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Abstract
Mycetoma is a chronic, incapacitating, destructive inflammatory disease with many serious damaging impacts. Currently, there is no control or prevention program as many of its epidemiological characteristics, such as the causative organisms' ecological niche, natural habitat, primary reservoir, transmission mode, geographical distribution, incidence, and prevalence, remain unclear. This may be due to a lack of research interest, as mycetoma is still a neglected disease and the scarcity of accurate molecular diagnostic techniques in disease-endemic regions for accurate causative microorganisms identification and mapping. With this background, this study set out to address this knowledge gap by considering the mycetoma environmental occurrence predictors. The medical literature obtained data showed a close association between mycetoma occurrence and its environment. The causative microorganisms are available in the environment in active or dormant forms. Animal dung may be a natural niche and reservoir for these organisms, and thorns may facilitate the subcutaneous inoculation. Some environmental factors, such as the soil type and consistency, temperature, water sources, aridity index, and thorny trees, may be risk factors. The population in endemic areas socioeconomic, hygiene, and health education status are contributory factors for mycetoma. The individual's genetic and immunological backgrounds may determine the disease's susceptibility and resistance. Environmental conditions and personal hygiene improvement are mandatory to reduce disease occurrence. Mycetoma spatial mapping can detect disease cluster areas and then develop public health strategies for early case detection and management to reduce the disease burden. More research interests and facilities are needed to understand disease pathogenesis and appropriate patient management better.
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Yu Y, Yang G, Wang Y, Jin F, Wang H, Yu Z, Li L, Li X, Gao J, Xu W. A Rare Strain Actinomadura geliboluensis Was First Isolated from the Bronchoalveolar Lavage Fluid of a Patient with Pneumonia. Infect Drug Resist 2023; 16:3101-3108. [PMID: 37228659 PMCID: PMC10202698 DOI: 10.2147/idr.s409701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 05/11/2023] [Indexed: 05/27/2023] Open
Abstract
Background Actinomadura geliboluensis was first isolated in 2012 in Gelibolu, Canakkale, Turkey, and has not been reported to be isolated from humans until now. We have isolated it from the bronchoalveolar lavage fluid (BLF) of a patient with pneumonia and found its drug resistance. It is the first time that Actinomadura geliboluensis has been isolated from humans since its discovery and naming. This case may provide new ideas and methods for the clinical diagnosis and treatment of pulmonary actinomycosis. Case Description The patient was a 75-year-old male who was hospitalized in a township hospital and failed to improve after penicillin treatment. After admission to our hospital, the patient was treated with piperacillin/tazobactam according to clinical guidelines for 14 days. Actinomadura geliboluensis was isolated from the patient's BLF and was identified by 16S rRNA sequencing. This report shows the biological characteristics and in vitro drug susceptibility testing, as well as the genomics analysis based on next-generation sequencing (NGS). The results demonstrated that Actinomadura geliboluensis was easy to be mistakenly identified as Actinomyces dental caries by using the Merieux ANC identification card. Based on the MIC test, Actinomadura geliboluensis was susceptible to tetracyclines, quinolones and sulfonamides, but resistant to carbapenems, penicillins and cephalosporins. The K-B test results showed Actinomadura geliboluensis was highly sensitive to piperacillin/tazobactam. Genomic analysis based on NGS showed that the Actinomadura geliboluensis belongs to Planobispora rosea EF-Tu mutants conferring resistance to inhibitor GE2270A, AAC(3)-VIIa, vanRO, chrB, and mexY. Conclusion Actinomycetes is generally sensitive to Penicillin but Actinomadura geliboluensis is not. In vitro drug susceptibility test is needed to support individualized drug use to avoid delay in the disease.
