IA, Cognet O, Colosi HA, Sabou M, Costache C. Dermatophytes and Dermatophytosis in Cluj-Napoca, Romania-A 4-Year Cross-Sectional Study. J Fungi (Basel) 2020; 6:E154. [PMID: 32872110 PMCID: PMC7558200 DOI: 10.3390/jof6030154] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 08/23/2020] [Accepted: 08/27/2020] [Indexed: 12/28/2022] Open
Abstract
Dermatophytes are filamentous keratinophilic fungi which affect nails, skin, and hair. Their variable distribution in the world justifies local epidemiological studies. During recent decades, few studies have been published regarding the epidemiology and etiology of dermatophytosis in Romania. The aim of this study was to identify the dermatophytes isolated from superficial fungal infections. To the best of our knowledge, this is the first such study conducted in the area of North-Western Romania. Over the past four years, samples collected from outpatients with suggestive lesions for dermatophytoses (nails, skin, hair), who addressed several private practice dermatologists from Cluj-Napoca, Romania, were sent to a specialized laboratory and examined by microscopy and culture. A total of 350 samples from 322 patients were examined. One hundred samples (28.6%) collected from 90 patients (27.9%) were positive by direct microscopy and/or culture. Among the 63 positive cultures (18%), 44 dermatophytes (69.8%), 2 molds (3.2%), and 17 yeasts (27%) were isolated. The main dermatophyte species identified were Trichophyton rubrum (mostly from onychomycosis) and Microsporum canis (from tinea capitis and tinea corporis in children). Yeasts (Candida species) were isolated from nails, especially from women.
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Affiliation(s)
- Ioana Alina Colosi
- Department of Microbiology, Iuliu Hațieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania; (I.A.C.); (C.C.)
- Department of Laboratory Medicine, Regina Maria Private Health Network, Unirea Medical Center, 400117 Cluj-Napoca, Romania
| | - Odile Cognet
- Parasitology-Mycology Laboratory, Grenoble Alpes University Hospital, 38043 Grenoble CEDEX 9, France;
| | - Horațiu Alexandru Colosi
- Division of Medical Informatics and Biostatistics, Department of Medical Education, Iuliu Hațieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
| | - Marcela Sabou
- Dynamique des Interactions Hôte-Pathogène UR 7292, Université de Strasbourg, F-67000 Strasbourg, France;
| | - Carmen Costache
- Department of Microbiology, Iuliu Hațieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania; (I.A.C.); (C.C.)
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The Sensitivity Modifying Activity of Nerolidol and α-Bisabolol Against Trichophyton spp. Indian J Microbiol 2020; 60:505-510. [PMID: 33088000 DOI: 10.1007/s12088-020-00895-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 06/03/2020] [Indexed: 12/28/2022] Open
Abstract
Trichophyton spp. is one of the main causative agents of dermatophytosis such as tinea ungium and tinea pedis. Resistance to antifungal drugs is a significant clinical problem in dermatophytosis. The main molecular mechanism of antifungal resistance to conventional therapy in dermatophytes is the expression of efflux pumps. Efforts aimed at improving the efficacy of current antifungals such as griseofulvin are relevant. Given this, sesquiterpenes such as α-bisabolol and nerolidol found in essential oils represent promissing alternatives. Griseofulvin sensitivity modulation activity in T. rubrum, T. interdigitale H6, and T. interdigitale Δmdr2 (mutant strain of T. interdigitale) promoted by α-bisabolol and nerolidol were investigated. The minimum inhibitory concentration (MIC) of the test drugs were determined by microdilution. Subsequently, the effect of the drugs tested on plasma membrane functionality (K+ release) was analyzed. The MIC of griseofulvin was determined at sub-inhibitory sesquiterpene concentrations (modulation assay). An association study was performed with griseofulvin and sesquiterpenes (checkerboard). α-bisabolol was more potent than nerolidol; presenting lower MIC values. All of the fungi were sensitive to griseofulvin, starting at 8 µg/mL. With the exception of griseofulvin, all of the test drugs increased K+ release (p < 0.05). Nerolidol modulated the sensitivity of all strains to griseofulvin; α-bisabolol sensitivity modulation was limited to T. interdigitale H6 and T. interdigitale Δmdr2. In association with griseofulvin: nerolidol and α-bisabolol respectively presented synergism and additivity. Finally, the results of our study suggest using α-bisabolol and nerolidol compounds as potential antifungal agents and griseofulvin sensitivity modulators for Trichophyton spp.
