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Hoffmann LC, Reinholz M, French LE, Sárdy M, Wollenberg A, Kerschnitzki A, Horváth ON. Epidemiological overview of mucocutaneous fungal infections in Munich. J Dtsch Dermatol Ges 2024. [PMID: 39097945 DOI: 10.1111/ddg.15484] [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: 12/14/2023] [Accepted: 05/07/2024] [Indexed: 08/06/2024]
Abstract
BACKGROUND AND OBJECTIVES Knowledge about the current spectrum of dermatomycoses is important for diagnosis and therapy. PATIENTS AND METHODS A retrospective, monocentric analysis of mucocutaneous fungal infections diagnosed at a large European academic dermatology department in Munich was conducted; 87,229 samples from 48,916 patients from January 1, 2011, to August 30, 2020, were included. RESULTS Fungi were detected in 11,513 samples from 48,916 (23.54%), and 36 different species were identified. Candida (C.) albicans was the most common pathogen (5,055 detections; 43.91% of all positive samples), followed by Trichophyton (T.) rubrum (3,076 detections; 26.72% of all positive samples) and Candida parapsilosis (923 detections; 8.02% of all positive samples). Rare pathogens such as Trichophyton raubitschekii were also detected. Coinfections with multiple species were detected in 44 cases. CONCLUSIONS Even though C. albicans, T. rubrum, and C. parapsilosis were confirmed as the most common pathogens, rare pathogens should also be considered in clinical practice. The predominant spectrum of fungi differed from that reported in other countries. Furthermore, a difference in the pathogen spectrum could be observed depending on the age group and body site.
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Affiliation(s)
- Liv C Hoffmann
- Department of Dermatology and Allergy, LMU University Hospital, Munich, Germany
| | - Markus Reinholz
- Department of Dermatology and Allergy, LMU University Hospital, Munich, Germany
| | - Lars E French
- Department of Dermatology and Allergy, LMU University Hospital, Munich, Germany
- Dr. Philip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Miklós Sárdy
- Department of Dermatology and Allergy, LMU University Hospital, Munich, Germany
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - Andreas Wollenberg
- Department of Dermatology and Allergy, LMU University Hospital, Munich, Germany
- Department of Dermatology and Allergy, University Hospital Augsburg (UKA), Augsburg, Germany
| | | | - Orsolya N Horváth
- Department of Dermatology and Allergy, LMU University Hospital, Munich, Germany
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Gangneux JP, Miossec C, Machouart M, Gits-Muselli M, Benderdouche M, Ranque S, Botterel F, Brun S. Epidemiology and management of tinea capitis in France: A 6-year nationwide retrospective survey. Med Mycol 2024; 62:myae047. [PMID: 38653717 DOI: 10.1093/mmy/myae047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 04/10/2024] [Accepted: 04/22/2024] [Indexed: 04/25/2024] Open
Abstract
Tinea capitis (TC) is still a frequent dermatophytosis in France, both autochthonous and imported. A nationwide retrospective survey was performed and a total of 4395 TC cases were recorded within 36 French mycology laboratories during a 6-year period. TC is a disease that occurs in childhood with 85% of the cases occurring before 10 years old and 94% before the age of 15. Anthropophilic origin was predominant with 779 cases of Trichophyton tonsurans (32.6%), 738 cases of Trichophyton soudanense/T. violaceum (31%), and 445 cases of Microsporum audouinii (19.2%). Of note, T. tonsurans represents more than 80% of the cases in the French West Indies (Martinique and Guadeloupe). By contrast, zoophilic species were less prevalent with mainly M. canis (10.3%) confirming the shift from zoophilic to anthropophilic species observed in many centers during the last decades. During this survey, diagnosis methods were also collected. Most labs had a classical process for the diagnosis: microscopic direct examination associated to cultures on Sabouraud and Sabouraud-cycloheximide media (incubated between 25 ± 5°C for at least 3 weeks) in all laboratories. Identification of the causal dermatophyte was performed by microscopic and macroscopic examination of the cultures in 100% of the labs, with various specific culture media available when fructification was insufficient (mainly malt or potato-dextrose agar, or Borelli medium). New techniques were also implemented with the introduction of MALDI-TOF mass spectrometry identification in more than two third of the labs, and molecular identification available if necessary in half of the labs.
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Affiliation(s)
- Jean-Pierre Gangneux
- Department of Parasitology-Mycology, Excellence Center in Medical Mycology (ECMM EC), Rennes University Hospital, Rennes, France
| | - Charline Miossec
- Department of Parasitology-Mycology, Fort-de-France University Hospital, Martinique, France
| | - Marie Machouart
- Department of Parasitology-Mycology, Nancy University Hospital, Nancy, France
| | - Maud Gits-Muselli
- Department of Parasitology-Mycology, Saint-Louis University Hospital, AP-HP, Paris, France
| | - Mazouz Benderdouche
- Department of Parasitology-Mycology, Saint-Louis University Hospital, AP-HP, Paris, France
| | - Stéphane Ranque
- Department of Parasitology-Mycology, Marseille University Hospital, Marseille, France
| | - Françoise Botterel
- Unit of Parasitology-Mycology, Henri Mondor University Hospital, AP-HP, Dynamyc research group, UPEC, Créteil, France
| | - Sophie Brun
- Department of Parasitology-Mycology, Avicenne Hospital, AP-HP, Sorbone Paris Nord University, Bobigny, France
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3
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Johansen CD, Shen JJR, Astvad KMT, Jemec GBE, Christensen JJ, Saunte DML. Exploring treatment and antifungal resistance in an outbreak of tinea caused by Microsporum audouinii. Mycoses 2024; 67:e13760. [PMID: 38943042 DOI: 10.1111/myc.13760] [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: 06/14/2024] [Accepted: 06/19/2024] [Indexed: 06/30/2024]
Abstract
BACKGROUND Microsporum audouinii has resurged recently. Infections with the dermatophyte are difficult to treat, which raises the question if we treat M. audouinii infections with the most effective antifungal (AF) agent. OBJECTIVES The aims of this study was to investigate an outbreak of tinea capitis (TC) in Denmark, address the challenges in outbreak management and to conduct two reviews regarding previous outbreaks and minimal inhibitory concentration (MIC). METHODS We used Wood's light, culture, direct microscopy, and PCR for screening and antifungal susceptibility testing (AFST) for treatment optimization. We performed two reviews to explore M. audouinii outbreaks and MIC values using broth microdilution method. RESULTS Of 73 screened individuals, 10 had confirmed M. audouinii infections. Clinical resistance to griseofulvin was observed in 4 (66%) cases. While previous outbreaks showed high griseofulvin efficacy, our study favoured terbinafine, fluconazole and itraconazole in our hard-to-treat cases. AFST guided the choice of AF. Through the literature search, we identified five M. audouinii outbreaks, where differences in management included the use of Wood's light and prophylactic topical AF therapy. Terbinafine MIC values from the literature ranged from 0.002 to 0.125 mg/L. CONCLUSION Use of Wood's light and preventive measurements were important for limiting infection. The literature lacked MIC data for griseofulvin against M. audouinii, but indicated sensitivity for terbinafine. The clinical efficacy for M. audouinii treatment was contradictory favouring both terbinafine and griseofulvin. AFST could have a key role in the treatment of difficult cases, but lack of standardisation of AFST and MIC breakpoints limits its usefulness.
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Affiliation(s)
| | - Julia Jia Rui Shen
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
- Unit of Mycology, Statens Serum Institut, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Medical and Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Gregor Borut Ernst Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
- Department of Clinical Medicine, Faculty of Medical and Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Ditte Marie Lindhardt Saunte
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
- Unit of Mycology, Statens Serum Institut, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Medical and Health Sciences, University of Copenhagen, Copenhagen, Denmark
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Capoor MR, Sharma S, Goenka S, Das S, Rudramurthy SM, Khunger N, Kamra N. Tinea capitis caused by Microsporum canis: A case study of three family members in India, a non-endemic region. Indian J Med Microbiol 2024; 50:100621. [PMID: 38885904 DOI: 10.1016/j.ijmmb.2024.100621] [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: 03/15/2024] [Revised: 04/19/2024] [Accepted: 05/27/2024] [Indexed: 06/20/2024]
Abstract
INTRODUCTION Tinea capitis, a common scalp infection primarily affecting children, is caused by keratinophilic dermatophytic fungi, notably Microsporum and Trichophyton species. Microsporum canis, primarily transmitted from cats and dogs to humans, is rarely reported in non-endemic regions like India. We report a cases involving three family members from Delhi, India, diagnosed with tinea capitis caused by Microsporum canis. The index case, a five-year-old boy, contracted the infection through contact with a cat, while his younger brother and sister acquired it through human-to-human transmission within the family. METHODS Clinical examination, microscopic analysis, and molecular identification techniques confirmed the diagnosis. Antifungal susceptibility testing revealed sensitivity to itraconazole and terbinafine but resistance to griseofulvin. RESULTS Treatment with oral terbinafine and topical ketoconazole cream led to successful outcomes for all three patients. Molecular typing confirmed clonality of the isolates, indicating human-to-human transmission. CONCLUSION This case study underscores the significance of considering atypical sources of infection and human-to-human transmission in the diagnosis and management of tinea capitis caused by Microsporum canis in non-endemic regions. It emphasizes the necessity of thorough contact history assessment and appropriate antifungal therapy for effective control of the infection.
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Affiliation(s)
- Malini R Capoor
- Department of Microbiology, Vardhman Mahavir Medical College (VMMC) and Safdarjung Hospital, New Delhi, India.
| | - Sheetal Sharma
- Department of Microbiology, Vardhman Mahavir Medical College (VMMC) and Safdarjung Hospital, New Delhi, India.
| | - Sheetal Goenka
- Department of Microbiology, Vardhman Mahavir Medical College (VMMC) and Safdarjung Hospital, New Delhi, India; Dept of Microbiology, VMMC and Safdarjung Hospital, Delhi, India.
| | - Sutapa Das
- Department of Microbiology, Vardhman Mahavir Medical College (VMMC) and Safdarjung Hospital, New Delhi, India.
| | - Shivaprakash M Rudramurthy
- Department of Microbiology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
| | - Niti Khunger
- Department of Dermatology, Vardhman Mahavir Medical College (VMMC) and Safdarjung Hospital, India.
| | - Namita Kamra
- Department of Medicine, Vardhman Mahavir Medical College (VMMC) and Safdarjung Hospital, India.
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5
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Shi L, Li J, Liu W, Shi D. Coexistence of Malassezia Species and Microsporum canis in the Lesions of Adult with Tinea Capitis. Infect Drug Resist 2024; 17:2431-2438. [PMID: 38912215 PMCID: PMC11193443 DOI: 10.2147/idr.s455485] [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: 12/18/2023] [Accepted: 05/22/2024] [Indexed: 06/25/2024] Open
Abstract
Tinea capitis, primarily caused by dermatophytes such as Trichophyton and Microsporum species, is a superficial fungal infection affecting the scalp and hair, commonly observed in prepubertal children but rare in adults. Here we report a unique case of an adult female with tinea capitis presenting as diffused alopecia and erythema inflammation on the scalp's apex, mimicking seborrheic dermatitis. Examination of the hair and scalp using fluorescence microscopy and fungal culture identified the presence of hyphae from Malassezia globosa, Malassezia furfur and Microsporum canis. The patient underwent with oral antifungal treatment for 3 months, resulting in the resolution of the rash and subsequent hair regrowth, with no recurrence during 6-month follow-up. In vitro co-culture experiments of Microsporum canis and Malassezia (both Malassezia globose and Malassezia furfur) revealed that Malassezia appears to facilitate Microsporum canis growth, while the reverse was not observed. This data suggests that Malassezia's use of long-chain fatty acids by might reduce its antibacterial effect, potentially aiding adult tinea capitis development caused by Microsporum canis.
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Affiliation(s)
- Leyao Shi
- The Second Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, People’s Republic of China
| | - Juanjuan Li
- Department of First Clinical Medical College, Xuzhou Medical University, Xuzhou, Jiangsu Province, 221004, People’s Republic of China
| | - Weida Liu
- Department of Medical Mycology, Institute of Dermatology, Chinese Academy of Medical Science and Peking Union Medical College, Nanjing, 210042, People’s Republic of China
| | - Dongmei Shi
- Department of Dermatology, Jining No. 1 People’s Hospital, Jining, Shandong, 272067, People’s Republic of China
- Laboratory of Medical Mycology, Jining No. 1 People’s Hospital, Jining, Shandong, People’s Republic of China
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Hill RC, Gold JAW, Lipner SR. Comprehensive Review of Tinea Capitis in Adults: Epidemiology, Risk Factors, Clinical Presentations, and Management. J Fungi (Basel) 2024; 10:357. [PMID: 38786712 PMCID: PMC11122068 DOI: 10.3390/jof10050357] [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: 04/16/2024] [Revised: 05/07/2024] [Accepted: 05/14/2024] [Indexed: 05/25/2024] Open
Abstract
Tinea capitis is a fungal infection of the scalp and hair caused by dermatophyte molds, that most often affects children and may also affect adults. Previous estimates suggest that between 3% and 11% of all tinea capitis cases worldwide occur in adults, although updated epidemiological studies are needed to reassess the prevalence of tinea capitis in adult populations specifically. Postmenopausal adult women are most often affected by tinea capitis, with African American or Black women particularly at risk. Adults who experience crowded living conditions, who live in close proximity to animals, who are immunosuppressed, and/or who live in households with affected children are at greatest risk of infection. Tinea capitis can be non-inflammatory or inflammatory in nature, and the subtype affects the extent and severity of clinical symptoms. Fungal culture and potassium hydroxide preparations are the most commonly used diagnostic tools. Trichoscopy, defined as dermoscopic imaging of the scalp and hair, is a useful adjunct to the physical examination. The mainstay of therapy is oral antifungal therapy, and topical therapy alone is not recommended. Since tinea capitis infection is uncommon in adults, there are no widely accepted treatment guidelines. Rather, the same medications used for tinea capitis infection among children are recommended for adults at varying doses, including griseofulvin, and terbinafine, and, less commonly, itraconazole and fluconazole. The prognosis for tinea capitis in adults is typically excellent when prompt and adequate treatment is administered; however, delayed diagnosis or inadequate treatment can result in scarring alopecia. Over the past decade, dermatophyte infections resistant to treatment with topical and oral antifungal agents have emerged. While tinea capitis infections resistant to antifungal therapy have been rarely reported to date, antifungal resistance is rising among superficial fungal infections in general, and antifungal stewardship is necessary to ensure that resistance to treatment does not develop among dermatophytes that cause tinea capitis.
