1
|
Ehemann K, Contreras A, Celis-Ramírez AM. In vitro sensitivity of Malassezia furfur isolates from HIV-positive and negative patients to antifungal agents. BIOMEDICA : REVISTA DEL INSTITUTO NACIONAL DE SALUD 2023; 43:120-131. [PMID: 37721914 PMCID: PMC10599713 DOI: 10.7705/biomedica.6871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 05/02/2023] [Indexed: 09/20/2023]
Abstract
INTRODUCTION Malassezia is a lipophilic and lipid-dependent yeast genus belonging to the skin microbiota of humans and other animals. However, due to dysbiosis processes or other factors in the host, this yeast can cause different pathologies, ranging from skin diseases, such as seborrheic dermatitis, to fungemia. Isolation of Malassezia furfur has been reported in HIV-positive patients with or without skin lesions. Due to its opportunistic nature and its variable resistance to antifungal compounds, it is relevant to know the Malassezia sensitivity profiles. OBJECTIVE To determine the sensitivity to different antifungal agents, of clinical isolates of M. furfur obtained from HIV-positive or negative patients, with or without seborrheic dermatitis. MATERIALS AND METHODS Assessment of isolates sensitivity to itraconazole, voriconazole, fluconazole, and amphotericin B was performed by two techniques: (1) Broth microdilution using Clinical and Laboratory Standards Institute (CLSI) protocol M27-A3 with modifications; and (2) agar tests using Etest®. RESULTS Isolates obtained from HIV patients showed an increase in the minimum inhibitory concentration of fluconazole, voriconazole, and amphotericin B, compared with those of non-HIV patients. Itraconazole was the antifungal with the lowest minimum inhibitory concentration (MIC) in most isolates. CONCLUSION We observed differences in the sensitivity profiles of M. furfur isolates according to the context of the patient. High MIC of antifungals like fluconazole, commonly used for treating pathologies caused by Malassezia, were identified.
Collapse
Affiliation(s)
- Kevin Ehemann
- Grupo de Investigación Celular y Molecular de Microorganismos Patógenos, Departamento de Ciencias Biológicas, Universidad de los Andes, Bogotá, D. C., Colombia.
| | - Andrés Contreras
- Grupo de Investigación Celular y Molecular de Microorganismos Patógenos, Departamento de Ciencias Biológicas, Universidad de los Andes, Bogotá, D. C., Colombia.
| | - Adriana Marcela Celis-Ramírez
- Grupo de Investigación Celular y Molecular de Microorganismos Patógenos, Departamento de Ciencias Biológicas, Universidad de los Andes, Bogotá, D. C., Colombia.
| |
Collapse
|
2
|
Ehemann K, Mantilla MJ, Mora-Restrepo F, Rios-Navarro A, Torres M, Celis Ramírez AM. Many ways, one microorganism: Several approaches to study Malassezia in interactions with model hosts. PLoS Pathog 2022; 18:e1010784. [PMID: 36074792 PMCID: PMC9455852 DOI: 10.1371/journal.ppat.1010784] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Malassezia, a lipophilic and lipid-dependent yeast, is a microorganism of current interest to mycobiologists because of its role as a commensal or pathogen in health conditions such as dermatological diseases, fungemia, and, as discovered recently, cancer and certain neurological disorders. Various novel approaches in the study of Malassezia have led to increased knowledge of the cellular and molecular mechanisms of this yeast. However, additional efforts are needed for more comprehensive understanding of the behavior of Malassezia in interactions with the host. This article reviews advances useful in the experimental field for Malassezia.