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Carrascal-Correa DF, Zuluaga A, González A. Species distribution of the main aetiologic agents causing skin dermatophytosis in Colombian patients: A 23-year experience at a Mycological Reference Center. Mycoses 2020; 63:494-499. [PMID: 32163641 DOI: 10.1111/myc.13073] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 03/02/2020] [Accepted: 03/04/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Dermatophytosis is one of the most frequent superficial mycoses in the world. MAIN AIM To describe the cases of skin dermatophytosis and its main aetiologic agents in patients referred to a Mycological Reference Laboratory in Medellín, Colombia. METHODS A retrospective study was carried out with records of patients referred between 1994 and 2016 to the Corporación para Investigaciones Biológicas (CIB), Medellín-Colombia, because of clinical suspicion of skin dermatophytosis. RESULTS Of a total of 5628 clinical records of patients with suspicion of skin dermatophytosis analysed, 2780 (49.4%) had a proven or probable dermatophytosis diagnosis, 2774 cultures were performed, and aetiologic agents were isolated in 2576 samples (92.9%). The most frequently isolated aetiologic agents were Trichophyton rubrum (44.3%), followed by Trichophyton mentagrophytes complex (33.3%), Epidermophyton floccosum (12.4%), Nannizzia gypseum complex (5.7%, formerly Microsporum gypseum), Microsporum canis (3.5%) and Trichophyton tonsurans (0.8%). The most frequent clinical forms were tinea pedis (72.7%) and tinea corporis (12.7%). In addition, a group of patients (0.9%) developed mixed infections by two dermatophyte agents and another (4.1%) developed infections in more than one anatomical site. CONCLUSIONS The results of the present study are coherent with previous reports where T rubrum and T mentagrophytes complex were the main causative agents of dermatophytosis. However, the increased incidence of N gypsea complex over M canis is worth highlighting.
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Affiliation(s)
| | - Alejandra Zuluaga
- Medical and Experimental Mycology Unit, Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia
| | - Angel González
- Basic and Applied Microbiology Research Group (MICROBA), School of Microbiology, Universidad de Antioquia, Medellín, Colombia
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21
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Pfavayi LT, Sibanda EN, Mutapi F. The Pathogenesis of Fungal-Related Diseases and Allergies in the African Population: The State of the Evidence and Knowledge Gaps. Int Arch Allergy Immunol 2020; 181:257-269. [PMID: 32069461 DOI: 10.1159/000506009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 01/20/2020] [Indexed: 11/19/2022] Open
Abstract
The prevalence of allergic diseases in the African continent has received limited attention with the allergic diseases due to fungal allergens being among the least studied. This lead to the opinion being that the prevalence of allergic disease is low in Africa. Recent reports from different African countries indicate that this is not the case as allergic conditions are common and some; particularly those due to fungal allergens are increasing in prevalence. Thus, there is need to understand both the aetiology and pathogenies of these diseases, particularly the neglected fungal allergic diseases. This review addresses currently available knowledge of fungal-induced allergy, disease pathogenesis comparing findings from human versus experimental mouse studies of fungal allergy. The review discusses the potential role of the gut mycobiome and the extent to which this is relevant to fungal allergy, diagnosis and human health.
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Affiliation(s)
- Lorraine Tsitsi Pfavayi
- Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Old Road Campus, Oxford, United Kingdom, .,Institute of Immunology and Infection Research, University of Edinburgh, Ashworth Laboratories, King's Buildings, Edinburgh, United Kingdom,
| | - Elopy Nimele Sibanda
- Asthma Allergy and Immunology Clinic, Twin Palms Medical Centre, Harare, Zimbabwe.,Department of Pathology, National University of Science and Technology Medical School, Bulawayo, Zimbabwe.,NIHR Global Health Research Unit Tackling Infections to Benefit Africa, University of Edinburgh, Ashworth Laboratories, King's Buildings, Edinburgh, United Kingdom
| | - Francisca Mutapi
- Institute of Immunology and Infection Research, University of Edinburgh, Ashworth Laboratories, King's Buildings, Edinburgh, United Kingdom.,NIHR Global Health Research Unit Tackling Infections to Benefit Africa, University of Edinburgh, Ashworth Laboratories, King's Buildings, Edinburgh, United Kingdom
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22
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Ponte HAS, Lima MIDO, Lima EDO, Pereira FDO. Linalool modulates dermatophyte susceptibility to azole drugs. Med Mycol 2020; 58:272-274. [PMID: 31329906 DOI: 10.1093/mmy/myz041] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 04/02/2019] [Accepted: 04/06/2019] [Indexed: 02/06/2023] Open
Abstract
This study investigated the monoterpene linalool and its resistance modulating activity involving ergosterol biosynthesis inhibitors (ketoconazole, fluconazole, and itraconazole) in strains of Microsporum spp. and Trichophyton spp. The minimum inhibitory concentration (MIC) of test-drugs were determined by microdilution. The modulating effect of linalool was evaluated by determining the MIC of the antifungals in the presence of subinhibitory concentrations of linalool. We also investigated the association effect (checkerboard) of linalool together with ketoconazole and itraconazole. The fungi became more sensitive to ketoconazole and itraconazole in the presence of linalool. The linalool and azole drug associations presented synergism.