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Affiliation(s)
| | - Jeremy A. W. Gold
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Shari R. Lipner
- Department of Dermatology, Weill Cornell Medicine, New York, NY 10021, USA
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Piorunek M, Kubisiak-Rzepczyk H, Dańczak-Pazdrowska A, Trafas T, Walkowiak J. Superficial Zoonotic Mycoses in Humans Associated with Cats. J Fungi (Basel) 2024; 10:244. [PMID: 38667915 PMCID: PMC11051258 DOI: 10.3390/jof10040244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/14/2024] [Accepted: 03/19/2024] [Indexed: 04/28/2024] Open
Abstract
Dermatophytosis is a superficial fungal skin infection common in humans around the world and is one of the many zoonotic skin diseases that cat owners are at risk of contracting. This retrospective study was conducted based on a detailed analysis of the results of mycological examination and medical documentation of 56 patients diagnosed with cat-to-human dermatophytoses from January 2017 to July 2022. Zoonotic mycoses were diagnosed more frequently in young people and women. In children, lesions most often occurred in the scalp area, and in adults, in the glabrous skin area. Skin infections caused by Microsporum canis (M. canis) prevailed and were confirmed in 47 patients (83.9%). Trichophyton mentagrophytes (T. mentagrophytes) was found in nine (16.1%) patients. M. canis predominantly caused infections of the scalp, followed by lower limb infections. Hairy scalps were almost exclusively involved in children. The odds of diagnosing M. canis infection compared to T. mentagrophytes infection was significantly higher in the head than in other regions, especially among children. The positive predictive value of a direct macroscopic examination was relatively low.
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Affiliation(s)
- Marcin Piorunek
- Veterinary Practice Marcin Piorunek, Olimpijska 12, 60-185 Skorzewo, Poland
| | - Honorata Kubisiak-Rzepczyk
- Department of Dermatology, Poznan University of Medical Sciences, 60-355 Poznan, Poland; (H.K.-R.); (A.D.-P.)
| | | | - Tomasz Trafas
- Department of Pulmonology, Allergology and Pulmonary Oncology, Poznan University of Medical Sciences, 60-569 Poznan, Poland;
| | - Jarosław Walkowiak
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, 60-572 Poznan, Poland;
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Song G, Zhang M, Kong X, Liu W, Liang G. Tinea Capitis in Children Younger than Two Years Old: A Retrospective Study and Treatment Recommendations. Mycopathologia 2023; 188:461-478. [PMID: 36581775 DOI: 10.1007/s11046-022-00703-z] [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: 07/29/2022] [Accepted: 12/11/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND Tinea capitis (TC) is a dermatophytosis of the scalp and hair, which occurs less common in children younger than two years of age, and the data of TC in this age group are still unknown. OBJECTIVES We aimed to reveal the epidemiological, clinical and mycological characteristics of TC in children under two years old. METHODS We retrospectively analyzed all reported cases of TC in children in their first two years of life from 1991 to 2022, by searching PubMed, Embase, Web of Science, CNKI, Wanfang and Weipu databases. RESULTS A total of 47 articles involving 126 cases of pediatric TC were enrolled in this study. The sex ratio (M/F) was 1.28:1. The age of the children ranged from ten days old to two years old with a median age of three months. The main clinical manifestations were alopecic patches (40 cases, 31.7%) and scaling (39 cases, 31.0%) on the scalp, and 29 infants (23.0%) appeared kerion. The most common sources of contagion were animals (35 cases, 27.78%) and humans (31 cases, 24.60%). The leading pathogens were Microsporidium canis (64 cases, 50.79%), followed by Trichophyton violaceum (13 cases, 10.32%), T. mentagrophytes complex (12 cases, 9.52%) and T. tonsurans (10 cases, 7.94%). Ninety-five children (75.40%) were treated with systemic antifungal drugs and 22 patients (17.46%) were only treated with topical therapy. Except for 10 patients with unknown final prognosis, all the other cases were cured after treatment. There was one child (0.79%) relapsed after treatment with griseofulvin and one case (0.79%) presented with gastrointestinal symptoms from griseofulvin. CONCLUSION The principal clinical symptoms of TC in children less than two years old were alopecic patches and scaling. The top four pathogens were M. canis, T. violaceum, T. mentagrophytes complex and T. tonsurans. Oral treatment for pediatric TC had achieved good therapeutic effects, and topical therapy can be an alternative choice.
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Affiliation(s)
- Ge Song
- Department of Medical Mycology, Institute of Dermatology and Hospital for Skin Diseases, Chinese Academy of Medical Science & Peking Union Medical College, Nanjing, 210042, China
- CAMS Collection Center of Pathogen Microorganisms-D (CAMS-CCPM-D), Nanjing, 210042, China
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, 210042, China
| | - Meijie Zhang
- Department of Medical Mycology, Institute of Dermatology and Hospital for Skin Diseases, Chinese Academy of Medical Science & Peking Union Medical College, Nanjing, 210042, China
- CAMS Collection Center of Pathogen Microorganisms-D (CAMS-CCPM-D), Nanjing, 210042, China
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, 210042, China
| | - Xue Kong
- Department of Medical Mycology, Institute of Dermatology and Hospital for Skin Diseases, Chinese Academy of Medical Science & Peking Union Medical College, Nanjing, 210042, China
- CAMS Collection Center of Pathogen Microorganisms-D (CAMS-CCPM-D), Nanjing, 210042, China
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, 210042, China
| | - Weida Liu
- Department of Medical Mycology, Institute of Dermatology and Hospital for Skin Diseases, Chinese Academy of Medical Science & Peking Union Medical College, Nanjing, 210042, China.
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.
- CAMS Collection Center of Pathogen Microorganisms-D (CAMS-CCPM-D), Nanjing, 210042, China.
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, 210042, China.
| | - Guanzhao Liang
- Department of Medical Mycology, Institute of Dermatology and Hospital for Skin Diseases, Chinese Academy of Medical Science & Peking Union Medical College, Nanjing, 210042, China.
- CAMS Collection Center of Pathogen Microorganisms-D (CAMS-CCPM-D), Nanjing, 210042, China.
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, 210042, China.
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9
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Abastabar M, Babaei M, Mohammadi R, Valadan R, Javidnia J, Zaedi A, Aghili SR, Haghani I, Khojasteh S, Reazaei-Matehkolaei A, Kiasat N, Hesari KK, Ghasemi Z, Azish M, Zarrinfar H, Taghizadeh-Armaki M, Keikha N, Kharazi M, Khodadadi H, Hedayati MT, Shokohi T. Iranian National Survey on Tinea Capitis: Antifungal Susceptibility Profile, Epidemiological Characteristics, and Report of Two Strains with a Novel Mutation in SQLE Gene with Homology Modeling. Mycopathologia 2023; 188:449-460. [PMID: 35980496 DOI: 10.1007/s11046-022-00657-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 07/31/2022] [Indexed: 10/15/2022]
Abstract
BACKGROUND The data on the epidemiological and antifungal susceptibility profile of tinea capitis (TC) in Iran has not been updated in recent decades. This report presents the Iranian epidemiological and drug susceptibility data regarding the distribution of dermatophytes species isolated by six national mycology centers for a period of one year (2020-2021). MATERIAL AND METHODS A total of 2100 clinical samples from individuals suspeted to TC were subjected to mycological analysis of direct microscopy and culture. For definite species identification, the culture isolates were additionally subjected to PCR-RFLP and PCR-sequencing of the ITS ribosomal DNA (ITS-rDNA) region. Antifungal susceptibility profiles for eight common antifungal drugs were determined by CLSI M38-A3 guidelines. The SQLE gene was partially amplified and sequenced in two terbinafine-resistant and two susceptible T. mentagrophytes isolates to elucidate probable substitutions involved in resistance. RESULTS TC (n = 94) was diagnosed in 75 children (79.8%) and 19 adults (20.2%) by direct microscopy and culture. Frequency of TC was significantly more among males (66 males = 70.2% vs 28 females = 29.8%). The prevalent age group affected was 5-9 years (39.36%). Thirty-two (34.04%) T. mentagrophytes, 27 (28.7%) T. tonsurans, 14 (14.9%) M. canis, 13 (13.8%) T. violaceum, 5 (5.32%) T. indotineae, 2 (2.1%) T. benhamiae, and 1 (1.1%) T. schoenleinii were identified as the causative agents. MIC values of isolates showed susceptibility to all antifungal agents, except for fluconazole and griseofulvin with GM MIC of 11.91 μg/ml and 2.01 μg/ml, respectively. Terbinafine exhibited more activity against isolates, with GM MIC 0.084 μg/ml followed by ketoconazole (0.100 μg/ml), econazole (0.107 μg/ml), itraconazole (0.133 μg/ml), butenafine (0.142 μg/ml), and miconazole (0.325 μg/ml). Two resistant T. mentagrophytes isolates harbored missense mutations in SQLE gene, corresponding to amino acid substitution F397L. Remarkably, one unique mutation, C1255T, in the SQLE sequence of two terbinafine-susceptible T. mentagrophytes strains leading to a change of leucine at the 419th position to phenylalanine (L419F) was detected. CONCLUSIONS T. mentagrophytes, T. tonsurans, and M. canis remained the main agents of TC in Iran, however less known species such as T. indotinea and T. benhamiae are emerging as new ones. Terbinafine could still be the appropriate choice for the treatment of diverse forms of TC.
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Affiliation(s)
- Mahdi Abastabar
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Maryam Babaei
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Rasoul Mohammadi
- Department of Medical Parasitology and Mycology, School of Medicine, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Reza Valadan
- Molecular and Cell Biology Research Center (MCBRC), Mazandaran University of Medical Sciences, Sari, Iran
| | - Javad Javidnia
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Arezoo Zaedi
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Seyed Reza Aghili
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Iman Haghani
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Shaghayegh Khojasteh
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ali Reazaei-Matehkolaei
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Neda Kiasat
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Kambiz Kamyab Hesari
- Department of Dermatopathology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Zeinab Ghasemi
- Department of Medical Mycology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Azish
- Department of Parasitology and Medical Mycology, School of Medicine, Dezful University of Medical Sciences, Dezful, Iran
| | - Hossein Zarrinfar
- Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mojtaba Taghizadeh-Armaki
- Department of Parasitology and Mycology, Infectious Diseases and Tropical Medicine Research Center, Health Research Center, School of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Naser Keikha
- Medical Laboratory Sciences Department, Infectious Diseases and Tropical Medicine Research Center, Resistant Tuberculosis Institute, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Mahboobeh Kharazi
- Department of Medical Parasitology and Mycology, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein Khodadadi
- Department of Medical Parasitology and Mycology, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Taghi Hedayati
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Tahereh Shokohi
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.
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10
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Xiao YY, Zhou YB, Chao JJ, Ma L. Epidemiology of Tinea Capitis in Children in Beijing and Adjacent Regions, China: A 15-Year Retrospective Study. Mycopathologia 2023; 188:531-535. [PMID: 35980497 DOI: 10.1007/s11046-022-00649-2] [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: 05/15/2022] [Accepted: 06/29/2022] [Indexed: 10/15/2022]
Abstract
BACKGROUND Tinea capitis is the most common dermatophytosis in children. Due to many factors, the types of pathogenic fungi of tinea capitis vary all over the world, and the pathogenic fungi of tinea capitis may change over time even in the same region. OBJECTIVES To investigated the epidemiological characteristics and pathogenic strains distribution of tinea capitis in children in Beijing and adjacent regions. Patients/Methods Through retrospective study and epidemiological analysis, we investigated the epidemiological characteristics of tinea capitis in children in Beijing and adjacent regions over 15 years. RESULTS A total of 1739 children with tinea capitis were retrospectively investigated from January 2006 to December 2020, including 1100 boys and 639 girls. A total of 67.4% of tinea capitis patients were between 1 and 5 years of age. A decreasing trend in tinea capitis was observed before 2009, while for the following 12 years, the incidence rate of tinea capitis fluctuated little. Zoophilic isolates (primarily Microsporum canis) were responsible for 88.4% of tinea capitis. Males are at greater risk for M. canis infection (p = 0.02). CONCLUSION Zoophilic species were responsible for approximately nine-tenth of the tinea capitis cases. The incidence of tinea capitis decreased before 2009.
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Affiliation(s)
- Yuan Yuan Xiao
- Department of Dermatology, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, No. 56 Nan Lishi Rd, Xicheng District, Beijing, 100045, China
| | - Ya Bin Zhou
- Department of Dermatology, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, No. 56 Nan Lishi Rd, Xicheng District, Beijing, 100045, China
| | - Jin Jing Chao
- Department of Dermatology, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, No. 56 Nan Lishi Rd, Xicheng District, Beijing, 100045, China
| | - Lin Ma
- Department of Dermatology, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, No. 56 Nan Lishi Rd, Xicheng District, Beijing, 100045, China.