Collapse
Affiliation(s)
- Kevin Ehemann
- Grupo de Investigación Celular y Molecular de Microorganismos Patógenos (CeMoP), Departamento de Ciencias Biológicas, Universidad de los Andes, Bogotá, Colombia
| | - María Juliana Mantilla
- Grupo de Investigación Celular y Molecular de Microorganismos Patógenos (CeMoP), Departamento de Ciencias Biológicas, Universidad de los Andes, Bogotá, Colombia
| | - Felipe Mora-Restrepo
- Grupo de Investigación Celular y Molecular de Microorganismos Patógenos (CeMoP), Departamento de Ciencias Biológicas, Universidad de los Andes, Bogotá, Colombia
| | - Andrea Rios-Navarro
- Grupo de Investigación Celular y Molecular de Microorganismos Patógenos (CeMoP), Departamento de Ciencias Biológicas, Universidad de los Andes, Bogotá, Colombia
| | - Maritza Torres
- Grupo de Investigación Celular y Molecular de Microorganismos Patógenos (CeMoP), Departamento de Ciencias Biológicas, Universidad de los Andes, Bogotá, Colombia
| | - Adriana Marcela Celis Ramírez
- Grupo de Investigación Celular y Molecular de Microorganismos Patógenos (CeMoP), Departamento de Ciencias Biológicas, Universidad de los Andes, Bogotá, Colombia
- * E-mail:
| |
Collapse
|
3
|
Hobi S, Cafarchia C, Romano V, Barrs VR. Malassezia: Zoonotic Implications, Parallels and Differences in Colonization and Disease in Humans and Animals. J Fungi (Basel) 2022; 8:jof8070708. [PMID: 35887463 PMCID: PMC9324274 DOI: 10.3390/jof8070708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 06/29/2022] [Accepted: 06/30/2022] [Indexed: 12/13/2022] Open
Abstract
Malassezia spp. are commensals of the skin, oral/sinonasal cavity, lower respiratory and gastrointestinal tract. Eighteen species have been recovered from humans, other mammals and birds. They can also be isolated from diverse environments, suggesting an evolutionary trajectory of adaption from an ecological niche in plants and soil to the mucocutaneous ecosystem of warm-blooded vertebrates. In humans, dogs and cats, Malassezia-associated dermatological conditions share some commonalities. Otomycosis is common in companion animals but is rare in humans. Systemic infections, which are increasingly reported in humans, have yet to be recognized in animals. Malassezia species have also been identified as pathogenetic contributors to some chronic human diseases. While Malassezia species are host-adapted, some species are zoophilic and can cause fungemia, with outbreaks in neonatal intensive care wards associated with temporary colonization of healthcare worker’s hands from contact with their pets. Although standardization is lacking, susceptibility testing is usually performed using a modified broth microdilution method. Antifungal susceptibility can vary depending on Malassezia species, body location, infection type, disease duration, presence of co-morbidities and immunosuppression. Antifungal resistance mechanisms include biofilm formation, mutations or overexpression of ERG11, overexpression of efflux pumps and gene rearrangements or overexpression in chromosome 4.
Collapse
Affiliation(s)
- Stefan Hobi
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University, Tat Chee Avenue, Kowloon, Hong Kong, China
- Correspondence: (S.H.); (V.R.B.)
| | - Claudia Cafarchia
- Department of Veterinary Medicine, University of Bari, Str. prov. per Casamassima Km 3, Valenzano, (Bari), 70010, Italy; (C.C.); (V.R.)
| | - Valentina Romano
- Department of Veterinary Medicine, University of Bari, Str. prov. per Casamassima Km 3, Valenzano, (Bari), 70010, Italy; (C.C.); (V.R.)
| | - Vanessa R. Barrs
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University, Tat Chee Avenue, Kowloon, Hong Kong, China
- Centre for Animal Health and Welfare, City University of Hong Kong, Kowloon Tong, Hong Kong, China
- Correspondence: (S.H.); (V.R.B.)
| |
Collapse
|
4
|
Rhimi W, Theelen B, Boekhout T, Otranto D, Cafarchia C. Malassezia spp. Yeasts of Emerging Concern in Fungemia. Front Cell Infect Microbiol 2020; 10:370. [PMID: 32850475 PMCID: PMC7399178 DOI: 10.3389/fcimb.2020.00370] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 06/16/2020] [Indexed: 12/23/2022] Open
Abstract
Malassezia spp. are lipid-dependent yeasts, inhabiting the skin and mucosa of humans and animals. They are involved in a variety of skin disorders in humans and animals and may cause bloodstream infections in severely immunocompromised patients. Despite a tremendous increase in scientific knowledge of these yeasts during the last two decades, the epidemiology of Malassezia spp. related to fungemia remains largely underestimated most likely due to the difficulty in the isolation of these yeasts species due to their lipid-dependence. This review summarizes and discusses the most recent literature on Malassezia spp. infection and fungemia, its occurrence, pathogenicity mechanisms, diagnostic methods, in vitro susceptibility testing and therapeutic approaches.