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Affiliation(s)
- Hellen Aparecida Silva Ponte
- Laboratory of Biochemistry, Academic Unit of Health, Education and Health Center, Federal University of Campina Grande, Cuité, Brazil
| | - Maria Islaine de Oliveira Lima
- Laboratory of Biochemistry, Academic Unit of Health, Education and Health Center, Federal University of Campina Grande, Cuité, Brazil
| | - Edeltrudes de Oliveira Lima
- Laboratory of Mycology, Department of Pharmaceutical Science, Health Sciences Center, Federal University of Paraıba, João Pessoa, Brazil
| | - Fillipe de Oliveira Pereira
- Laboratory of Biochemistry, Academic Unit of Health, Education and Health Center, Federal University of Campina Grande, Cuité, Brazil
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Gregoriou S, Mpali N, Vrioni G, Hatzidimitriou E, Chryssou SE, Rigopoulos D. Epidemiology of Onychomycosis in an Academic Nail Unit in South Greece during a Three-Year Period. Skin Appendage Disord 2019; 6:102-107. [PMID: 32258053 DOI: 10.1159/000504812] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 11/14/2019] [Indexed: 12/12/2022] Open
Abstract
Background Onychomycosis is the most common disease of the nails. Objective This retrospective study aimed at evaluating the epidemiology of onychomycosis in adult patients in South Greece during the 2015-2017 period. Material and Methods A total of 3,226 patients with clinical signs of possible onychomycosis were included. Diagnosis was confirmed by microscopy with KOH 20% and by culture in Sabouraud agar with and without actidione. Results Diagnosis of onychomycosis was confirmed in 27.99% of the patients. Men were infected more often (40.04%) than women (23.30%). Toenails (68.77%) were infected more than fingernails (31.23%) in both sexes. Onychomycosis in fingernails was more common among women (39.74%) than men (18.51%). Men were more often diagnosed with onychomycosis in toenails (81.49%) than women (60.26%). Dermatophytes were the most frequently isolated fungi (34.11%), followed by Candida(29.79%) and non-dermatophyte molds (NDM) (7.20%). In fingernails, the most frequently isolated fungus was Candida spp. (84.04%), followed by dermatophytes (3.55%) and NDM (0.71%). In toenails, dermatophytes (47.99%) were more commonly identified, followed by NDM (10.14%) and Candida spp. (5.15%). Conclusion Onychomycosis in Greece follows a pattern of higher incidence in males, with toenails more frequently infected with T. rubrum and fingernails more frequently infected with C. albicans in the present era.
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Affiliation(s)
- Stamatios Gregoriou
- National and Kapodistrian University of Athens 1st Department of Dermatology and Venereology, A. Sygros Hospital for Skin and Venereal Diseases, Athens, Greece
| | - Nikoletta Mpali
- National and Kapodistrian University of Athens 1st Department of Dermatology and Venereology, A. Sygros Hospital for Skin and Venereal Diseases, Athens, Greece
| | - Georgia Vrioni
- National and Kapodistrian University of Athens 1st Department of Dermatology and Venereology, A. Sygros Hospital for Skin and Venereal Diseases, Athens, Greece.,Department of Microbiology, A. Sygros Hospital for Skin and Venereal Diseases, Athens, Greece
| | - Eleni Hatzidimitriou
- National and Kapodistrian University of Athens 1st Department of Dermatology and Venereology, A. Sygros Hospital for Skin and Venereal Diseases, Athens, Greece
| | - Stella-Eugenia Chryssou
- Department of Microbiology, A. Sygros Hospital for Skin and Venereal Diseases, Athens, Greece
| | - Dimitrios Rigopoulos
- National and Kapodistrian University of Athens 1st Department of Dermatology and Venereology, A. Sygros Hospital for Skin and Venereal Diseases, Athens, Greece
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Maurya VK, Kachhwaha D, Bora A, Khatri PK, Rathore L. Determination of antifungal minimum inhibitory concentration and its clinical correlation among treatment failure cases of dermatophytosis. J Family Med Prim Care 2019; 8:2577-2581. [PMID: 31548935 PMCID: PMC6753804 DOI: 10.4103/jfmpc.jfmpc_483_19] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 06/19/2019] [Accepted: 08/01/2019] [Indexed: 12/24/2022] Open
Abstract
Introduction: Dermatophytes are most common infectious agents causing superficial mycosis worldwide. A number of topical as well as systemic antifungal drugs are available for treatment of dermatophytosis. Superficial mycosis caused by dermatophytes can be easily treated by topical or oral antifungal drugs, but in the course of time, an increased number of treatment failure cases are appearing. Possible cause for treatment failure could be poor patient compliance, poor drug penetration into affected lesion, and also drug resistance in dermatophytes. The aim of this study is to investigate minimum inhibitory concentration and clinical correlation in treatment failure cases of dermatophytosis. Methods: Skin, hair and nail samples were collected from treatment failure cases of dermatophytosis. A total 75 isolates were tested for MIC against four antifungal drugs in the study. Fluconazole, itraconazole, ketoconazole and terbinafine were the antifungal drugs tested using broth microdilution method. MIC50 and MIC90 values were recorded. Results: A total of 75 dermatophytic isolates were tested. Dermatophytic isolates in this study were Trichophyton mentagrophytes (n = 31), T. rubrum (n = 13), T. tonsurans (n = 12), T. verrucosum (n = 9), M. gypseum (n = 5), E. floccosum (n = 4) and T. violaceum (n = 1). MIC90 value for fluconazole and terbinafine was significantly higher. Conclusion: MIC of 17.33% isolates for fluconazole and 33.33% isolates for terbinafine were lower than cut-off value, which indicates that not all treatment failure cases are due to drug resistance.