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Affiliation(s)
- Yefu Yu
- Department of Clinical Laboratory, Affiliated Hospital of Shaoxing University, Shaoxing, 312000, People’s Republic of China
| | - Guier Yang
- Emergency Ward of Affiliated Hospital of Shaoxing University, Shaoxing, 312000, People’s Republic of China
| | - Yanan Wang
- Department of Clinical Laboratory, Affiliated Hospital of Shaoxing University, Shaoxing, 312000, People’s Republic of China
| | - Faxiang Jin
- Department of Clinical Laboratory, Affiliated Hospital of Shaoxing University, Shaoxing, 312000, People’s Republic of China
| | - Huiyu Wang
- Department of Clinical Laboratory, Affiliated Hospital of Shaoxing University, Shaoxing, 312000, People’s Republic of China
| | - Zhongqiang Yu
- Department of Imaging, Affiliated Hospital of Shaoxing University, Shaoxing, 312000, People’s Republic of China
| | - Lanqing Li
- Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Hangzhou, 310016, People’s Republic of China
| | - Xiangcheng Li
- Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Hangzhou, 310016, People’s Republic of China
| | - Junshun Gao
- Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Hangzhou, 310016, People’s Republic of China
| | - Wenfang Xu
- Department of Clinical Laboratory, Affiliated Hospital of Shaoxing University, Shaoxing, 312000, People’s Republic of China
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Fongwen N, Asiedu KB, Bakhiet S, Bonifaz A, Cruz I, Argaw D, Estrada-Chavez G, Fahal AH, Litvintseva A, Marks M, Salinas-Carmona MC, Sow D, van de Sande WWJ. Diagnostics to support mycetoma management-Development of two target product profiles. Trop Med Int Health 2022; 27:1059-1064. [PMID: 36329624 PMCID: PMC10099886 DOI: 10.1111/tmi.13828] [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: 11/06/2022]
Abstract
OBJECTIVE Mycetoma is a neglected tropical disease caused by more than 70 different microorganisms and identified by the WHO as one of the high-priority diseases for developing diagnostic tests. To ensure the production of diagnostic assays for use by clinical staff in endemic regions, target product profiles (TPPs) were designed. METHODS We describe the development of two TPPs: one for a diagnostic test able to identify the causative agent of mycetoma and another that would determine when treatment could be stopped. The TPPs were developed by considering product use, design, performance, product configuration and costs. RESULTS Version 1.0 TPPs for two uses were posted by WHO for a 1-month online public consultation on 25 October 2021, and the final TPP was posted online on 5 May 2022. CONCLUSION A major difficulty encountered in developing both TPPs was the large number of agents able to cause mycetoma and the lack of specific biomarkers for most of them.
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Affiliation(s)
- Noah Fongwen
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Kingsley B Asiedu
- Department of Control of Neglected Tropical Diseases, WHO, Geneva, Switzerland
| | - Sahar Bakhiet
- Mycetoma Research Center, Soba University Hospital, Khartoum, Sudan.,Institute of Endemic Diseases, University of Khartoum, Khartoum, Sudan
| | - Alexandro Bonifaz
- Dermatology Service & Mycology Department, Hospital General de México, Cuauhtémoc, Mexico
| | - Israel Cruz
- National School of Public Health, CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - Daniel Argaw
- Department of Control of Neglected Tropical Diseases, WHO, Geneva, Switzerland
| | - Guadalupe Estrada-Chavez
- Community Dermatology Mexico C.A./Faculty of Medicine, Universidad Autonoma de Guerrero, Acapulco, Mexico
| | - Ahmed H Fahal
- Mycetoma Research Center, Soba University Hospital, Khartoum, Sudan
| | - Ana Litvintseva
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, USA
| | - Michael Marks
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.,Infectious Diseases and General Medicine, Hospital for Tropical Diseases, London, UK.,Division of Infection and Immunity, University College London, London, UK
| | - Mario C Salinas-Carmona
- Departamento de Inmunología, Universidad Autónoma de Nuevo León, Facultad de Medicina, Nuevo León, Mexico
| | - Doudou Sow
- Service de Parasitologie-Mycologie, UFR Sciences de la Santé, Université Gaston Berger, Saint-Louis, Senegal
| | - Wendy W J van de Sande
- Department of Medical Microbiology & Infectious Diseases, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
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Epidemiologic Aspects of Mycetoma in Africa. J Fungi (Basel) 2022; 8:jof8121258. [PMID: 36547591 PMCID: PMC9781793 DOI: 10.3390/jof8121258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/09/2022] [Accepted: 11/18/2022] [Indexed: 12/02/2022] Open
Abstract
Mycetoma is a chronic, disabling infection caused by fungi or actinomycetes that affects the disadvantaged rural populations of arid tropical regions. The identification of etiological agents is long, difficult, and often imprecise or unsuccessful. Recently developed molecular methods can be used to identify causal agents at the species level. However, diagnosis can only be implemented in specialized laboratories. For these reasons, the distribution of causal agents in endemic African countries remains approximate. It is known that the pathogenic organisms of mycetoma are present in the environment, introduced as a result of injuries or trauma. There are still unknowns concerning the natural habitats of agents and the mode of infection. A potential association between mycetoma and acacia was uncovered in Sudan, allowing the elaboration of a risk map of the country. A new hypothesis for the mode of contamination involves the intervention of an intermediate host. The first surveys in Sudanese endemic villages gave a higher prevalence than the previous estimates, indicating that the prevalence of mycetoma in endemic African countries has previously been underestimated.