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Luzardo OP, Zaldívar-Laguía JE, Zumbado M, Travieso-Aja MDM. The Role of Veterinarians in Managing Community Cats: A Contextualized, Comprehensive Approach for Biodiversity, Public Health, and Animal Welfare. Animals (Basel) 2023; 13:ani13101586. [PMID: 37238021 DOI: 10.3390/ani13101586] [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: 04/12/2023] [Revised: 05/07/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023] Open
Abstract
Homeless cats are a major problem in Europe, with hundreds of thousands abandoned every year. While many die, others can adapt to a lifestyle of roaming freely and establish community cat populations that tend to cluster together in groups. These groups of cats are typically found in urban areas that offer food and shelter to the cats. Animal welfare organizations often care for these cats, providing them with food, shelter, and medical attention. Despite this, conflicts can arise due to the presence of free-roaming cats, with some individuals advocating for drastic measures such as trapping and killing the cats to reduce their populations. However, it is essential to note that such methods are frequently illegal, inhumane, and ultimately ineffective in most situations. A thorough assessment of the impact of cats on a particular natural area requires a comprehensive cat census, a detailed study of the species being preyed upon, and an investigation into the prevalence of zoonotic or epizootic diseases. Moreover, veterinary experts assert that the public health risks associated with cats are often overstated. This article aims to provide a nuanced perspective on the impact of cats on biodiversity in natural areas, while also discussing their role in transmitting the main zoonotic diseases identified in European countries in recent years, with a particular focus on Spain. Effective cat control programs should focus on non-lethal methods such as trap-neuter-return (TNR) and adoption. TNR has proven to be the most effective and humane method of controlling the free-roaming cat population, but its effectiveness is influenced by several factors, including adoption programs and public education on responsible pet ownership. According to Spanish veterinarians, sustainable and science-based solutions such as TNR programs are the best way to achieve population control of free-roaming cats. The veterinary profession should raise awareness regarding sterilization, vaccination, and identification of cats and the consequences of abandonment. They oppose lethal control and removal of cats from the environment, which are ineffective and unethical methods. To promote animal welfare, veterinary professionals must collaborate with public administrations to implement long-term, sustainable solutions to the problem of cat overpopulation. Greater social awareness regarding the importance of sterilization and identification to prevent abandonment and reduce the number of free-roaming cats is also needed. Despite the challenges presented by homeless cat populations in Spain and the rest of Europe, there are many reasons for optimism. Animal welfare organizations and veterinary professionals are actively collaborating to develop humane and effective solutions to manage community cats, including programs such as TNR and adoption. Furthermore, these initiatives are gaining momentum and support from emerging laws and regulations, such as the recent Spanish animal welfare law. Through these efforts, we can reduce the number of free-roaming cats and improve their quality of life.
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Affiliation(s)
- Octavio P Luzardo
- Biomedical and Health Research Institute (IUIBS), University of Las Palmas de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain
- Faculty of Veterinary Medicine, University of Las Palmas de Gran Canaria, 35400 Arucas, Spain
- Abolitionist Association of Veterinarians against Bullfighting and Animal Abuse (AVATMA), 28045 Madrid, Spain
| | | | - Manuel Zumbado
- Biomedical and Health Research Institute (IUIBS), University of Las Palmas de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain
- Faculty of Veterinary Medicine, University of Las Palmas de Gran Canaria, 35400 Arucas, Spain
- Abolitionist Association of Veterinarians against Bullfighting and Animal Abuse (AVATMA), 28045 Madrid, Spain
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12
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Zhou X, Liu W, Yang S, Wu A, Chen P, Yin S, de Hoog S, Li M, Feng P. Exploring the clinical features and risk factors for children tinea capitis complicated with allergic diseases. Mycoses 2023; 66:338-345. [PMID: 36564975 DOI: 10.1111/myc.13558] [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: 10/17/2022] [Revised: 12/07/2022] [Accepted: 12/19/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND Tinea capitis, atopic dermatitis and allergic rhinitis are the most common disorders endured by prepubescent children. Dermatophyte infections have been linked to allergic disorders, such as increased sensitivity to dermatophytes in patients with atopic dermatitis. OBJECTIVES To explore the correlation between tinea capitis and allergic diseases in children and to analyse their risk factors. METHODS This study monitored epidemiological changes in childhood tinea capitis and risk factors for whom with allergic disease in a single centre in three consecutive five-year intervals by reviewing clinical data and multivariate logistic data analysis. RESULTS Between 2007 and 2022, there were 127 children patients with tinea capitis, the mean age was 4.83 years, and the male-to-female ratio was 1.76:1. Zoophilic Microsporum canis and Trichophyton mentagrophytes were the most prevalent pathogens, and the proportions remained relatively constant every 5 years. There were 34 (26.8%) children with tinea capitis complicated with allergic disease, among them 14 children with atopic dermatitis/eczema, 13 with allergic rhinitis, 8 urticaria, 6 food allergies and 1 allergic asthma. Male, kerion, zoophilic species infections and animal contact history were prevalent features in allergic disease combined with tinea capitis. Patients with tinea capitis plus allergic disease mostly had a family history with similar complications. CONCLUSION M. canis and T. mentagrophytes were the most prevalent pathogens of tinea capitis in the last 15 years; atopic dermatitis/eczema and allergic rhinitis were the most frequently associated allergic diseases. Male, kerion, zoophilic pathogen and animal contact history are risk factors.
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Affiliation(s)
- Xin Zhou
- Department of Dermatology & Allergy, 3rd Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.,Center of Expertise in Mycology of Radboud University Medical Center/Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
| | - Wentao Liu
- Department of Dermatology, 3rd Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Sulian Yang
- Department of Dermatology, 3rd Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Angela Wu
- Department of Dermatology, 3rd Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Peiran Chen
- Department of Dermatology, 3rd Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Songchao Yin
- Department of Dermatology, 3rd Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Sybren de Hoog
- Center of Expertise in Mycology of Radboud University Medical Center/Canisius Wilhelmina Hospital, Nijmegen, The Netherlands.,Foundation Atlas of Clinical Fungi, Hilversum, The Netherlands
| | - Meirong Li
- Department of Dermatology, 3rd Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Peiying Feng
- Department of Dermatology & Allergy, 3rd Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
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13
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Dascalu J, Zaaroura H, Renert-Yuval Y, Khamaysi Z, Avitan-Hersh E, Friedland R. Pediatric Tinea Capitis: A Retrospective Cohort Study from 2010 to 2021. J Fungi (Basel) 2023; 9:jof9030366. [PMID: 36983534 PMCID: PMC10054890 DOI: 10.3390/jof9030366] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/12/2023] [Accepted: 03/15/2023] [Indexed: 03/19/2023] Open
Abstract
Pediatric tinea capitis displays a wide range of prevalence, with significant variability among populations. We retrospectively extracted the medical records of 456 pediatric patients diagnosed with tinea capitis during the years 2010–2021, from the dermatology outpatient clinics in two tertiary medical centers. Three species were isolated in 90% of patients: T. tonsurans, M. canis, and T. violaceum. While T. tonsurans presented a six-fold increase in incidence during the years 2019–2021, M. canis maintained stable incidence rates. Furthermore, terbinafine was the most efficient antifungal agent against T. tonsurans, achieving complete clinical clearance in 95% of patients, as compared to fluconazole (68%) and griseofulvin (38%) (p < 0.001). The mycological cure was recorded in 61/90 (68%) of patients with available data, at an average of 10 weeks. For patients with M. canis, griseofulvin and fluconazole were equally efficient (73% and 66%, respectively) (p = 0.44). Kerion was described in 36% and 14% of patients with T. tonsurans and M. canis, respectively, (p < 0.001). In conclusion, since 2019, there has been a significant increase in the prevalence of T. tonsurans, establishing this pathogen as the most common cause for tinea capitis in our population. Our data suggest that terbinafine is effective and presents high cure rates for tinea capitis in the pediatric population.
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Affiliation(s)
- Joel Dascalu
- Department of Dermatology, Rambam Health Care Campus, Haifa 3525408, Israel; (J.D.); (H.Z.); (Z.K.)
| | - Hiba Zaaroura
- Department of Dermatology, Rambam Health Care Campus, Haifa 3525408, Israel; (J.D.); (H.Z.); (Z.K.)
| | - Yael Renert-Yuval
- Pediatric Dermatology Unit, Schneider Children’s Medical Center of Israel, Petach Tikva 4920235, Israel;
| | - Ziyad Khamaysi
- Department of Dermatology, Rambam Health Care Campus, Haifa 3525408, Israel; (J.D.); (H.Z.); (Z.K.)
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 3525422, Israel
| | - Emily Avitan-Hersh
- Department of Dermatology, Rambam Health Care Campus, Haifa 3525408, Israel; (J.D.); (H.Z.); (Z.K.)
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 3525422, Israel
- Correspondence: (E.A.-H.); (R.F.)
| | - Rivka Friedland
- Pediatric Dermatology Unit, Schneider Children’s Medical Center of Israel, Petach Tikva 4920235, Israel;
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Correspondence: (E.A.-H.); (R.F.)
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14
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Effects of Coleus amboinicus L. Essential Oil and Ethanolic Extracts on Planktonic Cells and Biofilm Formation of Microsporum canis Isolated from Feline Dermatophytosis. Antibiotics (Basel) 2022; 11:antibiotics11121734. [PMID: 36551390 PMCID: PMC9774219 DOI: 10.3390/antibiotics11121734] [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: 10/27/2022] [Revised: 11/27/2022] [Accepted: 11/28/2022] [Indexed: 12/03/2022] Open
Abstract
Microsporum canis is an important zoonotic fungus that causes dermatophytosis in domestic animals and their owners. Domestic cats are the primary reservoir for M. canis. Antifungal drugs frequently produce adverse effects on the host animal, increasing the demand for novel alternative treatments derived from nature. We evaluated the antifungal activity of Coleus amboinicus essential oil (CEO) and ethanolic extracts (CEE) against M. canis in planktonic and biofilm growth. Twelve clinical isolates of M. canis were identified in feline dermatophyte samples. Using GC-MS, 18 compounds were identified in CEO, with carvacrol being the major constituent. HPLC analysis of CEE revealed that it contained rosmarinic acid, apigenin, and caffeic acid. The planktonic growth of all M. canis isolates was inhibited by C. amboinicus extracts. The minimum inhibitory concentration at which ≥50% of the isolates were inhibited (MIC50) was 128 µg/mL (32-256 µg/mL) for both CEO and CEE. The MIC90 values of CEO and CEE were 128 and 256 µg/mL, respectively. CEO at MIC (128 µg/mL) and 2× MIC (256 µg/mL) significantly inhibited the biofilm formation of weak, moderate, and strong biofilm-producing M. canis. CEE at 2× MIC (256 µg/mL) significantly inhibited the biofilm formation of all isolates. Overall, C. amboinicus extracts inhibited planktonic growth and exhibited a significant antibiofilm effect against M. canis. Thus, C. amboinicus is a potential source of natural antifungal compounds.
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15
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Maruani A, Barbarot S, Gangneux JP, Caseris M, Moreau C, Brun S, Botterel F, Menotti J, Toubiana J, Chouchana L, Beylot-Barry M, Dupin N, Guillot B, Chosidow O. Management of tinea capitis in children following the withdrawal of griseofulvin from the French market: A fast-track algorithm proposed by the Center of Evidence of the French Society of Dermatology. Ann Dermatol Venereol 2022; 149:238-240. [PMID: 36229261 DOI: 10.1016/j.annder.2022.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 01/07/2022] [Accepted: 07/12/2022] [Indexed: 11/06/2022]
Affiliation(s)
- A Maruani
- Universités de Tours et Nantes, Inserm 1246-SPHERE, CHRU de Tours, service de dermatologie, unité de dermatologie pédiatrique, 37000 Tours, France; Centre de Preuves en Dermatologie, Société Française de Dermatologie Pédiatrique, Société Française de Dermatologie, France.
| | - S Barbarot
- Centre de Preuves en Dermatologie, Société Française de Dermatologie Pédiatrique, Société Française de Dermatologie, France; Nantes Université, Servie de Dermatologie, CHU Nantes, UMR 1280 PhAN, INRAE, F-44000 Nantes, France
| | - J P Gangneux
- Service de Parasitologie-Mycologie, CHU de Rennes, Univ Rennes, Inserm, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F35000 Rennes, France; Société Française de Mycologie Médicale, France
| | - M Caseris
- Infectiologie mobile, Hôpital Robert Debré, AP-HP, 75019 Paris, France; Groupe de Pathologie Infectieuse Pédiatrique de la Société Française de Pédiatrie, France
| | - C Moreau
- Service Pharmacie, Hôpital Robert-Debré (AP-HP), 75019 Paris, France
| | - S Brun
- Service de Parasitologie-Mycologie, Hôpital Avicenne, AP-HP, Université Sorbonne Paris Nord, Bobigny, France; Société Française de Mycologie Médicale, France
| | - F Botterel
- Unité de Parasitologie - Mycologie, Département de Prévention, diagnostic et traitement des infections, CHU de Créteil, AP-HP, Université Paris Est Créteil, Créteil, France; Société Française de Mycologie Médicale, France
| | - J Menotti
- Service de Parasitologie et Mycologie Médicale, Institut des Agents Infectieux, Hospices Civils de Lyon / Université Lyon 1, Lyon, France; Société Française de Mycologie Médicale, France
| | - J Toubiana
- Service de pédiatrie générale et maladies infectieuses, Hôpital Necker Enfants malades, AP-HP, Université de Paris, Paris, France
| | - L Chouchana
- Centre Régional de Pharmacovigilance, Service de Pharmacologie, EA 7323 Pharmacologie et Evaluation des Thérapeutiques chez l'enfant et la femme enceinte, Hôpital Cochin, AP-HP, Université de Paris, Paris, France; Société Française de Pharmacologie et Thérapeutique, France
| | - M Beylot-Barry
- Service de Dermatologie, CHU de Bordeaux, INSERM U1312, Bordeaux, France; Centre de Preuves en Dermatologie, Société Française de Dermatologie, France
| | - N Dupin
- Centre de Preuves en Dermatologie, Société Française de Dermatologie, France; Service de dermatologie Hôpital Cochin AP-HP, Paris, France
| | - B Guillot
- Université de Montpellier, Montpellier, France
| | - O Chosidow
- Service de Dermatologie, Hôpitaux Universitaires Henri-Mondor, AP-HP, Créteil, France; Universités de Tours et Nantes, Inserm 1246-SPHERE, France; Centre de Preuves en Dermatologie, GrIDIST Groupe Infectiologie Dermatologique, ISD-SIDA, Société Française de Dermatologie, Paris, France
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Bitew A, Yilma B, Taye T. High Trichophyton violaceum-Induced Tinea Capitis with Isolation of Many Non-Dermatophyte Molds in Scalp Scrapings in Patients Referred to a Dermatology Clinic in Addis Ababa, Ethiopia. CLINICAL, COSMETIC AND INVESTIGATIONAL DERMATOLOGY 2022; 15:1313-1324. [PMID: 35847420 PMCID: PMC9285527 DOI: 10.2147/ccid.s367763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 07/05/2022] [Indexed: 11/23/2022]
Abstract
Objective This work aimed to determine the magnitude of tinea capitis, the diversity and species composition of fungi, and the predominant dermatophytes implicated in causing tinea capitis. Methods A prospective, cross-sectional study was conducted at a dermatology clinic. Scalp scrapings were collected and cultured, and dermatophyte and non-dermatophyte molds were identified. Results Of 364 scalp scrapings, fungi were recovered from 301 (82.7%) clinical samples. About 60.7% of the samples were collected from women, while 39.3% were collected from male study subjects. The association between the magnitude of scalp ringworm and gender was not statistically significant (P = 0.105). Two hundred eighty study subjects were less than 15 years of age, of which 254 were culture positive. The association of tinea capitis and the age of patients was statistically significant (P = 0). Three hundred forty-nine fungal isolates were isolated, of which 54.2% were dermatophytes, while 45.8% were non-dermatophyte molds. The occurrence of dermatophytes in their decreasing order was T. violaceum (138; 73%), Trichophyton mentagrophytes (18; 9.5%), Trichophyton tonsurans (16; 8.5%), Trichophyton verrucosum (8; 4.5%), Microsporum audouinii (7; 3.7%), Trichophyton schoenleinii (1; 0.5%), and Trichophyton soudanense (1; 0.5%). Conclusion A high prevalence rate of T. violaceum-induced tinea capitis was reported. The magnitude of scalp ringworm in adults was remarkably high. Therefore, conducting a nationwide epidemiological survey on tinea capitis regardless of age is suggested. The isolation of many non-dermatophyte molds in the current study may shade questions about the perception that tinea capitis is caused by dermatophytes only. Therefore, studies on their potential pathogenic role on skin and skin-related (nail and the scalp) infections appear to be an active field of research.