Collapse
Affiliation(s)
- Wafa Rhimi
- Dipartimento di Medicina Veterinaria, Università degli Studi "Aldo Moro", Bari, Italy
| | - Bart Theelen
- Yeast Research, Westerdijk Fungal Biodiversity Institute, Utrecht, Netherlands
| | - Teun Boekhout
- Yeast Research, Westerdijk Fungal Biodiversity Institute, Utrecht, Netherlands.,The Institute for Biodiversity and Ecosystem Dynamics (IBED), University of Amsterdam, Amsterdam, Netherlands.,Shanghai Key Laboratory of Molecular Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Domenico Otranto
- Dipartimento di Medicina Veterinaria, Università degli Studi "Aldo Moro", Bari, Italy.,Faculty of Veterinary Sciences, Bu-Ali Sina University, Hamedan, Iran
| | - Claudia Cafarchia
- Dipartimento di Medicina Veterinaria, Università degli Studi "Aldo Moro", Bari, Italy
| |
Collapse
|
5
|
Pedrosa AF, Lisboa C, Branco J, Almeida AC, Mendes C, Pellevoisin C, Leite-Moreira A, Miranda IM, Rodrigues AG. Malassezia colonisation on a reconstructed human epidermis: Imaging studies. Mycoses 2019; 62:1194-1201. [PMID: 31556177 DOI: 10.1111/myc.13011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Revised: 09/19/2019] [Accepted: 09/22/2019] [Indexed: 01/30/2023]
Abstract
BACKGROUND Biofilm formation represents a major microbial virulence attribute especially at epithelial surfaces such as the skin. Malassezia biofilm formation at the skin surface has not yet been addressed. OBJECTIVE The present study aimed to evaluate Malassezia colonisation pattern on a reconstructed human epidermis (RhE) by imaging techniques. METHODS Malassezia clinical isolates were previously isolated from volunteers with pityriasis versicolor and seborrhoeic dermatitis. Yeast of two strains of M furfur and M sympodialis were inoculated onto the SkinEthic™ RHE. The tissues were processed for light microscopy, wide-field fluorescence microscopy and scanning electron microscopy. RESULTS Colonisation of the RhE surface with aggregates of Malassezia yeast entrapped in a multilayer sheet with variable amount of extracellular matrix was unveiled by imaging techniques following 24, 48, 72 and 96 hours of incubation. Whenever yeast were suspended in RPMI medium supplemented with lipids, the biofilm substantially increased with a dense extracellular matrix in which the yeast cells were embedded. Slight differences were found in the biofilm architectural structure between the two tested species with an apparently higher entrapment and viscosity in M furfur biofilm. CONCLUSION Skin isolates of M furfur and M sympodialis were capable of forming biofilm in vitro at the epidermal surface simulating in vivo conditions. Following 24 hours of incubation, without added lipids, rudimental matrix was barely visible, conversely to the reported at plastic surfaces. The amount of biofilm apparently increased progressively from 48 to 96 hours. A structural heterogeneity of biofilm between species was found.