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Affiliation(s)
- Vinod K Maurya
- Department of Microbiology, ESIC Medical College and Hospital, Faridabad, Haryana, India
| | - Dileep Kachhwaha
- Department of Skin and VD, Dr. S. N. Medical College, Jodhpur, Rajsthan, India
| | - Archana Bora
- Department of Microbiology, Dr. S. N. Medical College, Jodhpur, Rajsthan, India
| | - Prabhat K Khatri
- Department of Microbiology, Dr. S. N. Medical College, Jodhpur, Rajsthan, India
| | - Laxmi Rathore
- Department of Microbiology, Dr. S. N. Medical College, Jodhpur, Rajsthan, India
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Mycoses in northeastern Brazil: epidemiology and prevalence of fungal species in 8 years of retrospective analysis in Alagoas. Braz J Microbiol 2019; 50:969-978. [PMID: 31140098 DOI: 10.1007/s42770-019-00096-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 05/22/2019] [Indexed: 12/14/2022] Open
Abstract
Superficial and cutaneous mycoses are common in tropical countries, caused by dermatophytes, yeast, and non-dermatophyte molds in different clinical specimens. In order to define the epidemiology of mycoses and the profile of their etiological agents in Alagoas (northeastern Brazil) between 2009 and 2016, we obtained data of patients from the main laboratories of Alagoas, by examining clinical samples with direct microscopy and culture on Sabouraud dextrose agar and Chromagar®Candida. A total of 3316 patients were confirmed with mycoses (595 men/2716 women) and 40.25 of average age. Positive samples totaled 3776, mainly vaginal secretion (1593/42.2%), toenails (876/23.2%), and fingernails (589/15.6%). Yeasts were the most isolated (3129/82.9%), including 3012 Candida spp. (79.8%), 57 Malassezia spp. (1.5%), 42 Trichosporon sp. (1.1%), 10 Geotrichum spp. (0.3%), and 8 Rhodotorula spp. (0.2%). Candida albicans was the most frequent species (715/18.9%), followed by C. krusei (194/5.1%), C. tropicalis (24/0.6%), and 2079 unspecified species (55.1%). Among 17.1% filamentous fungi, 14.8% dermatophytes were distributed as 211 Trichophyton sp. (5.6%), 125 T. rubrum (3.3%), 106 T. tonsurans (2.8%), 72 T. mentagrophytes (1.9%), 2 Microsporum sp. (0.1%), 15 M. canis (0.4%), and 26 Epidermophyton sp. (0.7%). Other fungi represented the minority: Fusarium sp. and Aspergillus sp. These are the first clinical data on the Alagoas population affected by fungi pathogens, confirming a higher incidence of candidiasis (mainly vulvovaginal and onychomycosis) and dermatophytes, providing a better understanding of different mycoses in northeastern Brazil.
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Pereira R, Pereira AL, Ferreira MM, Fontenelle ROS, Saker-Sampaio S, Santos HS, Bandeira PN, Vasconcelos MA, Queiroz JAN, Braz-Filho R, Teixeira EH. Evaluation of the antimicrobial and antioxidant activity of 7-hydroxy-4', 6-dimethoxy-isoflavone and essential oil from Myroxylon peruiferum L.f. AN ACAD BRAS CIENC 2019; 91:e20180204. [PMID: 31038534 DOI: 10.1590/0001-3765201920180204] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 06/04/2018] [Indexed: 11/21/2022] Open
Abstract
This study evaluated the antibacterial, antifungal, and antioxidant effect of 7-hydroxy-4',6-dimethoxy-isoflavone and essential oil of Myroxylon peruiferum. The compound was isolated and its structure elucidated by NMR. The chemical composition of essential oil determined by GC-MS analysis. To evaluation of antimicrobial activity, the Minimum Inhibitory Concentration (MIC), Minimum Bactericidal Concentration (MBC) and Minimum Fungicidal Concentration (MFC) were performed. In addition to analysis of antioxidant activity, DPPH radical scavenging tests, iron chelating assay (FIC), antioxidant reducing power assay (FRAP) and β-carotene bleaching assay (BCB) were performed. For the essential oil were identified 24 organized compounds having as main constituents; Germacrene D (17.2%), α-pinene (14.8%) and E-caryophyllene (10.8%). The results showed that isoflavone (2000 to 156 μg/mL) and essential oil (5.0 to 1.25%) present antibacterial and antifungal activity against Gram-positive bacteria and filamentous fungi. The isoflavone and the essential oil also presented antioxidant activity in all the tests, mainly on inhibition of the oxidation of β-carotene test concentrations ranging from 60 to 100%. In conclusion, isoflavone and essential oil from M. peruiferum present an antimicrobial alternative against Gram-positive bacteria, especially of the genus Staphylococcus and dermatophyte fungi of the genus Trichophyton, as well as a natural compound antioxidant.