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Affiliation(s)
- Adane Bitew
- Department of Medical Laboratory Science, College Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Betelhem Yilma
- Saint Peter's Specialized Tuberculosis Referral Hospital, Addis Ababa, Ethiopia
| | - Tomas Taye
- Rank Specialized Dermatology Clinic, Addis Ababa, Ethiopia
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Moskaluk A, Darlington L, Kuhn S, Behzadi E, Gagne RB, Kozakiewicz CP, VandeWoude S. Genetic Characterization of Microsporum canis Clinical Isolates in the United States. J Fungi (Basel) 2022; 8:676. [PMID: 35887433 PMCID: PMC9321804 DOI: 10.3390/jof8070676] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 06/21/2022] [Accepted: 06/24/2022] [Indexed: 12/16/2022] Open
Abstract
Microsporum canis is the primary agent causing dermatophytosis in cats, and also infects humans, dogs, and other species. Assessment of genetic variation among M. canis isolates in the United States has not been conducted. Further, M. canis mating type and assessment of disease severity associated with genotypic characteristics have not been rigorously evaluated. We therefore isolated M. canis from 191 domestic cats across the US and characterized genotypes by evaluation of ITS sequence, MAT locus, and microsatellite loci analysis. The genes SSU1 and SUB3, which are associated with keratin adhesion and digestion, were sequenced from a subset of isolates to evaluate potential genetic associations with virulence. Analysis of microsatellite makers revealed three M. canis genetic clusters. Both clinic location and disease severity were significant predictors of microsatellite variants. 100% of the M. canis isolates were MAT1-1 mating gene type, indicating that MAT1-2 is very rare or extinct in the US and that asexual reproduction is the dominant form of replication. No genetic variation at SSU1 and SUB3 was observed. These findings pave the way for novel testing modalities for M. canis and provide insights about transmission and ecology of this ubiquitous and relatively uncharacterized agent.
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Affiliation(s)
- Alex Moskaluk
- Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, CO 80523, USA; (A.M.); (L.D.); (E.B.); (C.P.K.)
| | - Lauren Darlington
- Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, CO 80523, USA; (A.M.); (L.D.); (E.B.); (C.P.K.)
| | - Sally Kuhn
- Behavior Analysis, Simmons University, Boston, MA 02115, USA;
| | - Elisa Behzadi
- Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, CO 80523, USA; (A.M.); (L.D.); (E.B.); (C.P.K.)
| | - Roderick B. Gagne
- Pathobiology, Wildlife Futures Program, University of Pennsylvania, Philadelphia, PA 19104, USA;
| | - Christopher P. Kozakiewicz
- Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, CO 80523, USA; (A.M.); (L.D.); (E.B.); (C.P.K.)
| | - Sue VandeWoude
- Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, CO 80523, USA; (A.M.); (L.D.); (E.B.); (C.P.K.)
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Powell J, Porter E, Field S, O'Connell N, Carty K, Dunne CP. Epidemiology of dermatomycoses and onychomycoses in Ireland (2001 to 2020): A single-institution review. Mycoses 2022; 65:770-779. [PMID: 35598177 PMCID: PMC9327510 DOI: 10.1111/myc.13473] [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: 02/25/2022] [Accepted: 05/19/2022] [Indexed: 12/01/2022]
Abstract
Background Fungal skin infections are recognised as one of the most common health disorders globally, and dermatophyte infections of the skin, hair and nails are the most common fungal infections. Dermatophytes can be classified as anthropophilic, zoophilic or geophilic species based on their primary habitat association, and this classification makes epidemiological analysis useful for the prevention and control of these infections. The Irish contribution to the epidemiology of these infections has been scant, with just two papers (both reporting paediatric tinea capitis only) published in the last 20 years, and none in the last seven. Objectives To perform a comprehensive retrospective epidemiological analysis of all dermatological mycology tests performed in University Hospital Limerick over a 20‐year period. Methods All mycology laboratory test results were extracted from the Laboratory Information Management System (LIMS, iLab, DXC Technologies) from 2001 to 2020 inclusive for analysis. Specimen types were categorised according to the site of sampling. The data were analysed using Microsoft Excel. Results About 12,951 specimens of skin, hair and nails were studied. Median patient age was 42 years (IQR 26–57) with a slight female preponderance (57.2%). Two thirds of samples (67%, n = 8633) were nail, 32% were skin scrapings (n = 4118) and 200 hair samples (1.5%) were received. Zoophilic dermatophytes were more commonly present in females (38% F, 23% M, proportion of dermatophytes) and in those under 10 years of age or from 45 to 70 years (36% and 34% zoophiles, respectively, proportion of dermatophytes), although anthropophiles predominated every age and gender category. Anthropophiles had their highest prevalence in the 10–20 years age category (80% anthropophiles, proportion of dermatophytes), and yeast infections were more prevalent in older patients (29% of >60 year olds vs. 17% of <60 year olds, proportion of all fungal positives). Trichophyton rubrum was the most prevalent pathogen detected, accounting for 53% of all dermatophytes detected, 61% of those detected from nail samples and 34% from skin and hair samples. Trichophyton tonsurans was the most prevalent dermatophyte in tinea capitis, accounting for 37% of dermatophytes detected. Both of these organisms are anthropophilic, and this group showed consistently increased prevalence in proportion to all fungal isolates. The proportion of this dermatophyte class (anthropophiles) increased among both nail samples and skin/hair samples during the study period, from 55% of samples in the first 5 years of the study (2001–2005) to 88% (proportion of dermatophytes) in the final 5 years. Conversely, yeast detection decreased. Conclusions This study provides a detailed overview of the epidemiology of the fungal cultures of skin, nail and hair samples in the Mid‐West of Ireland over a 20‐year period. Monitoring this changing landscape is important in identifying likely sources of infections, to identifying potential outbreaks, and may help guide empiric treatment. To the best of our knowledge, this study provides the first detailed analysis from Ireland of fungal detections from skin, hair and nail samples, and is the first epidemiological fungal report of any kind in over 7 years.
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Affiliation(s)
- James Powell
- Department of Microbiology, University Hospital Limerick, Limerick, Ireland.,School of Medicine and Centre for Interventions in Infection, Inflammation, and Immunity (4i), University of Limerick, Limerick, Ireland
| | - Emma Porter
- Department of Dermatology, University Hospital Limerick, Limerick, Ireland
| | - Sinead Field
- Department of Dermatology, University Hospital Limerick, Limerick, Ireland
| | - Nuala O'Connell
- Department of Microbiology, University Hospital Limerick, Limerick, Ireland.,School of Medicine and Centre for Interventions in Infection, Inflammation, and Immunity (4i), University of Limerick, Limerick, Ireland
| | - Kieran Carty
- Department of Microbiology, University Hospital Limerick, Limerick, Ireland
| | - Colum P Dunne
- School of Medicine and Centre for Interventions in Infection, Inflammation, and Immunity (4i), University of Limerick, Limerick, Ireland
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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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20
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Song G, Zhang M, Liu W, Liang G. The Changing Face of Epidemiology of Dermatophytoses in Chinese Mainland: A 30 years Nationwide Retrospective Study from 1991 to 2020. Mycoses 2022; 65:440-448. [PMID: 35102623 DOI: 10.1111/myc.13425] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 01/06/2022] [Accepted: 01/25/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Dermatophytoses are the most common infectious skin disease. Its epidemiology varies in different countries and regions, and its prevalence in China is still unknown. OBJECTIVES We aimed to reveal the epidemiological features of dermatophytoses in Chinese mainland in the past thirty years. METHODS From 1991 to 2020, a 30-year retrospective epidemiological study was carried out. All published literatures containing dermatophytoses and dermatophytes were collected and analyzed. RESULTS A total of more than 180,000 cases in 124 articles from more than 100 hospitals were included and analyzed. Among dermatophytoses, tinea cruris (24.92%) was the predominant clinical type, followed by tinea pedis (22.97%) and tinea corporis (18.12%). In recent 10 years, tinea pedis (25.40%) was more common than tinea cruris (22.39%) and became the most common infection. Among dermatophytes, T. rubrum (69.48%) has always been the most common isolates, followed by T. mentagrophytes (16.45%) and M. canis (8.09%). Other species were found below 3%. In superficial mycoses, dermatophytes accounted for 75.52%, higher than that of yeasts/yeast-like (21.83%) and molds (2.65%). The prevalence of tinea capitis was lower in economically developed eastern region than that in central and western regions. Tinea cruris was more common in warm zones than cold zones. CONCLUSIONS The top three dermatophytoses are tinea cruris, tinea pedis and tinea corporis, while the top three dermatophytes are T. rubrum, T. mentagrophytes and M. canis. The distribution of dermatophytoses may be influenced by socioeconomic status and geographical-meteorological conditions.
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Affiliation(s)
- Ge Song
- Department of Medical Mycology, Institute of Dermatology, Chinese Academy of Medical Science and Peking Union Medical College, Nanjing, 210042, China.,Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, 210042, China
| | - Meijie Zhang
- Department of Medical Mycology, Institute of Dermatology, Chinese Academy of Medical Science and Peking Union Medical College, Nanjing, 210042, China.,Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, 210042, China
| | - Weida Liu
- Department of Medical Mycology, Institute of Dermatology, Chinese Academy of Medical Science and Peking Union Medical College, Nanjing, 210042, China.,Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, 210042, China.,Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Guanzhao Liang
- Department of Medical Mycology, Institute of Dermatology, Chinese Academy of Medical Science and Peking Union Medical College, Nanjing, 210042, China.,Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, 210042, China
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Faramarzi S, Motamedi M, Rezaei-Matehkolaei A, Aboutalebian S, Ansari S, Didehdar M, Bahadoran M, Mirhendi H. A simple multiplex polymerase chain reaction assay for rapid identification of the common pathogenic dermatophytes: Trichophyton interdigitale, Trichophyton rubrum, and Epidermophyton floccosum. Curr Med Mycol 2022; 7:1-7. [PMID: 35028478 PMCID: PMC8740852 DOI: 10.18502/cmm.7.2.7030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 05/22/2021] [Accepted: 06/30/2021] [Indexed: 12/04/2022] Open
Abstract
Background and Purpose: The most common etiological agents of human dermatophytosis in various parts of the world are Trichophyton rubrum, Trichophyton interdigitale, and Epidermophyton floccosum.
The main aim of this study was to design and evaluate a simple and straightforward multiplex polymerase chain reaction (PCR) assay for reliable identification/differentiation of these species
in clinical isolates. Materials and Methods: The reliable sequences of several molecular targets of dermatophytes species were used to design a multiplex PCR for the identification of common pathogenic dermatophytes.
The isolates and clinical specimens examined in this study included seven standard strains of dermatophytes, 101 isolates of dermatophytes and non-dermatophyte molds/yeasts which
had already been identified by sequencing or PCR-restriction fragment length polymorphism (RFLP), and 155 clinical samples from patients suspected of cutaneous mycoses. Results: Species-specific primer pairs for T. rubrum and T. interdigitale/T. mentagrophytes were designed based on the sequence data of the translation elongation factor 1-alpha gene,
and the primers for E. floccosum targeted the specific sequence of the internal transcribed spacer region (ITS). The multiplex PCR successfully
detected T. rubrum, T. interdigitale/T. mentagrophytes, and E. floccosum strains that were identified by sequencing or PCR-RFLP. However, the primer pairs selected
for T. interdigitale/T. mentagrophytes cross-reacted with Trichophyton tonsurans. In testing the PCR system directly for clinical samples, the proportion of positive
multiplex PCR was higher than positive culture (68.1% vs. 55.4%, respectively). Conclusion: The multiplex assay could detect three common agents out of several causal agents of dermatophytosis, namely T. rubrum, T. interdigitale, and E. floccosum. Therefore, by adding
pan-dermatophyte primers it can be used as a comprehensive detection/identification test.