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Watson AK, Kepplinger B, Bakhiet SM, Mhmoud NA, Chapman J, Allenby NEE, Mickiewicz K, Goodfellow M, Fahal AH, Errington J. Systematic whole-genome sequencing reveals an unexpected diversity among actinomycetoma pathogens and provides insights into their antibacterial susceptibilities. PLoS Negl Trop Dis 2022; 16:e0010128. [PMID: 35877680 PMCID: PMC9352199 DOI: 10.1371/journal.pntd.0010128] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 08/04/2022] [Accepted: 06/29/2022] [Indexed: 11/18/2022] Open
Abstract
Mycetoma is a neglected tropical chronic granulomatous inflammatory disease of the skin and subcutaneous tissues. More than 70 species with a broad taxonomic diversity have been implicated as agents of mycetoma. Understanding the full range of causative organisms and their antibiotic sensitivity profiles are essential for the appropriate treatment of infections. The present study focuses on the analysis of full genome sequences and antibiotic inhibitory concentration profiles of actinomycetoma strains from patients seen at the Mycetoma Research Centre in Sudan with a view to developing rapid diagnostic tests. Seventeen pathogenic isolates obtained by surgical biopsies were sequenced using MinION and Illumina methods, and their antibiotic inhibitory concentration profiles determined. The results highlight an unexpected diversity of actinomycetoma causing pathogens, including three Streptomyces isolates assigned to species not previously associated with human actinomycetoma and one new Streptomyces species. Thus, current approaches for clinical and histopathological classification of mycetoma may need to be updated. The standard treatment for actinomycetoma is a combination of sulfamethoxazole/trimethoprim and amoxicillin/clavulanic acid. Most tested isolates had a high IC (inhibitory concentration) to sulfamethoxazole/trimethoprim or to amoxicillin alone. However, the addition of the β-lactamase inhibitor clavulanic acid to amoxicillin increased susceptibility, particularly for Streptomyces somaliensis and Streptomyces sudanensis. Actinomadura madurae isolates appear to have a particularly high IC under laboratory conditions, suggesting that alternative agents, such as amikacin, could be considered for more effective treatment. The results obtained will inform future diagnostic methods for the identification of actinomycetoma and treatment.
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Affiliation(s)
- Andrew Keith Watson
- Centre for Bacterial Cell Biology, Biosciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Bernhard Kepplinger
- Centre for Bacterial Cell Biology, Biosciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | | | - Najwa Adam Mhmoud
- The Mycetoma Research Centre, University of Khartoum, Khartoum, Sudan
| | - Jonathan Chapman
- Centre for Bacterial Cell Biology, Biosciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Nick EE Allenby
- Odyssey Therapeutics Inc, The Biosphere, Draymans Way, Newcastle Helix, Newcastle upon Tyne, United Kingdom
| | - Katarzyna Mickiewicz
- Centre for Bacterial Cell Biology, Biosciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Michael Goodfellow
- School of Natural and Environmental Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Ahmed Hassan Fahal
- The Mycetoma Research Centre, University of Khartoum, Khartoum, Sudan
- * E-mail: (AHF); (JH)
| | - Jeff Errington
- Centre for Bacterial Cell Biology, Biosciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
- * E-mail: (AHF); (JH)
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Saricaoglu S, Saygin H, Topkara AR, Gencbay T, Guven K, Cetin D, Sahin N, Isik K. Actinomadura soli sp. nov., isolated from the top soil layer on basaltic material in Turkey. Int J Syst Evol Microbiol 2021; 71. [PMID: 34705623 DOI: 10.1099/ijsem.0.005062] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
An actinobacterium, designated 14C53T, was isolated from a soil sample on basaltic material from Samsun, Turkey. The growth ranges for NaCl concentration and pH of strain 14C53T were quite limited and the growth temperature range of the strain was 20-37 °C, with an optimum at 28 °C. Phylogenetic analysis of 16S rRNA gene sequences revealed that strain 14C53T was most closely related to Actinomadura geliboluensis A8036T (98.5 % similarity value), but in the phylogenetic tree, it formed a clade with Actinomadura alkaliterrae D310AT. The genome tree revealed a close relationship between the strain and Actinomadura pelletieri DSM 43383T. However, the digital DNA-DNA hybridization and average nucleotide identity values between strain 14C53T with Actinomadura geliboluensis A8036T and Actinomadura pelletieri DSM 43383T were 28.6-30.2 % and 84.3-85.5 %, respectively, and comparative analyses based on the genome sequences demonstrated that it represents a novel species of the genus Actinomadura. The genome size of strain 14C53T was approximately 9.0 Mb and the genomic DNA G+C content of the strain was 71.3 mol%. The major cellular fatty acids of strain 14C53T were C16 : 0 and iso-C16 : 0. Strain 14C53T contained meso-diaminopimelic acid as the diamino acid in the cell-wall peptidoglycan. The predominant menaquinones were MK-9(H8) and MK-9(H6). Based on evidence collected from the phenotypic, genotypic and phylogenetic analyses, a novel species Actinomadura soli sp. nov. is proposed, with 14C53T (=DSM 104447T=KCTC 39878T) as the type strain.