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Affiliation(s)
- Rafael Pereira
- Laboratório Integrado de Biomoléculas/LIBS, Departamento de Patologia e Medicina Legal, Universidade Federal do Ceará, Rua Monsenhor Furtado, s/n, Rodolfo Teófilo, 60441-750 Fortaleza, CE, Brazil
| | - Anna L Pereira
- Laboratório Integrado de Biomoléculas/LIBS, Departamento de Patologia e Medicina Legal, Universidade Federal do Ceará, Rua Monsenhor Furtado, s/n, Rodolfo Teófilo, 60441-750 Fortaleza, CE, Brazil
| | - Marcilio M Ferreira
- Laboratório de Microbiologia/LABMIC, Departamento de Ciências Biológicas, Universidade Estadual Vale do Acaraú, Av. da Universidade, 850, Campus da Betânia, 62040-370 Sobral, CE, Brazil 3Departamento de Engenharia de Pesca, Centro de Ciências Agrárias, Universidade Federal do Ceará, Av. Mister Hull, 2977, 60356-001 Fortaleza, CE, Brazil
| | - Raquel O S Fontenelle
- Laboratório de Microbiologia/LABMIC, Departamento de Ciências Biológicas, Universidade Estadual Vale do Acaraú, Av. da Universidade, 850, Campus da Betânia, 62040-370 Sobral, CE, Brazil 3Departamento de Engenharia de Pesca, Centro de Ciências Agrárias, Universidade Federal do Ceará, Av. Mister Hull, 2977, 60356-001 Fortaleza, CE, Brazil
| | - Silvana Saker-Sampaio
- Departamento de Engenharia de Pesca, Centro de Ciências Agrárias, Universidade Federal do Ceará, Av. Mister Hull, 2977, 60356-001 Fortaleza, CE, Brazil
| | - Hélcio S Santos
- Curso de Química Orgânica, Centro de Ciências Exatas e Tecnologia, Universidade Estadual Vale do Acaraú, Av. Dr. Guarani, 608, 62042-030 Sobral, CE, Brazil
| | - Paulo N Bandeira
- Curso de Química Orgânica, Centro de Ciências Exatas e Tecnologia, Universidade Estadual Vale do Acaraú, Av. Dr. Guarani, 608, 62042-030 Sobral, CE, Brazil
| | - Mayron A Vasconcelos
- Laboratório Integrado de Biomoléculas/LIBS, Departamento de Patologia e Medicina Legal, Universidade Federal do Ceará, Rua Monsenhor Furtado, s/n, Rodolfo Teófilo, 60441-750 Fortaleza, CE, Brazil.,Departamento de Ciências Biológicas, Faculdade de Ciências Exatas e Naturais, Universidade do Estado do Rio Grande do Norte, Rua Prof. Antônio Campos, s/n, BR 110, Km 48, Costa e Silva, 59610-090 Mossoró, RN, Brazil
| | - José A N Queiroz
- Laboratório Integrado de Biomoléculas/LIBS, Departamento de Patologia e Medicina Legal, Universidade Federal do Ceará, Rua Monsenhor Furtado, s/n, Rodolfo Teófilo, 60441-750 Fortaleza, CE, Brazil
| | - Raimundo Braz-Filho
- Laboratório de Ciências Químicas, Universidade Estadual do Norte Fluminense Darcy Ribeiro/UENF, Av. Alberto Lamego, 2000, 28013-600 Campos dos Goytacazes, RJ, Brazil
| | - Edson H Teixeira
- Laboratório Integrado de Biomoléculas/LIBS, Departamento de Patologia e Medicina Legal, Universidade Federal do Ceará, Rua Monsenhor Furtado, s/n, Rodolfo Teófilo, 60441-750 Fortaleza, CE, Brazil
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Fay VDS, Gregianini TS, Veiga ABGD, Gonçalves SMB, Rodrigues DM, Bonamigo RR. A 12-year study of fungal infections in Rio Grande do Sul, Southern Brazil. Rev Iberoam Micol 2019; 36:55-60. [PMID: 31014946 DOI: 10.1016/j.riam.2018.10.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 06/19/2018] [Accepted: 10/23/2018] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The number of fungal infections has increased in recent years in Rio Grande do Sul (RS), Brazil. Epidemiological studies are important for proper control of infections. AIMS To evaluate the etiology of fungal infections in patients in RS, from 2003 to 2015. METHODS This is a retrospective and longitudinal study carried out at Mycology Department of Central Laboratory of RS; 13,707 samples were evaluated. The variables sex, age, site of infection, and etiologic agent were analyzed. Susceptibility of Candida to fluconazole was tested in isolates from samples collected in 2015 from 51 outpatients. RESULTS Of the 13,707 samples, 840 cases (6.12%) of fungal infections were found and included in the analyses; female gender accounted for the 55.9% of the cases. The main fungus was Candida albicans (450 cases, 53.38%; p<0.001). Onychomycosis was the most frequent infection in superficial mycoses. Systemic mycoses accounted for 54.05% of the cases, from which 68.8% occurred in males, mainly HIV-positive (33.11%), and the main etiologic agent in these cases was Cryptococcus neoformans (73.13%). Among 51 samples tested for susceptibility to fluconazole, 78.43% of Candida isolates were susceptible; 5.88% were susceptible in a dose-dependent manner, and 15.69% were resistant. CONCLUSIONS C. albicans is a common cause of fungal infections in RS, accounting for half of the cases; resistance to antifungals was found in non-hospitalized patients. In addition, women seem to be more susceptible to fungal infections than men, however men show more systemic mycoses than women. The nails are the most common site of infection.