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Affiliation(s)
- Sama Faramarzi
- Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Marjan Motamedi
- Department of Medical Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Rezaei-Matehkolaei
- Department of Medical Mycology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Shima Aboutalebian
- Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Saham Ansari
- Department of Medical Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mojtaba Didehdar
- Department of Medical Parasitology and Mycology, School of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Mehran Bahadoran
- Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hossein Mirhendi
- Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Lim SS, Shin K, Mun JH. Dermoscopy for cutaneous fungal infections: A brief review. Health Sci Rep 2022; 5:e464. [PMID: 35024456 PMCID: PMC8733849 DOI: 10.1002/hsr2.464] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 11/15/2021] [Accepted: 11/15/2021] [Indexed: 01/22/2023] Open
Abstract
Background Fungal dermatological diseases are significant public health issues. Dermoscopy is a useful bedside assessment tool that helps clinicians diagnose various skin neoplasms and general dermatological diseases. Aim This brief review aims to update clinicians on the dermoscopic features of cutaneous fungal infections such as tinea capitis, tinea corporis, tinea incognito, onychomycosis, and pityrosporum folliculitis. Methods The PubMed database was searched using the terms “dermoscopy” or its synonyms, “tinea capitis”, “tinea corporis”, “tinea incognito”, “onychomycosis” and “pityrosporum folliculitis”. Results The diagnostic value of dermoscopy is well‐recognised in the evaluation of tinea capitis and onychomycosis. There are fewer studies investigating the dermoscopic features of tinea corporis, tinea incognito and pityrosporum folliculitis, but the current data suggest that dermoscopy can aid clinical evaluation of these diseases. Understanding dermoscopic features of cutaneous fungal infection has the potential to increase diagnostic accuracy. Conclusion Dermoscopy in the evaluation of fungal dermatological diseases has the potential to optimize diagnostic accuracy, reduce unnecessary testing, and, consequently, improve clinical practice.
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Affiliation(s)
| | - Kihyuk Shin
- Department of Dermatology, College of Medicine Pusan National University Busan South Korea.,Department of Dermatology Pusan National University Yangsan Hospital Yangsan South Korea.,Research Institute for Convergence of Biomedical Science and Technology Pusan National University Yangsan Hospital Yangsan South Korea
| | - Je-Ho Mun
- Department of Dermatology Seoul National University Hospital Seoul Republic of Korea.,Department of Dermatology Seoul National University College of Medicine Seoul Republic of Korea
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Martínez Campayo N, Rego Campuzano I, González de Aledo M, Arévalo Bermúdez M, Fernández Torres R, Fonseca E. New Epidemiological Outcomes in Anthropophilic tinea capitis, a Case Series Study in Northwestern Spain. ACTAS DERMO-SIFILIOGRAFICAS 2022; 113:74-77. [DOI: 10.1016/j.ad.2020.11.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 11/23/2020] [Indexed: 11/25/2022] Open
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24
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Martínez Campayo N, Rego Campuzano I, González de Aledo M, Arévalo Bermúdez M, Fernández Torres R, Fonseca E. [Artículo traducido] Nuevos hallazgos epidemiológicos en la tinea capitis antropófila, un estudio de una serie de casos en el noroeste de España. ACTAS DERMO-SIFILIOGRAFICAS 2022; 113:T74-T77. [DOI: 10.1016/j.ad.2020.11.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 11/18/2020] [Accepted: 11/23/2020] [Indexed: 10/20/2022] Open
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Lecerf P, Dangoisse C, Van Ooteghem A, Vujovic A, Vollono L, Richert B. Asymptomatic Scalp Carriage among Household Contacts of Children Affected by Tinea Capitis: A Prospective Study in the Metropolitan Area of Brussels, Belgium. Skin Appendage Disord 2021; 8:200-205. [PMID: 35707285 PMCID: PMC9149463 DOI: 10.1159/000520107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 10/04/2021] [Indexed: 11/19/2022] Open
Abstract
<b><i>Introduction:</i></b> Tinea capitis (TC) is a superficial fungal infection affecting the scalp. The existence of asymptomatic carriers (ACs) could represent a potential reservoir responsible of (re)contamination and failure of treatment. No prospective studies on ACs in household contacts of TC patients in Europe have been published to date. <b><i>Objectives:</i></b> The aim of this study was to assess the prevalence of ACs in a cohort of household contacts of children who were diagnosed with TC in the metropolitan area of Bruxelles, Belgium. <b><i>Methods:</i></b> This prospective observational study was conducted from October 2015 to April 2016 at the Dermatology Department of the University Hospitals Brugmann, Saint-Pierre, Queen Fabiola Children Hospital. <b><i>Results:</i></b> Ninety-nine cases of TC from 95 different family circles were included. The main infectious agent identified was <i>Microsporum audouinii</i> in 53 cases. The mean age of TC patients was 5.8 years. Male/female ratio was 2.8. Eighty-one household contacts of TC patients were enrolled in the study. Two cases of ACs (5%) were identified. <b><i>Conclusions:</i></b> <i>M. audouinii</i> was the most common pathogen identified. The prevalence of ACs we report is on average higher compared to other European large cities. Larger prospective studies including all close contacts of affected patients are required in order to establish guidelines regarding identification and management of ACs.
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Affiliation(s)
- Pauline Lecerf
- Dermatology Department, University Hospitals Brugmann, Saint-Pierre and Queen Fabiola Children's Hospital, Université Libre de Bruxelles, Brussels, Belgium
- *Pauline Lecerf,
| | - Chantal Dangoisse
- Dermatology Department, University Hospitals Brugmann, Saint-Pierre and Queen Fabiola Children's Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Aude Van Ooteghem
- Dermatology Department, University Hospitals Brugmann, Saint-Pierre and Queen Fabiola Children's Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Anja Vujovic
- Dermatology Department, University Hospitals Brugmann, Saint-Pierre and Queen Fabiola Children's Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Laura Vollono
- Dermatology Unity, Department of “Medicina Dei Sistemi”, Tor Vergata University, Rome, Italy
| | - Bertrand Richert
- Dermatology Department, University Hospitals Brugmann, Saint-Pierre and Queen Fabiola Children's Hospital, Université Libre de Bruxelles, Brussels, Belgium
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Ba O, Kébé M, Groun S, Sy O, Sidiya MA, Eibih ABA, Bollahi MA, Ben Abdelaziz A. Epidemiology of scalp ringworms and superficial fungal infections in schools in Mauritania. LA TUNISIE MEDICALE 2021; 99:1126-1133. [PMID: 35288918 PMCID: PMC8974423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Scalp Tinea is the most common mycosis in children and adolescents. The objective of this work was to determine the epidemiological and etiological profile of Scalp Tinea in schoolchildren in Mauritania, during the year 2019. METHODS This is a descriptive cross-sectional study lasting four months, from May to September 2019, in a sample of schoolchildren from Nouakchott, included following a random survey at three levels, having benefited from a clinical examination, mycological and culture samples. RESULTS A total of 228 children out of the 434 included (52,5%) were detected as carriers of Scalp Tinea, after fungal culture, i.e. rates of 54% in boys and 46% in girls. The most affected age group was 9-12 years (49%). Public schools were the most affected (37,7%), followed by private schools (32%) and traditional schools (30,3%), (p<0,05). Trichophyton sudanense represented 23,5% (n=102) followed by Trichophyton rubrum (15,4%, n=67) and Microsporum langeronii 8,1% (n=35). The type of habitat, the humidity of the environment and walking with bare feet did not significantly influence the presence of ringworms, unlike overcrowding (sleeping with more than two people). The prevalence of scalp ringworms increased from 1,3% for children sleeping on single beds to 22,8% in children sharing their beds and to 75,9% in students sleeping together on the same bed (p˂0,05). CONCLUSION The results of this survey, conducted in 2019, confirmed the changes in the epidemiological and ecological trend of the mycological profile of Scalp Tinea, in Mauritania. It is necessary to strengthen these results with the molecular characterization of fungal strains circulating in our country.
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Affiliation(s)
- O Ba
- 1. Faculté de Médecine, Université de Nouakchott Al Aasriya
| | - M Kébé
- 1. Faculté de Médecine, Université de Nouakchott Al Aasriya
| | | | - O Sy
- 3. Centre Hospitalier des Spécialités (CHS) Nouakchott
| | - MA Sidiya
- 1. Faculté de Médecine, Université de Nouakchott Al Aasriya
| | - ABA Eibih
- 1. Faculté de Médecine, Université de Nouakchott Al Aasriya
| | - MA Bollahi
- 1. Faculté de Médecine, Université de Nouakchott Al Aasriya
| | - A Ben Abdelaziz
- 4. Réseau Maghrébin PRP2S (Pédagogie-Recherche-Publication en Sciences de la Santé). Laboratoire de Recherche LR19SP01
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New Epidemiological Outcomes in Anthropophilic tinea capitis, a Case Series Study in Northwestern Spain. ACTAS DERMO-SIFILIOGRAFICAS 2021. [DOI: 10.1016/j.adengl.2021.11.014] [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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28
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Kassem R, Shemesh Y, Nitzan O, Azrad M, Peretz A. Tinea capitis in an immigrant pediatric community; a clinical signs-based treatment approach. BMC Pediatr 2021; 21:363. [PMID: 34445992 PMCID: PMC8390185 DOI: 10.1186/s12887-021-02813-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 07/16/2021] [Indexed: 12/23/2022] Open
Abstract
Background Tinea capitis is a common cutaneous infection of the scalp and hair follicles, typically diagnosed by direct examination and culture. Treatment with oral antifungals is usually withheld until mycology results are available. In Israel, African refugee children demonstrate higher susceptibility to Tinea capitis and generally fail to undergo follow-up evaluations. Methods This study aimed to identify the clinical characteristics and treatment responses of refugee children in Israel with Tinea capitis, in order to formulate a treatment plan for primary care physicians. To this end, demographic, clinical and laboratory data were extracted from the electronic medical records of 76 refugee children presenting with Tinea capitis during 2016–2017. All measured variables and derived parameters are presented using descriptive statistics. The correlation between background clinical and demographic data and Tinea capitis diagnosis was assessed using the chi-squared and Wilcoxon tests. Correlations between demographic/clinical/laboratory characteristics and other types of fungi or other important findings were assessed using a T-test. Results Scaling was the most common clinical finding. Cultures were positive in 64 (84%) and direct examination in 65 (85%) cases, with a positive correlation between the methods in 75% of cases. The most common fungal strain was T. violaceum. Fluconazole treatment failed in 27% of cases. Griseofulvin 50 mg/kg/day was administered to 74 (97%) children, and induced clinical responses. No side effects were reported. Conclusions The key aim of this study was to emphasize the importance of diagnosis and treatment of these immigrant children by their primary pediatric doctor since it takes, an average of 4.3 months until they visit a dermatologist. During this critical time period, the scalp can become severely and permanently damaged, and the infection can become systemic or cause an outbreak within the entire community. In conclusion, we recommend to relate to scaly scalp in high-risk populations as Tinea capitis, and to treat with griseofulvin at a dosage of up to 50 mg/kg/day, starting from the first presentation to the pediatrician.
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Affiliation(s)
- Riad Kassem
- Dermatology Department, Sheba Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yahel Shemesh
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Orna Nitzan
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel.,Infectious Disease Unit, Baruch Padeh Medical Center, Poriya, Israel
| | - Maya Azrad
- Clinical Microbiology Laboratory, Baruch Padeh Medical Center, Poriya, Israel
| | - Avi Peretz
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel. .,Clinical Microbiology Laboratory, Baruch Padeh Medical Center, Poriya, Israel.
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Kromer C, Celis D, Hipler UC, Zampeli VA, Mößner R, Lippert U. Dermatophyten-Infektionen bei Kindern und Erwachsenen in Deutschland - eine retrospektive multizentrische Studie. J Dtsch Dermatol Ges 2021; 19:993-1002. [PMID: 34288468 DOI: 10.1111/ddg.14432_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 01/07/2021] [Indexed: 12/01/2022]
Affiliation(s)
- Christian Kromer
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Göttingen
| | - Daniel Celis
- Fakultät für Wirtschaftswissenschaften, Georg-August-Universität Göttingen
| | | | - Vasiliki A Zampeli
- Hochschulklinik für Dermatologie, Venerologie und Allergologie, Immunologisches Zentrum, Städtisches Klinikum Dessau
| | - Rotraut Mößner
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Göttingen
| | - Undine Lippert
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Göttingen
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30
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Wang M, Zhao Y, Cao L, Luo S, Ni B, Zhang Y, Chen Z. Transcriptome sequencing revealed the inhibitory mechanism of ketoconazole on clinical Microsporum canis. J Vet Sci 2021; 22:e4. [PMID: 33522156 PMCID: PMC7850795 DOI: 10.4142/jvs.2021.22.e4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/26/2020] [Accepted: 11/05/2020] [Indexed: 11/30/2022] Open
Abstract
Background Microsporum canis is a zoonotic disease that can cause dermatophytosis in animals and humans. Objectives In clinical practice, ketoconazole (KTZ) and other imidazole drugs are commonly used to treat M. canis infection, but its molecular mechanism is not completely understood. The antifungal mechanism of KTZ needs to be studied in detail. Methods In this study, one strain of fungi was isolated from a canine suffering with clinical dermatosis and confirmed as M. canis by morphological observation and sequencing analysis. The clinically isolated M. canis was treated with KTZ and transcriptome sequencing was performed to identify differentially expressed genes in M. canis exposed to KTZ compared with those unexposed thereto. Results At half-inhibitory concentration (½MIC), compared with the control group, 453 genes were significantly up-regulated and 326 genes were significantly down-regulated (p < 0.05). Quantitative reverse transcription polymerase chain reaction analysis verified the transcriptome results of RNA sequencing. Gene ontology enrichment analysis and Kyoto Encyclopedia of Genes and Genomes enrichment analysis revealed that the 3 pathways of RNA polymerase, steroid biosynthesis, and ribosome biogenesis in eukaryotes are closely related to the antifungal mechanism of KTZ. Conclusions The results indicated that KTZ may change cell membrane permeability, destroy the cell wall, and inhibit mitosis and transcriptional regulation through CYP51, SQL, ERG6, ATM, ABCB1, SC, KER33, RPA1, and RNP genes in the 3 pathways. This study provides a new theoretical basis for the effective control of M. canis infection and the effect of KTZ on fungi.