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Affiliation(s)
- Salih Saricaoglu
- Department of Basic Sciences, Faculty of Dentistry, Cankiri Karatekin University, 18200 Cankiri, Turkey
| | - Hayrettin Saygin
- Department of Molecular Biology and Genetics, Faculty of Sciences and Arts, Ondokuz Mayis University, 55139 Samsun, Turkey
| | - Ahmet Ridvan Topkara
- Department of Biology, Faculty of Science and Arts, Ondokuz Mayis University, 55139 Samsun, Turkey
| | - Talha Gencbay
- Department of Biology, Faculty of Science and Arts, Ondokuz Mayis University, 55139 Samsun, Turkey
| | - Kiymet Guven
- Department of Biology, Faculty of Science, Eskisehir Technical University, 26555 Eskisehir, Turkey
| | - Demet Cetin
- Division of Science Education, Department of Mathematics and Science Education, Gazi Faculty of Education, Gazi University, 06500 Ankara, Turkey
| | - Nevzat Sahin
- Department of Molecular Biology and Genetics, Faculty of Sciences and Arts, Ondokuz Mayis University, 55139 Samsun, Turkey
| | - Kamil Isik
- Department of Biology, Faculty of Science and Arts, Ondokuz Mayis University, 55139 Samsun, Turkey
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Oladele RO, Ly F, Sow D, Akinkugbe AO, Ocansey BK, Fahal AH, van de Sande WWJ. Mycetoma in West Africa. Trans R Soc Trop Med Hyg 2021; 115:328-336. [PMID: 33728466 DOI: 10.1093/trstmh/trab032] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 11/07/2020] [Accepted: 02/14/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Mycetoma is a neglected disease, which is socioeconomically important, and with the possibility of permanent disability in infected persons if not treated early. This is especially true in resource-limited settings such as West Africa, where there is a lack of facilities and skilled personnel to make a definitive laboratory diagnosis. Countries in West Africa have similar climatic conditions to Sudan. The majority of patients seek medical care very late, when there is already bone involvement, resulting in amputations. This results in poor capture of the true burden of the problem in the literature. METHODS A review of the literature revealed about 2685 documented cases in West Africa from 1929 to 2020; from 15 out of 16 countries, Senegal accounted for 74.1% (1943) of cases in the subregion. RESULTS The majority of lesions were found on the foot; however, other body parts were also reported. Rural dwellers accounted for most cases. Only 547 (20.4%) cases had identified isolates reported. Actinomycetoma accounted for 47.9% of cases, eumycetoma 39.7% and unidentified pathogens 12.4%. Actinomadura pelletieri was the predominant pathogen isolated (21.4%; 117 isolates). CONCLUSION There is a dire need for capacity building, provision of facility and health education to raise awareness of this debilitating disease in West Africa.
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Affiliation(s)
- Rita Okeoghene Oladele
- Department of Medical Microbiology & Parasitology, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Fatimata Ly
- Dermatology unit of Institut d'Hygiene Sociale de Dakar Hospital, Faculty of Medicine Pharmacy Odontology, University Cheikh Anta Diop of Dakar, Dakar, Senegal
| | - Douduo Sow
- Service de Parasitologie-Mycologie, UFR Sciences de la Santé, Université Gaston Berger, Saint-Louis, Sénégal
| | - Ayesha O Akinkugbe
- Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Bright K Ocansey
- Dermatology Unit, Department of Medicine, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Ahmed H Fahal
- The Mycetoma Research Centre, University of Khartoum, Khartoum, Sudan
| | - Wendy W J van de Sande
- Erasmus MC, University Medical Centre Rotterdam, Department of Medical Microbiology and Infectious Diseases, Wytemaweg 80, 3015 CE, Rotterdam, the Netherlands
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