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Affiliation(s)
- Vanessa da Silva Fay
- LACEN/SES-RS (Laboratório Central de Saúde Pública da Secretaria de Saúde do Estado do Rio Grande do Sul), Porto Alegre, RS, Brazil
| | - Tatiana Schäffer Gregianini
- LACEN/SES-RS (Laboratório Central de Saúde Pública da Secretaria de Saúde do Estado do Rio Grande do Sul), Porto Alegre, RS, Brazil
| | - Ana Beatriz Gorini da Veiga
- Programa de Pós-Graduação em Patologia da Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil.
| | - Stela Maris Bottin Gonçalves
- LACEN/SES-RS (Laboratório Central de Saúde Pública da Secretaria de Saúde do Estado do Rio Grande do Sul), Porto Alegre, RS, Brazil
| | - Diana Mara Rodrigues
- LACEN/SES-RS (Laboratório Central de Saúde Pública da Secretaria de Saúde do Estado do Rio Grande do Sul), Porto Alegre, RS, Brazil
| | - Renan Rangel Bonamigo
- Programa de Pós-Graduação em Patologia da Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil; Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Serviço de Dermatologia da Irmandade Santa Casa de Misericórdia de Porto Alegre, RS, Brazil; Ambulatório de Dermatologia Sanitária da Secretaria de Saúde do Estado do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Costa MC, Pereira de Sá N, Johann S, Santos DA. Social, environmental and microbiologic aspects of endemic mycoses in Brazil. New Microbes New Infect 2019; 29:100496. [PMID: 30949344 PMCID: PMC6430732 DOI: 10.1016/j.nmni.2018.11.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 11/14/2018] [Accepted: 11/14/2018] [Indexed: 12/12/2022] Open
Abstract
Many factors that lead to host immunosuppression are clearly known to predispose the host to fungal diseases, significantly influencing the occurrence of mycoses. However, little or nothing has been discussed regarding social or economic factors that can influence the occurrence of diseases caused by fungi. In this minireview, we discuss several factors that may affect the occurrence of mycoses in Brazil, a continentally extended country that is marked by large climatic variations and severe socioeconomic distortions that may limit access to health services for the population.
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Affiliation(s)
| | - N Pereira de Sá
- Laboratório de Taxonomia e Biologia de Leveduras, Departamento de Microbiologia, ICB-UFMG, Belo Horizonte, MG, Brazil
| | - S Johann
- Laboratório de Taxonomia e Biologia de Leveduras, Departamento de Microbiologia, ICB-UFMG, Belo Horizonte, MG, Brazil
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30
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Neves JS, Lopes-da-Silva Z, de Sousa Brito Neta M, Chaves SB, Karla de Medeiros Nóbrega Y, Henrique de Lira Machado A, Machado F. Preparation of terpolymer capsules containingRosmarinus officinalisessential oil and evaluation of its antifungal activity. RSC Adv 2019; 9:22586-22596. [PMID: 35519452 PMCID: PMC9067078 DOI: 10.1039/c9ra02336d] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 07/14/2019] [Indexed: 01/14/2023] Open
Abstract
The essential oil fromRosmarinus officinalispresents antifungal activity and is used in industry as a natural preserving agent. However, essential oils are unstable compounds.
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Affiliation(s)
- Juliete Silva Neves
- Instituto de Química
- Universidade de Brasília
- Campus Universitário Darcy Ribeiro
- Brazil
| | - Zita Lopes-da-Silva
- Faculdade de Ciências da Saúde
- Universidade de Brasília
- Campus Universitário Darcy Ribeiro
- Brazil
| | - Maria de Sousa Brito Neta
- Departamento de Genética e Morfologia
- Instituto de Biologia
- Universidade de Brasília
- Campus Universitário Darcy Ribeiro
- Brazil
| | - Sacha Braun Chaves
- Departamento de Genética e Morfologia
- Instituto de Biologia
- Universidade de Brasília
- Campus Universitário Darcy Ribeiro
- Brazil
| | | | | | - Fabricio Machado
- Instituto de Química
- Universidade de Brasília
- Campus Universitário Darcy Ribeiro
- Brazil
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Gupta AK, Mays RR, Versteeg SG, Piraccini BM, Takwale A, Shemer A, Babaev M, Grover C, Di Chiacchio NG, Taborda PRO, Taborda VBA, Shear NH, Piguet V, Tosti A. Global perspectives for the management of onychomycosis. Int J Dermatol 2018; 58:1118-1129. [PMID: 30585300 DOI: 10.1111/ijd.14346] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 09/24/2018] [Accepted: 11/24/2018] [Indexed: 12/18/2022]
Abstract
Onychomycosis is a fungal nail infection caused by dermatophytes, nondermatophyte molds, and yeasts. This difficult-to-treat chronic infection has a tendency to relapse despite treatment. This paper aims to offer a global perspective on onychomycosis management from expert physicians from around the world. Overall, the majority of experts surveyed used systemic, topical, and combination treatments approved in their countries and monitored patients based on the product insert or government recommendations. Although the basics of treating onychomycosis were similar between countries, slight differences in onychomycosis management between countries were found. These differences were mainly due to different approaches to adjunctive therapy, rating the severity of disease and use of prophylaxis treatment. A global perspective on the treatment of onychomycosis provides a framework of success for the committed clinician with appreciation of how onychomycosis is managed worldwide.