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Affiliation(s)
- Mingyang Wang
- Key Laboratory of Livestock Infectious Diseases in Northeast China, Ministry of Education, College of Animal Science and Veterinary Medicine, Shenyang Agricultural University, Shenyang 110866, China
| | - Yan Zhao
- Key Laboratory of Livestock Infectious Diseases in Northeast China, Ministry of Education, College of Animal Science and Veterinary Medicine, Shenyang Agricultural University, Shenyang 110866, China
| | - Lingfang Cao
- Key Laboratory of Livestock Infectious Diseases in Northeast China, Ministry of Education, College of Animal Science and Veterinary Medicine, Shenyang Agricultural University, Shenyang 110866, China
| | - Silong Luo
- Key Laboratory of Livestock Infectious Diseases in Northeast China, Ministry of Education, College of Animal Science and Veterinary Medicine, Shenyang Agricultural University, Shenyang 110866, China
| | - Binyan Ni
- Qingdao Vetlab Biotechnology Co., Ltd., Qingdao 266109, China
| | - Yi Zhang
- Key Laboratory of Livestock Infectious Diseases in Northeast China, Ministry of Education, College of Animal Science and Veterinary Medicine, Shenyang Agricultural University, Shenyang 110866, China.
| | - Zeliang Chen
- Key Laboratory of Livestock Infectious Diseases in Northeast China, Ministry of Education, College of Animal Science and Veterinary Medicine, Shenyang Agricultural University, Shenyang 110866, China.
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Friedland R, Reiss-Huss S, Sabbah F, Ben Amitai D. Clinical clues and trends in epidemiology and pathogens in paediatric tinea capitis: a retrospective cohort study. Clin Exp Dermatol 2021; 47:50-56. [PMID: 34236716 DOI: 10.1111/ced.14831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Tinea capitis is the most common dermatophyte infection in children. Pathogens differ between populations. During the past few decades pathogen shifts have been reported in many countries around the world. This study aimed to characterize the pathogens involved in tinea capitis in a large tertiary paediatric medical centre in Israel. METHODS The electronic medical records of the dermatology unit were searched for patients diagnosed with tinea capitis from 2010 to 2019, and demographic, clinical and mycological data were retrieved. A stepwise logistic regression was performed to determine the variables most significantly associated with positive cultures. RESULTS The prevalence of Trichophyton tonsurans isolates was found to be significantly increased during 2019. In the logistic regression analysis, alopecia was most significantly associated with a positive culture (OR = 8.72, 95% CI 4.29-17.7, P < 0.001) while positive culture was also associated with age (OR = 1.11 per year of age, 95% CI 1.02-1.22, P = 0.01) and Ethiopian ethnicity (OR = 3.67, 95% CI 1.42-9.45, P = 0.01). The presentation of alopecia was significantly related to having a positive culture. This symptom was more prevalent in boys than in girls, and the diagnosis of tinea capitis was delayed by an average of 2 months in girls. CONCLUSION The results of this study may herald a pathogen shift in Israel. Physicians should be aware that rates of alopecia are lower in girls and this can result in delayed diagnosis and the development of complications, including chronicity, scarring alopecia and kerion formation.
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Affiliation(s)
- R Friedland
- Pediatric Dermatology Unit, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - S Reiss-Huss
- Pediatric Dermatology Unit, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - F Sabbah
- Pediatric Dermatology Unit, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - D Ben Amitai
- Pediatric Dermatology Unit, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Hedgehogs as a Potential Source of Zoonotic Pathogens-A Review and an Update of Knowledge. Animals (Basel) 2021; 11:ani11061754. [PMID: 34208276 PMCID: PMC8230866 DOI: 10.3390/ani11061754] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 06/08/2021] [Accepted: 06/09/2021] [Indexed: 11/24/2022] Open
Abstract
Simple Summary Up to date studies indicate that wild hedgehogs may act as carriers and/or hosts for bacterial, viral, and fungal pathogens with zoonotic potential, posing a significant threat to humans. The same applies to domestic hedgehogs, which are increasingly kept as pets. Considering the potential risk of infection to humans through close contact with hedgehogs or the contaminated environment they inhabit, current data on the prevalence of various zoonotic pathogens in these animals is desirable. Abstract Hedgehogs are small insectivorous mammals common across Europe, Asia, and Africa. The increased encroachment of humans into hedgehog habitats has disrupted the human-animal-environment interface. With growing interest in the zoonotic diseases of wildlife species, more studies have been devoted to this subject in the last few years. These papers provide information about known and new emerging diseases. Here we review the current knowledge regarding bacterial, viral, protozoic, and mycotic pathogens with zoonotic potential and assess the importance of hedgehogs as their carriers. Both wild and pet hedgehogs were included in the review. Data from several countries and various hedgehog species were included. The study shows the importance of hedgehogs as carriers of zoonotic diseases and reservoirs of zoonotic pathogens in varied habitats.
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Kromer C, Celis D, Hipler UC, Zampeli VA, Mößner R, Lippert U. Dermatophyte infections in children compared to adults in Germany: a retrospective multicenter study in Germany. J Dtsch Dermatol Ges 2021; 19:993-1001. [PMID: 33973357 DOI: 10.1111/ddg.14432] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 01/07/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND AND OBJECTIVE Dermatophyte infections of the skin and nails are common worldwide and vary between geographical areas and over time. The aim of this study was to determine the epidemiological profile of dermatophytes in Germany with a focus on comparing children with adults. PATIENTS AND METHODS In this retrospective multicenter study, mycological dermatophyte culture results in the period 01/2014 to 12/2016 were analyzed according to identified pathogen, age and gender of patients, and type of disease. RESULTS Of 1,136 infections (children: n = 88, adults: n = 1,048), 50.8 % were clinically classified as onychomycosis, followed by tinea pedis (34.6 %), tinea corporis (16.2 %), tinea manus (16.2 %), tinea capitis (2.5 %), and tinea faciei (1.2 %). The most frequent pathogen was Trichophyton (T.) rubrum (78.6 %), followed by T. interdigitale (14.3 %), T. benhamiae (3.2 %), T. mentagrophytes (2.1 %), and Microsporum canis (1.7 %). The fungal spectrum differed particularly in tinea corporis and tinea capitis between children and adults with a more diverse pathogen spectrum in children. Trichophyton tonsurans was rarely identified as cause for tinea corporis (2.7 %) or tinea capitis (3.3 %). CONCLUSIONS Differences in pathogens and frequency of fungal infections between age groups should be considered for optimal selection of the appropriate therapeutic regimen.
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Affiliation(s)
- Christian Kromer
- Department of Dermatology, Venereology, and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Daniel Celis
- Faculty of Economic Sciences, Georg August University Göttingen, Göttingen, Germany
| | | | - Vasiliki A Zampeli
- Department of Dermatology, Venereology, Allergology, and Immunology, Dessau Medical Center, Dessau, Germany
| | - Rotraut Mößner
- Department of Dermatology, Venereology, and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Undine Lippert
- Department of Dermatology, Venereology, and Allergology, University Medical Center Göttingen, Göttingen, Germany
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Ge LY, Liu J, Zheng HL, Mei H, Liang GZ, Liu WD. Comprehensive genome and transcriptome analysis of the dermatophyte Trichophyton schoenleinii reveals the candidate pathogenic genes. Mycoses 2021; 64:624-633. [PMID: 33586267 DOI: 10.1111/myc.13257] [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: 09/03/2020] [Revised: 02/06/2021] [Accepted: 02/08/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Trichophyton schoenleinii is an anthropophilic dermatophyte that causes tinea favosa. Nowadays, it remains an important pathogen in some regions of the world, mainly epidemic in Africa and West Asia. Despite the medical importance of T. schoenleinii infections, a high-quality reference genome for T. schoenleinii is still unavailable, neither its transcriptomic profile. OBJECTIVES The aim of the current study was to improve understanding of the underlying pathogenic mechanism of T. schoenleinii, and to define the candidate pathogenic genes of T. schoenleinii. METHODS Comprehensive genomic analysis of T. schoenleinii was carried out by Illumina and PacBio sequencing platforms. Transcriptome profiles of T. schoenleinii cultured in vitro in two media containing either keratin or soy protein were determined using RNA sequencing (RNA-seq) technology. RESULTS Here, we present the first draft genome sequence of T. schoenleinii strain T2s, which consists of 11 scaffolds containing 7474 predicted genes. Transcriptome analysis showed that genes involved in keratin hydrolysis have higher expression in T. schoenleinii grown in keratin medium, including genes encoding proteases, cysteine dioxygenase and acetamidase. Other genes with higher expression include genes encoding the components of the pH-responsive signal transduction pathways and transcription factors, many of which may play a role in pathogenicity. CONCLUSION In summary, this study provides new insights into the pathogenic mechanism of T. schoenleinii and highlights candidate genes for further development of novel targets in disease diagnosis and treatment of tinea favosa.
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Affiliation(s)
- Li-Yu Ge
- Department of Medical Mycology, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Jia Liu
- Department of Medical Mycology, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China.,Department of Dermatology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Hai-Lin Zheng
- Department of Medical Mycology, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China.,Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, China
| | - Huan Mei
- Department of Medical Mycology, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China.,Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, China
| | - Guan-Zhao Liang
- Department of Medical Mycology, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China.,Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, China
| | - Wei-Da Liu
- Department of Medical Mycology, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China.,Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, China.,Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
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Zhi H, Shen H, Zhong Y, Sang B, Lv W, Li Q, Liu Z, Xia X. Tinea capitis in children: A single-institution retrospective review from 2011 to 2019. Mycoses 2021; 64:550-554. [PMID: 33455042 DOI: 10.1111/myc.13243] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 12/02/2020] [Accepted: 01/11/2021] [Indexed: 11/29/2022]
Abstract
Tinea capitis remains a common public health problem worldwide, especially in developing countries. OBJECTIVES To investigate the changes of the predominant dermatophytes of tinea capitis in children in Hangzhou in recent 9 years. METHODS The age, gender and pathogen spectrum of 650 children with tinea capitis at the Department of Dermatology, Affiliated Third People's Hospital of Hangzhou, Anhui Medical University from 2011 to 2019 were analysed, and the distribution of pathogens from 1998 to 2000 was compared. RESULTS Among the 650 cases, 340 cases (48.2%) were males and 310 cases (51.8%) were females. The main population infected with tinea capitis was children aged 0-10 years (620 cases, 95.4%). From 2011 to 2019, the predominant dermatophyte was changed from Trichophyton violaceum (2011) to Trichophyton mentagrophytes complex (2012-2015) and later to Microsporum canis (2016-2019). In the past 9 years, M. canis (250 cases, 38.5%) was the most common dermatophyte and followed by T mentagrophytes complex (209 cases, 32.2%). The dermatophyte spectrum was statistically different between the years 2011 and 2019 (Chi square: χ2 = 69.75, P < .05), and the differences in anthropophilic and zoophilic pathogens between 1989-2000 and 2011-2019 were statistically significant (χ2 = 24.4, P < .05). CONCLUSIONS Research showed that children diagnosed with tinea capitis were mainly 0-10 years old. With age, the percentage of anthropophilic dermatophytes gradually increased, while the percentage of zoophilic dermatophytes decreased. M. canis was the predominant dermatophyte of tinea capitis in children, followed by T. mentagrophytes complex. The dermatophytes have shifted from anthropophilic to zoophilic dermatophytes in the past two decades.
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Affiliation(s)
- Huilin Zhi
- Department of Dermatology, Affiliated Third People's Hospital of Hangzhou, Anhui Medical University, Hangzhou, China
| | - Hong Shen
- Department of Dermatology, Affiliated Third People's Hospital of Hangzhou, Anhui Medical University, Hangzhou, China
| | - Yan Zhong
- Department of Dermatology, Affiliated Third People's Hospital of Hangzhou, Anhui Medical University, Hangzhou, China
| | - Bo Sang
- Department of Dermatology, Affiliated Third People's Hospital of Hangzhou, Anhui Medical University, Hangzhou, China
| | - Wenwen Lv
- Department of Dermatology, Affiliated Third People's Hospital of Hangzhou, Anhui Medical University, Hangzhou, China
| | - Qiuping Li
- Department of Dermatology, Affiliated Third People's Hospital of Hangzhou, Anhui Medical University, Hangzhou, China
| | - Zehu Liu
- Department of Dermatology, Affiliated Third People's Hospital of Hangzhou, Anhui Medical University, Hangzhou, China
| | - Xiujiao Xia
- Department of Dermatology, Affiliated Third People's Hospital of Hangzhou, Anhui Medical University, Hangzhou, China
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36
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Tinea Capitis by Microsporum canis in an Elderly Female with Extensive Dermatophyte Infection. Mycopathologia 2021; 186:299-305. [PMID: 33496917 PMCID: PMC8106592 DOI: 10.1007/s11046-020-00519-9] [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: 08/08/2020] [Accepted: 12/03/2020] [Indexed: 10/31/2022]
Abstract
Tinea capitis is a type of dermatophyte infection primarily affecting children. We report a case of an elderly woman with well-controlled diabetes mellitus presenting with a six-month history of erythema with yellow crusts on her scalp and extensive erythematous patches with scales on the body skin. She adopted a stray cat before the disease onset. Dermoscopic findings and manifestation under the Wood's lamp favoured the diagnosis of tinea capitis. Further microscopic examinations of her scalp, including direct KOH and fluorescence stain examination, fungal culture and polymerase chain reaction sequencing identification confirmed the diagnosis of tinea capitis caused by Microsporum canis. Treatment with oral terbinafine was effective. Adult tinea capitis is often misdiagnosed due to its rarity and atypical presentation. However, in some regions, the incidence of tinea capitis in immunocompetent adults is rising which requires the awareness of clinicians. A thorough history (including the animal contacting history), physical examination and further mycological examinations are required for diagnosis. Trichophyton violaceum is the most common dermatophyte species in most regions while adult tinea capitis caused by Microsporum canis is less common. Terbinafine, griseofulvin and itroconazole have been reported to be effective drugs for the treatment of tinea capitis, and terbinafine can be considered as systemic treatment in elderly patients with comorbidities to reduce the drug-drug interaction.