Collapse
Affiliation(s)
- Ana Filipa Pedrosa
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal.,Department of Dermatology and Venereology, Centro Hospitalar Universitário S.João EPE, Porto, Portugal.,CINTESIS-Center for Health Technology and Services Research, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Carmen Lisboa
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal.,Department of Dermatology and Venereology, Centro Hospitalar Universitário S.João EPE, Porto, Portugal.,CINTESIS-Center for Health Technology and Services Research, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Joana Branco
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal.,CINTESIS-Center for Health Technology and Services Research, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Ana C Almeida
- Chromosome Instability & Dynamics Laboratory, Instituto de Biologia Molecular e Celular, University of Porto, Porto, Portugal.,Instituto de Investigação e Inovação em Saúde (i3S), University of Porto, Porto, Portugal.,Graduate Program in Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Claudia Mendes
- Department of Surgery and Physiology, Cardiovascular R&D Centre, Faculty of Medicine, University of Porto, Porto, Portugal
| | | | - Adelino Leite-Moreira
- Department of Surgery and Physiology, Cardiovascular R&D Centre, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Isabel M Miranda
- Department of Surgery and Physiology, Cardiovascular R&D Centre, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Acacio G Rodrigues
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal.,CINTESIS-Center for Health Technology and Services Research, Faculty of Medicine of the University of Porto, Porto, Portugal.,Department of Plastic and Reconstructive Surgery, Burn Unit, Centro Hospitalar Universitário S.João EPE, Porto, Portugal
| |
Collapse
|
6
|
Leong C, Schmid B, Toi MJ, Wang J, Irudayaswamy AS, Goh JPZ, Bosshard PP, Glatz M, Dawson TL. Geographical and Ethnic Differences Influence Culturable Commensal Yeast Diversity on Healthy Skin. Front Microbiol 2019; 10:1891. [PMID: 31551938 PMCID: PMC6736582 DOI: 10.3389/fmicb.2019.01891] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 07/31/2019] [Indexed: 01/26/2023] Open
Abstract
Commensal fungi such as Malassezia, Candida, and Rhodotorula are common on healthy skin but are also associated with opportunistic invasive and superficial infections. Skin microbial community characterization has been extensively performed worldwide, with a focus on the 16S bacterial community. These studies have focused on geographically distinct or targeted cohorts with variable reported species distributions of commensal yeast species. To determine the effects of extrinsic environmental factors such as geography, climate, and ethnicity on detected healthy skin commensal yeast diversity, we compared cohorts from Singapore and Zürich, Switzerland, representative of two geographically and climatically distinct regions comprising multi-ethnic (Chinese, Malay, Indian, Caucasian) and predominantly white Caucasian cohorts, respectively, using identical skin sampling and culture methods. We chose to use a culture-based approach as cultures isolated from patients are still required for studies of pathogenicity and antifungal susceptibility. Detection of yeast species by culture-dependent and independent sequencing-based methods suggest healthy skin diversity reflects a species distribution representative of the geography, climate and ethnic background of their local populations. Culture success and species diversity was also found to be dependent on climate, with warm tropical climates favoring high positive culture rates and greater species diversity. Multilocus sequence typing data suggests some strains are geographically distinct and may be used to segregate potential disease-causing commensals. For accurate collection and characterization of skin microbial communities, it remains recommended to employ a combination of culture-dependent and sequence-based culture-independent methods. Characterization of healthy mycobiomes in geographically distinct local populations will be useful in defining the role of commensal fungi in health and disease.
Collapse
Affiliation(s)
- Cheryl Leong
- Agency for Science, Technology and Research (A∗STAR), Skin Research Institute of Singapore, Singapore, Singapore
| | - Bettina Schmid
- Department of Dermatology, University Hospital Zürich, Zurich, Switzerland.,Faculty of Medicine, University of Zürich, Zurich, Switzerland
| | - Min Jet Toi
- Agency for Science, Technology and Research (A∗STAR), Skin Research Institute of Singapore, Singapore, Singapore
| | - Joyce Wang
- Agency for Science, Technology and Research (A∗STAR), Skin Research Institute of Singapore, Singapore, Singapore
| | | | - Joleen Peh Zhen Goh
- Agency for Science, Technology and Research (A∗STAR), Skin Research Institute of Singapore, Singapore, Singapore
| | - Philipp P Bosshard
- Department of Dermatology, University Hospital Zürich, Zurich, Switzerland.,Faculty of Medicine, University of Zürich, Zurich, Switzerland
| | - Martin Glatz
- Department of Dermatology, University Hospital Zürich, Zurich, Switzerland.,Faculty of Medicine, University of Zürich, Zurich, Switzerland
| | - Thomas L Dawson
- Agency for Science, Technology and Research (A∗STAR), Skin Research Institute of Singapore, Singapore, Singapore.,Center for Cell Death, Injury & Regeneration, Departments of Drug Discovery & Biomedical Sciences and Biochemistry & Molecular Biology, Medical University of South Carolina, Charleston, SC, United States
| |
Collapse
|