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Affiliation(s)
- Aditya K Gupta
- Mediprobe Research Incorporated, London, Canada.,Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Canada
| | | | | | - Bianca Maria Piraccini
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Anita Takwale
- Gloucestershire Royal Hospital, Gloucester, United Kingdom
| | - Avner Shemer
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Meir Babaev
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Chander Grover
- Division of Dermatology and STD, University College of Medical Sciences and GTB Hospital, Delhi, India
| | - Nilton G Di Chiacchio
- Dermatology Clinic, Hospital do Servidor Público Municipal de São Paulo, São Paulo, Brazil
| | - Paulo R O Taborda
- Division of Dermatology, Faculdade de Medicina do ABC, Santo André, Brazil
| | | | - Neil H Shear
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Canada.,Division of Dermatology, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Vincent Piguet
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Canada.,Division of Dermatology, Women's College Hospital, Toronto, Canada.,Division of Infection and Immunity, Cardiff University School of Medicine, Cardiff, United Kingdom
| | - Antonella Tosti
- Fredric Brandt Endowed Professor of Dermatology, University of Miami, Miami, FL, USA
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Epidemiology of dermatomycoses in southwest Poland, years 2011-2016. Postepy Dermatol Alergol 2018; 36:604-608. [PMID: 31839778 PMCID: PMC6906960 DOI: 10.5114/ada.2018.80615] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 08/07/2018] [Indexed: 12/31/2022] Open
Abstract
Introduction Superficial mycosis is one of the most common diseases worldwide, however its epidemiology is changing over time. Aim To present epidemiological data of the skin fungal infections diagnosed in the years 2011–2016 in Lower Silesia. Material and methods A total of 11 004 patients with a clinically suspected superficial mycosis were investigated. Skin scrapings, nail clippings and plucked hair were examined with a direct microscopy, Wood’s lamp and culture. Particular species were identified via polymerase chain reaction (PCR) examination. The lesions suspected for pityriasis versicolor were screened for Malassezia with Wood’s lamp and direct microscopy. Results Dermatomycosis was diagnosed in 1653 (15.00%) patients with 1795 fungi identified. 1858 specimens were indicative of fungal infection including dermatophytes, yeasts and moulds. Out of 924 cases of dermatophytic infections (51.48%), Trichophyton rubrum accounted for the majority (71.75%) and was followed by Trichophyton tonsurans (16.77%). Among the yeasts (716; 39.89%), Candida spp. was the most common agent identified (521; 67.66%). The sites affected most often were toenails (956; 51.45%) and fingernails (319; 17.17%). In paediatric population the most common diagnosis was tinea corporis (60, 41.10%). Conclusions Our study revealed that toenail onychomycosis remains the most common superficial mycosis and T. rubrum is the most common pathogen. However, in a longer period of observation, a decrease in the number of tinea capitis cases and an increase in infections caused by T. tonsurans were noticed. Observed changes indicate the need for continuing studies to detect the upcoming epidemiological trends.
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Kollross B, Cunha-Filho M, Gelfuso GM, Gratieri T. Regulatory Requirements and Innovation: A Comparison of the Dermatologic Antifungal Drug Product Markets in Brazil and United States. Ther Innov Regul Sci 2018; 53:661-668. [PMID: 30286614 DOI: 10.1177/2168479018791791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Development of novel dermatological topical products for the treatment of cutaneous fungal infections is a constant necessity, especially in developing countries. Through public health policies, many developing countries have facilitated in the last decades the entry of generic products, which can be superficially seen as a threat to innovation. To verify whether regulatory requirements, or the waiving of some requirements, could have an impact on innovation, we performed a detailed technical comparison of the dermatologic antifungal markets of Brazil and of the United States, taking Brazil as an example of a developing country with more lenient requirements regarding the registration of generic topical drug products. METHODS The official databank of ANVISA (DATAVISA) and of US Food and Drug Administration (Orange Book) were assessed for valid topical dermatological antifungal drug products registered. RESULTS The Brazilian market has a greater number of registered drug products encompassing a greater variety of drug substances than the US, but the latter comprises more products with novel technologies. In both countries, cream was the predominant dosage form and imidazoles were the major substance group. Ketoconazole was the lead active substance in Brazil and ciclopirox was the lead drug in the US. Generic products dominated both markets. CONCLUSIONS Despite the great number of registered products, the Brazilian market lacks the latest technologies, reflecting that the ease of generics registration is not accompanied by innovation.