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Wang HN, Shang CS, Yang SJ, Shih IH, Hui CYR, Yang CY, Lu CW, Sun PL. Clinical and epidemiological characteristics of tinea capitis in northern Taiwan during 2014-2019: An unusual bimodal distribution of patients and comparison of paediatric and adult cases. Mycoses 2021; 64:484-494. [PMID: 33368733 DOI: 10.1111/myc.13234] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/27/2020] [Accepted: 12/19/2020] [Indexed: 12/14/2022]
Abstract
Tinea capitis (TC) mainly occurs in children, and related studies in adults are rare. We aimed to investigate the current epidemiological, clinical and mycological characteristics of TC and to compare adult and paediatric patients in northern Taiwan. We conducted a retrospective study at Chang Gung Memorial Hospital, Linkou Branch, from 2014 to 2019. The dataset included age, sex, records of underlying diseases, animal contact history, frequent hair salon visits, clinical patterns, treatment and outcome via chart or phone call reviews. The average ages of 72 children and 104 adults recruited were 6.0 and 74.0 years, respectively. A female predominance was noted in both groups, and the ratio of females was significantly higher in adults (94.2% vs 59.7%, P < .0001). Microsporum canis (76.4%) and Trichophyton mentagrophytes (11.1%) in children, and M. canis (49.0%) and T. violaceum (31.7%) in adults were the most common pathogens. Adults were more likely to be infected with T. violaceum (OR = 10.14, 95% CI = 2.04-50.26) than children. In contrast, adults were less likely to be infected with M. canis than children (OR = 0.31, 95% CI = 0.11-0.90). Furthermore, adults visited hair salons more, had less animal contact and were more immunosuppressed than children. TC is not unusual in the adult population. Dermatologists are advised to realise risk factors such as immunosuppression and regular hair salon visit in adult TC.
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Affiliation(s)
- Hsuan-Ning Wang
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chuin-Shee Shang
- Center for General Education, Tunghai University, Taichung, Taiwan
| | - Shih-Jyun Yang
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - I-Hsin Shih
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chung-Yee Rosaline Hui
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chin-Yi Yang
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Dermatology, New Taipei Municipal TuCheng Hospital, New Taipei City, Taiwan
| | - Chun-Wei Lu
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Pei-Lun Sun
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Research Laboratory of Medical Mycology, Chang Gung Memorial Hospital, Linkou, Taiwan
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Müller VL, Kappa-Markovi K, Hyun J, Georgas D, Silberfarb G, Paasch U, Uhrlaß S, Nenoff P, Schaller J. Tinea capitis et barbae caused by Trichophyton tonsurans: A retrospective cohort study of an infection chain after shavings in barber shops. Mycoses 2020; 64:428-436. [PMID: 33341968 DOI: 10.1111/myc.13231] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 11/21/2020] [Accepted: 11/24/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Tinea capitis is a highly contagious infectious disease caused by dermatophytes. In Central Europe, it is mainly caused by zoophilic dermatophytes, as, for example Microsporum (M) canis or Trichophyton (T) mentagrophytes and increasingly by anthropophilic fungi. T tonsurans was commonly related to the Tinea gladiatorum, where transmission occurred between infected persons or via contaminated floors. OBJECTIVE Reporting the transmission of this highly contagious dermatophyte for the first time via beard shaving and hairdressing in barber shops in Germany. PATIENTS AND METHODS 18 young male patients developed tinea capitis and/or barbae shortly after shavings of the beard and/or hair in a barber shop. Native, cultural and molecular diagnostics as well as tissue biopsies and resistance tests were performed of skin and hair samples. RESULTS In all samples, T tonsurans could be identified. The medical history and the clinical picture suggest a transmission through contaminated hairdressing tools. The patients were treated with terbinafine or itraconazole in combination with or exclusively with topical antimycotics. CONCLUSION The transmission and a resulting increase in the incidence of infections with T tonsurans may be due to shavings with direct skin contact of insufficiently disinfected hairdressing tools. This path of infection has already been observed in Africa and is now being described for the first time in Germany. Knowledge of the pathogen and its transmission ways are essential to interrupt the chain of infection.
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Affiliation(s)
- Valentina Laura Müller
- Klinik für Dermatologie, Allergologie und Phlebologie, Helios Klinikum Duisburg, Duisburg, Germany.,Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig, Leipzig, Germany
| | - Korina Kappa-Markovi
- Klinik für Dermatologie, Allergologie und Phlebologie, Helios Klinikum Duisburg, Duisburg, Germany
| | - Julia Hyun
- Klinik für Dermatologie, Allergologie und Phlebologie, Helios Klinikum Duisburg, Duisburg, Germany
| | - Dimitrios Georgas
- Klinik für Dermatologie, Allergologie und Phlebologie, Helios Klinikum Duisburg, Duisburg, Germany
| | | | - Uwe Paasch
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig, Leipzig, Germany
| | - Silke Uhrlaß
- Labor für Medizinische Mikrobiologie, Partnerschaft Prof. P. Nenoff und Dr. C. Krüger, Rötha OT Mölbis, Germany
| | - Pietro Nenoff
- Labor für Medizinische Mikrobiologie, Partnerschaft Prof. P. Nenoff und Dr. C. Krüger, Rötha OT Mölbis, Germany
| | - Jörg Schaller
- Dermatopathologie Duisburg, Prof. J. Schaller und Dr. C. Hendricks, Duisburg, Germany
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Mayser P, Nenoff P, Reinel D, Abeck D, Brasch J, Daeschlein G, Effendy I, Ginter-Hanselmayer G, Gräser Y, Hipler UC, Höger P, Kolb-Mäurer A, Ott H, Schaller M, Zidane M. S1 guidelines: Tinea capitis. J Dtsch Dermatol Ges 2020; 18:161-179. [PMID: 32026639 DOI: 10.1111/ddg.14026] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Tinea capitis describes a dermatophyte infection of scalp and hair that predominately occurs in children. The diagnostic workup includes microscopic examination, culture and/or molecular tests. Treatment is guided by the specific organism involved and should consist of systemic agents as well as adjuvant topical treatment. The aim of the present update of the interdisciplinary German S1 guidelines is to provide dermatologists, pediatricians and general practitioners with a decision tool for selecting and implementing appropriate diagnostic and therapeutic measures in patients with tinea capitis. The guidelines were developed based on current international guidelines, in particular the 2010 European Society for Pediatric Dermatology guidelines and the 2014 British Association of Dermatologists guidelines, as well as on a review of the literature conducted by the guideline committee. This multidisciplinary committee consists of representatives from the German Society of Dermatology (DDG), the German-Speaking Mycological Society (DMykG), the German Society for Hygiene and Microbiology (DGHM), the German Society of Pediatric and Adolescent Medicine (DGKJ) and the German Society for Pediatric Infectious Diseases (DGPI). The Division of Evidence-based Medicine (dEBM) provided methodological assistance. The guidelines were approved by the participating medical societies following a comprehensive internal and external review.
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Affiliation(s)
| | - Pietro Nenoff
- Partnership Pietro Nenoff, PhD, MD & Constanze Krüger, MD, Laboratory for Medical Microbiology, Rötha OT Mölbis, Germany
| | | | | | - Jochen Brasch
- Department of Dermatology, University Medical Center of Schleswig Holstein, Kiel, Germany
| | - Georg Daeschlein
- Department of Dermatology, Greifswald University Medical Center, Greifswald, Germany
| | - Isaak Effendy
- Department of Dermatology, Bielefeld Medical Center, Bielefeld, Germany
| | | | - Yvonne Gräser
- National Reference Laboratory for Dermatophytes, Institute for Microbiology and Hygiene, Charité - University Medicine Berlin, Campus Benjamin Franklin, Berlin, Germany
| | | | - Peter Höger
- Department of Pediatrics and Pediatric Dermatology/Allergology, Catholic Children's Hospital Wilhelmstift, Hamburg, Germany
| | - Annette Kolb-Mäurer
- Department of Dermatology, Venereology and Allergology, Würzburg University Medical Center, Würzburg, Germany
| | - Hagen Ott
- Department of Pediatric Dermatology and Allergology, Auf der Bult, Hanover, Germany
| | - Martin Schaller
- Department of Dermatology, Tübingen University Medical Center, Tübingen, Germany
| | - Miriam Zidane
- Department of Dermatology, Venereology and Allergology, Division of Evidence-based Medicine (dEBM) and Berlin Institute of Health, Charité - University Medicine Berlin, Corporate Member of Freie Universität Berlin, Humboldt University of Berlin, Berlin, Germany
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40
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Skin Fungal Infections in Children: Diagnostic Challenges. CURRENT FUNGAL INFECTION REPORTS 2020. [DOI: 10.1007/s12281-020-00407-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Wang X, Ding C, Xu Y, Yu H, Zhang S, Yang C. Analysis on the pathogenic fungi in patients with superficial mycosis in the Northeastern China during 10 years. Exp Ther Med 2020; 20:281. [PMID: 33209125 PMCID: PMC7668139 DOI: 10.3892/etm.2020.9411] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 09/25/2020] [Indexed: 12/15/2022] Open
Abstract
This study analyzed the infection of superficial mycosis and the relationship between the distribution characteristics of pathogenic fungi and age, time and sex in Northeast China in the past 10 years. We would like to provide a theoretical basis for the diagnosis and treatment of related diseases. From December 2008 to December 2018, 5,374 superficial mycoses from Northeast China were selected. The fungal species were identified by fungal microscopy, fungal culture, and species identification. Besides, the relationship between sex, age, time and the distribution of superficial mycosis and pathogenic fungi was analyzed. Among the 5,374 patients, the top three infections were tinea pedis (n=1,538, 28.62%), tinea cruris (n=1,018, 18.94%) and tinea corporis (n=938, 17.45%). The top three pathogens were Trichophyton rubrum (n=2,849, 48.65%), Trichophyton mentagrophytes (n=947, 16.14%) and Candida spp. (n=804, 13.70%). The main pathogenic fungi were dermatophytes. The age group with the highest incidence of tinea capitis was children (n=372, 6.92%). The highest incidence rate of tinea pedis was in 31-69-year adults (n=905, 16.84%); Malassezia mainly affects young people aged 15-30. Yeast and mold mostly invade the elderly patients >60 years old. The incidence of tinea cruris, tinea pedis and tinea corporis in male patients was higher than that in female patients. The incidence of onychomycosis in female patients was higher than that in male patients (P<0.05). The isolation rate of Candida, Mold, Microsporum canis, Malassezia and Sporothrix increased year by year, while that of Trichophyton rubrum, Trichophyton mentagrophyte, Trichophyton schoenleinii and Epidermophyton floccosum decreased. From December 2008 to December 2018, dermatophytes were the main pathogens of superficial mycosis in Northeast China. The distribution of disease species and pathogenic fungi varied in different gender, age and time.
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Affiliation(s)
- Xiufen Wang
- Department of Dermatology, The First Affiliated Hospital of Qiqihar Medical University, Qiqihar, Heilongjiang 161041, P.R. China
| | - Changrui Ding
- Department of Dermatology, The First Affiliated Hospital of Qiqihar Medical University, Qiqihar, Heilongjiang 161041, P.R. China
| | - Yulong Xu
- Department of Dermatology, The First Affiliated Hospital of Qiqihar Medical University, Qiqihar, Heilongjiang 161041, P.R. China
| | - Haomiao Yu
- Department of Dermatology, The First Affiliated Hospital of Qiqihar Medical University, Qiqihar, Heilongjiang 161041, P.R. China
| | - Songdi Zhang
- Department of Dermatology, The First Affiliated Hospital of Qiqihar Medical University, Qiqihar, Heilongjiang 161041, P.R. China
| | - Cuiyun Yang
- Department of Dermatology, The First Affiliated Hospital of Qiqihar Medical University, Qiqihar, Heilongjiang 161041, P.R. China
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Segal-Engelchin D, Shvarts S. Does Severity of Hair Loss Matter? Factors Associated with Mental Health Outcomes in Women Irradiated for Tinea Capitis in Childhood. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207388. [PMID: 33050469 PMCID: PMC7601621 DOI: 10.3390/ijerph17207388] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 10/04/2020] [Accepted: 10/06/2020] [Indexed: 12/04/2022]
Abstract
Hair loss resulting from childhood irradiation for tinea capitis has been linked to mental health effects in women. However, the association of hair loss severity with mental health in this population is unknown. To address this gap, this study examined the association between hair loss severity and mental health outcomes in women irradiated for tinea capitis in childhood as well as the factors that contribute to these outcomes. Medical records, held at the archives of the Israel National Center for Compensation of Scalp Ringworm Victims, were retrospectively reviewed for 2509 women who received compensation for full or partial alopecia resulting from irradiation for tinea capitis. Mental health outcomes were determined by the number of mental health conditions reported. The results show that among women with more hair loss, risk was increased for a range of mental health problems, especially social anxiety (RR 2.44, 95% CI 2.09–2.87). Hair loss severity emerged as a significant predictor of mental health, adding to the effects of other predictors such as family, social and physical health problems (β = 0.13, 95% CI 0.27, 0.56). The effects of hair loss severity on mental health outcomes were mediated by women’s negative social experiences (indirect = 0.72, 95% bias-corrected confidence interval, 0.53–1.08). Healthcare professionals supporting women with hair loss after irradiation for childhood tinea capitis should be alert to a history of severe levels of hair loss.