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Affiliation(s)
- Bianca Kollross
- 1 Management of Post-registration Evaluation of Synthetic's Medicines, General Office of Medicines, Brazilian Health Surveillance Agency (ANVISA), Brasília, Brazil.,2 Laboratory of Food, Drugs and Cosmetics (LTMAC), School of Health Sciences, University of Brasília (UnB), Brasília, Brazil
| | - Marcilio Cunha-Filho
- 2 Laboratory of Food, Drugs and Cosmetics (LTMAC), School of Health Sciences, University of Brasília (UnB), Brasília, Brazil
| | - Guilherme Martins Gelfuso
- 2 Laboratory of Food, Drugs and Cosmetics (LTMAC), School of Health Sciences, University of Brasília (UnB), Brasília, Brazil
| | - Tais Gratieri
- 2 Laboratory of Food, Drugs and Cosmetics (LTMAC), School of Health Sciences, University of Brasília (UnB), Brasília, Brazil
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Trichosporon inkin meningitis in Northeast Brazil: first case report and review of the literature. BMC Infect Dis 2018; 18:470. [PMID: 30227852 PMCID: PMC6145100 DOI: 10.1186/s12879-018-3363-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 08/24/2018] [Indexed: 02/06/2023] Open
Abstract
Background Trichosporon species may colonize the skin, respiratory tract and gastrointestinal tract of human beings. The yeast is recognized as etiological agent of white piedra, a superficial mycosis. Nevertheless, immunocompromised hosts may develop invasive Trichosporonosis. Central nervous system trichosporonosis is a very rare clinical manifestation. In fact, only a few cases have been published in the literature and none of them was caused by Trichosporon inkin. Case presentation Here we report the first clinical case of meningoencephalitis due to this species in a female previously healthy patient under corticosteroids and antibiotics therapy for several months. She was submitted to an invasive procedure to remove a left sided acoustic neuroma and further developed a cerebrospinal fistula. After some days of the procedure, she presented a predominantly and intensive occipital holocranial headache, followed by vomiting, hyporexia, weight loss, asthenia, irritability, difficulty to concentrate and rotator vertigo. The patient further developed a cerebrospinal fistula in the occipital region and was submitted to a surgical correction. After several months of clinical interventions, she was diagnosed with CNS Trichosporonosis, after Magnetic Resonance Imaging and positive microbiological cultures obtained within two different occasions (2 weeks apart). Despite the antifungal therapy with Amphotericin B and Voriconazole, the patient did not survive. Conclusions Despite CNS Fungal infections are mostly due to Cryptococcus spp., other emergent yeasts, such as T. inkin may be considered as a likely etiological agent. This is the first case report of CNS Trichosporonosis, where species identification was performed with rDNA sequencing.
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Epidemiology of fungal infections in China. Front Med 2018; 12:58-75. [DOI: 10.1007/s11684-017-0601-0] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Accepted: 10/23/2017] [Indexed: 01/19/2023]
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Epidemiology of dermatomycoses in Kerman province, southeast of Iran: A 10-years retrospective study (2004-2014). Microb Pathog 2017; 110:561-567. [PMID: 28757272 DOI: 10.1016/j.micpath.2017.07.043] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 07/25/2017] [Accepted: 07/25/2017] [Indexed: 01/19/2023]
Abstract
OBJECTIVES Superficial and cutaneous fungal infections (SCFIs) are an important public health problem and are common in tropical and subtropical countries. Pityriasis versicolor, dermatophytosis, erythrasma, onychomycosis, and otomycosis are the major diseases associated with SCFIs. The aim of this study was to evaluate the prevalence and causative agents of dermatomycoses over a period of 10 years in Kerman province, southeast of Iran. METHODS A number of 1782 subjects, including 1096 females and 686 males, with cutaneous disorders in their skin, nail, and hair suspected to have SCFIs participated in this study. The collected specimens were examined using direct microscopy examination, staining, culture on specific media and PCR-RFLP technique. RESULTS In total, 617 (34.62%) subjects had SCFIs, of whom 290 (47%) were female and 327 (53%) were male. Identified SCFIs included yeast infections, dermatophytosis, saprophyte onychomycosis, erythrasma, and otomycosis due to non-dermatophytic molds (NDMs). The highest prevalence of dermatomycoses was found among the 41-50-year and 31-40-year age groups. Tinea unguium was the most common clinical pattern of dermatomycoses, and T. mentagrophytes was the predominant agent. Also, Aspergillus spp. were the most common NDMs agents of onychomycosis and otomycosis. CONCLUSIONS This study summarized the epidemiological trends and etiologic agents of SCFIs in a 10-year period in Kerman, southeast of Iran. Consideration of the current epidemiologic trends in the prevalence and knowledge of the exact causative agents of SCFIs may play an important key role towards further investigations, diagnosis, and modification of current treatments.
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Gupta AK, Versteeg SG, Shear NH. Onychomycosis in the 21st Century: An Update on Diagnosis, Epidemiology, and Treatment. J Cutan Med Surg 2017. [PMID: 28639462 DOI: 10.1177/1203475417716362] [Citation(s) in RCA: 120] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Onychomycosis accounts for 50% of all nail disease cases and is commonly caused by dermatophytes. Diabetes, human immunodeficiency virus, immunosuppression, obesity, smoking, and advancing age are predisposing factors of this fungal infection. Potassium hydroxide and culture are considered the current standard for diagnosing onychomycosis, revealing both fungal viability and species identification. Other diagnostic tests currently available include periodic acid-Schiff staining, polymerase chain reaction techniques, and fluorescent staining. Across 6 recently published epidemiology studies, the global prevalence of onychomycosis was estimated to be 5.5%, falling within the range of previously reported estimates (2%-8%). Newly approved onychomycosis treatments include efinaconazole, tavaborole, and laser therapy with lasers only approved to temporarily increase the amount of clear nail. Additional onychomycosis treatments being investigated include iontophoresis and photodynamic therapy with small open-label studies reported thus far. Preventative strategies, to help decrease recurrence and reinfection rates, include sanitisation of footwear and prophylactic topical antifungal agents.
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Affiliation(s)
- Aditya K Gupta
- 1 Department of Medicine, University of Toronto School of Medicine, Toronto, Ontario, Canada.,2 Mediprobe Research, Inc, London, Ontario, Canada
| | | | - Neil H Shear
- 3 Department of Medicine (Dermatology, Clinical Pharmacology and Toxicology) and Department of Pharmacology, Sunnybrook and Women's College Health Science Centre and the University of Toronto, Toronto, Ontario, Canada
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