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Affiliation(s)
- Dorit Segal-Engelchin
- Spitzer Department of Social Work, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel
- Correspondence:
| | - Shifra Shvarts
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel;
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Sacheli R, Henri AS, Seidel L, Ernst M, Darfouf R, Adjetey C, Schyns M, Marechal L, Meex C, Arrese J, Hayette MP. Evaluation of the new Id-Fungi plates from Conidia for MALDI-TOF MS identification of filamentous fungi and comparison with conventional methods as identification tool for dermatophytes from nails, hair and skin samples. Mycoses 2020; 63:1115-1127. [PMID: 32757444 DOI: 10.1111/myc.13156] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 07/17/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVES We first compare the efficiency of mould/dermatophyte identification by MALDI-TOF MS using a new medium called Id-Fungi plates (IDFP) from Conidia® and two different databases. For the second purpose, we evaluated a new version of the medium supplemented with cycloheximide, Id-Fungi plates Plus (IDFPC) for the direct inoculation of nails, hair and skin samples and compared the efficiency of MALDI-TOF MS identification of dermatophytes to classical methods based on culture and microscopy. METHODS A total of 71 strains have been cultured IDFP and Sabouraud gentamicin plates (SGC2) and were identified by MALDI-TOF MS. For the evaluation of the combination IDFPC/ MALDI-TOF MS as a method of identification for dermatophytes, 428 samples of hair nails and skin were cultivated in parallel on IDFPC and Sabouraud + cycloheximide medium (SAB-ACTI). RESULTS For Aspergillus sp and non-Aspergillus moulds, the best performances were obtained on IDFP after maximum 48-h growth, following protein extraction. For dermatophytes, the best condition was using the IDFP at 72 hours, after extended direct deposit. Regarding the direct inoculation of nails, hair skin on IDFPC, 129/428 (30.1%) showed a positive culture against 150/428 (35%) on SAB-ACTI medium. Among the 129 positive strains, the identification by MALDI-TOF MS was correct for 92/129 (71.4%). CONCLUSION The IDFP allows the generation of better spectra by MALDI-TOF MS compared to SGC2. It facilitates sampling and deposit. Regarding the use of IDFPC, this medium seems less sensitive than SAB-ACTI but among positive strains, the rate of correct identification by MALDI-TOF MS is satisfactory.
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Affiliation(s)
- Rosalie Sacheli
- Department of Clinical Microbiology, National Reference Center for Mycosis, Center for Interdisciplinary research on Medicines (CIRM), University Hospital of Liege, Liege, Belgium
| | - Anne-Sophie Henri
- Department of Clinical Microbiology, National Reference Center for Mycosis, Center for Interdisciplinary research on Medicines (CIRM), University Hospital of Liege, Liege, Belgium
| | - Laurence Seidel
- Department of Biostatistics, University Hospital of Liege, Liege, Belgium
| | - Marie Ernst
- Department of Biostatistics, University Hospital of Liege, Liege, Belgium
| | - Rajae Darfouf
- Department of Clinical Microbiology, National Reference Center for Mycosis, Center for Interdisciplinary research on Medicines (CIRM), University Hospital of Liege, Liege, Belgium
| | - Caroline Adjetey
- Department of Clinical Microbiology, National Reference Center for Mycosis, Center for Interdisciplinary research on Medicines (CIRM), University Hospital of Liege, Liege, Belgium
| | - Marjorie Schyns
- Department of Clinical Microbiology, National Reference Center for Mycosis, Center for Interdisciplinary research on Medicines (CIRM), University Hospital of Liege, Liege, Belgium
| | - Ludwig Marechal
- Department of Dermatopathology, University Hospital of Liege, Liege, Belgium
| | - Cécile Meex
- Department of Clinical Microbiology, National Reference Center for Mycosis, Center for Interdisciplinary research on Medicines (CIRM), University Hospital of Liege, Liege, Belgium
| | - Jorge Arrese
- Department of Dermatopathology, University Hospital of Liege, Liege, Belgium
| | - Marie-Pierre Hayette
- Department of Clinical Microbiology, National Reference Center for Mycosis, Center for Interdisciplinary research on Medicines (CIRM), University Hospital of Liege, Liege, Belgium
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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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Aneke CI, Rhimi W, Pellicoro C, Cantacessi C, Otranto D, Cafarchia C. The best type of inoculum for testing the antifungal drug susceptibility of Microsporum canis: In vivo and in vitro results. Mycoses 2020; 63:711-716. [PMID: 32299129 DOI: 10.1111/myc.13090] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 04/03/2020] [Accepted: 04/09/2020] [Indexed: 01/17/2023]
Abstract
BACKGROUND Data correlating in vitro drug susceptibility of Microsporum canis with clinical outcomes of its infections are lacking as well as the most suitable inoculum and incubation time in broth microdilution assays. OBJECTIVES AND METHODS Microsporum canis strains were collected from animal hosts that tested positive (Group I; n = 13) and negative (Group II; n = 14) to this pathogen following itraconazole (ITC) therapy. In vitro ITC susceptibility was assessed according to the Clinical Laboratory Standards Institute (CLSI M38-A2) methodology using conidia, hypha-conidia and arthroconidia at 3 and 7 days of incubation in order to assess the most suitable inoculum and incubation time. Successively, ketoconazole (KTC), voriconazole (VRC), terbinafine (TRB), posaconazole (PSZ), fluconazole (FLC) and griseofulvin (GRI) susceptibilities were assessed using the chosen inoculum. RESULTS The MIC values of ITC after three-day incubation were equal than those recorded after 7-day incubation. Itraconazole MICs were ≤1 μg/mL for strains from Group II and >1 μg/mL for those of Group II only when conidia were used. All strains showed high susceptibility to VRC, POS, TEB and low susceptibility to ITC, KTC, GRI and FLC regardless of the source and incubation time. CONCLUSIONS AND CLINICAL IMPORTANCE Results suggest that correlation between the in vitro results and clinical outcome was observed only by incubating conidia for 3 days at 30 ± 2°C. These conditions might be most suitable to assess in vitro susceptibility of M. canis and assist in determining the occurrence of drug resistance and cross-resistance phenomena.
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Affiliation(s)
- Chioma Inyang Aneke
- Dipartimento di Medicina Veterinaria, Università degli Studi "Aldo Moro", Valenzano (Bari), Italy.,Department of Veterinary Pathology and Microbiology, University of Nigeria, Nsukka, Nigeria
| | - Wafa Rhimi
- Dipartimento di Medicina Veterinaria, Università degli Studi "Aldo Moro", Valenzano (Bari), Italy
| | | | - Cinzia Cantacessi
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - Domenico Otranto
- Dipartimento di Medicina Veterinaria, Università degli Studi "Aldo Moro", Valenzano (Bari), Italy
| | - Claudia Cafarchia
- Dipartimento di Medicina Veterinaria, Università degli Studi "Aldo Moro", Valenzano (Bari), Italy
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Nguyen CV, Collier S, Merten AH, Maguiness SM, Hook KP. Tinea capitis: A single-institution retrospective review from 2010 to 2015. Pediatr Dermatol 2020; 37:305-310. [PMID: 31957924 DOI: 10.1111/pde.14092] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND/OBJECTIVE Tinea capitis is a common infection of scalp hair in children. The prevalent etiologic organism has changed significantly over time, which may reflect the complex interaction of environmental factors, genetic predisposition, and movement of populations. We evaluate the prevalence of different infectious organisms causing tinea capitis and describe the clinical characteristics. METHODS A retrospective chart review of patients diagnosed with tinea capitis with tissue culture confirmation, who were seen in pediatric dermatology at a tertiary care center from 2010 to 2015. Patient demographics, culture data, and clinical characteristics were evaluated. Inflammatory pattern, characterized by presence of pustules, bogginess, or lymphadenopathy, was noted. RESULTS Forty-six patients with culture-positive tinea capitis were identified. In the 18 (42.9%) patients who were infected with either Trichophyton violaceum or Trichophyton soudanenese, all were of African ethnicity. In contrast, Trichophyton tonsurans was identified in a minority of African patients (3.8%), revealing a statistically significant difference between ethnicity and infective species (P-value < 0.001). T tonsurans was significantly more likely than T violaceum to exhibit an inflammatory pattern (68% vs 22%, P value < 0.027). CONCLUSIONS While T tonsurans remained the most common cause of tinea capitis, T violaceum and T soudanense have increased in prevalence. As these latter agents are less inflammatory, clinical diagnosis may be delayed. Studying changes in the infectious cause of tinea capitis can help us create a snapshot to better understand the evolution of our population make-up, allowing us to provide crucial quality health care to all.
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Affiliation(s)
- Cuong V Nguyen
- Department of Dermatology, Northwestern Feinberg School of Medicine, Chicago, IL, USA
| | - Sigrid Collier
- Department of Dermatology, University of Minnesota, Minneapolis, MN, USA.,Division of Dermatology, University of Washington, Seattle, WA, USA
| | - Ashley H Merten
- Department of Dermatology, University of Minnesota, Minneapolis, MN, USA
| | | | - Kristen P Hook
- Department of Dermatology, University of Minnesota, Minneapolis, MN, USA
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Gnat S, Łagowski D, Nowakiewicz A. Major challenges and perspectives in the diagnostics and treatment of dermatophyte infections. J Appl Microbiol 2020; 129:212-232. [PMID: 32048417 DOI: 10.1111/jam.14611] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 02/07/2020] [Accepted: 02/07/2020] [Indexed: 12/20/2022]
Abstract
Dermatophytes are the aetiological factors of a majority of superficial fungal infections. What distinguishes them from other pathogenic filamentous fungi is their unique ability to degrade keratin. The remarkable ability of this group of fungi to survive in different ecosystems results from their morphological and ecological diversity as well as high adaptability to changing environmental conditions. Paradoxically, despite the progress in medicine, the prevalence of dermatophyte infections is increasing from year to year. At the beginning of the third millennium, practical diagnostic and therapeutic options are still very limited. This review focuses on understanding the major problems in this aspect of dermatophyte infections and indicates future strategies and perspectives for novel approaches to identification and drugs for elimination of dermatophytes. Particular importance is placed on development of a strategy for a diagnostic pathway and implementation of rapid and reliable diagnostics methods designed by international teams. Furthermore, among compounds that currently arouse great interest, representatives of terpenoids, alkaloids, saponins, flavonoids and essential oils deserve attention. Many of these compounds are undergoing clinical trials as potential antifungal agents, and future research should focus on attempts at determination of the applicability of tested substances. Finally, the advantages and disadvantages in implementation of new diagnostic paths and medicinal substances for routine use are indicated.
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Affiliation(s)
- S Gnat
- Faculty of Veterinary Medicine, Institute of Biological Bases of Animal Diseases, Sub-Department of Veterinary Microbiology, University of Life Sciences, Lublin, Poland
| | - D Łagowski
- Faculty of Veterinary Medicine, Institute of Biological Bases of Animal Diseases, Sub-Department of Veterinary Microbiology, University of Life Sciences, Lublin, Poland
| | - A Nowakiewicz
- Faculty of Veterinary Medicine, Institute of Biological Bases of Animal Diseases, Sub-Department of Veterinary Microbiology, University of Life Sciences, Lublin, Poland
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Mayser P, Nenoff P, Reinel D, Abeck D, Brasch J, Daeschlein G, Effendy I, Ginter-Hanselmayer G, Gräser Y, Hipler UC, Höger P, Kolb-Mäurer A, Ott H, Schaller M, Zidane M. S1‐Leitlinie Tinea capitis. J Dtsch Dermatol Ges 2020; 18:161-180. [PMID: 32026649 DOI: 10.1111/ddg.14026_g] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
| | - Pietro Nenoff
- Partnerschaft Prof. Dr. med. Pietro Nenoff & Dr. med. Constanze Krüger, Labor für medizinische Mikrobiologie, Rötha OT Mölbis, Deutschland
| | | | | | - Jochen Brasch
- Universitäts-Hautklinik Kiel, Universitätsklinikums Schleswig-Holstein, Kiel, Deutschland
| | - Georg Daeschlein
- Universitätsmedizin Greifswald, Klinik und Poliklinik für Hautkrankheiten, Greifswald, Deutschland
| | - Isaak Effendy
- Hautklinik, Klinikum der Stadt Bielefeld, Bielefeld, Deutschland
| | | | - Yvonne Gräser
- Konsiliarlaboratorium für Dermatophyten, Institut für Mikrobiologie und Hygiene, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Deutschland
| | | | - Peter Höger
- Pädiatrie und Pädiatrische Dermatologie/Allergologie, Katholisches Kinderkrankenhaus Wilhelmstift, Hamburg, Deutschland
| | - Annette Kolb-Mäurer
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - Hagen Ott
- Pädiatrische Dermatologie und Allergologie, Auf der Bult, Hannover, Deutschland
| | - Martin Schaller
- Universitäts-Hautklinik Tübingen, Universitätsklinikum Tübingen, Tübingen, Deutschland
| | - Miriam Zidane
- Department of Dermatology, Venerology und Allergology, Division of Evidence-based Medicine (dEBM) and Berlin Institute of Health, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Deutschland
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Waśkiel-Burnat A, Rakowska A, Sikora M, Ciechanowicz P, Olszewska M, Rudnicka L. Trichoscopy of Tinea Capitis: A Systematic Review. Dermatol Ther (Heidelb) 2020; 10:43-52. [PMID: 31907867 PMCID: PMC6994564 DOI: 10.1007/s13555-019-00350-1] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION An increased incidence of tinea capitis has been observed over the last few decades. Trichoscopy is a non-invasive, in-office method helpful in establishing the correct diagnosis in patients with hair loss and inflammatory hair disorders. The objective was to review and analyze current data on the trichoscopy of tinea capitis. METHODS A systematic review of the literature was conducted using the PubMed, EBSCO and Scopus databases. The search terms included 'tinea capitis' combined with 'trichoscopy', 'dermatoscopy', 'dermoscopy', 'videodermatoscopy' or 'videodermoscopy'. RESULTS Of 326 articles, 37 were considered eligible for the quantitative analysis. The most characteristic (with a high predictive value) trichoscopic findings of tinea capitis included comma hairs (51%), corkscrew hairs (32%), Morse code-like hairs (22%), zigzag hairs (21%), bent hairs (27%), block hairs (10%) and i-hairs (10%). Other common, but not characteristic, trichoscopic features were broken hairs (57%), black dots (34%), perifollicular scaling (59%) and diffuse scaling (89%). Morse code-like hairs, zigzag hairs, bent hairs and diffuse scaling were only observed in Microsporum tinea capitis (8/29, 28%; 6/29, 21%; 4/29, 14% and 4/29, 14%, respectively). In Trichophyton tinea capitis, corkscrew hairs were more commonly detected compared to Microsporum tinea capitis (21/38, 55% vs 3/29, 10%). CONCLUSION The presence of characteristic trichoscopic features of tinea capitis is sufficient to establish the initial diagnosis and introduce treatment before culture results are available. Trichoscopy may be useful in distinguishing between Microsporum and Trichophyton tinea capitis.
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Affiliation(s)
| | - Adriana Rakowska
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland.
| | - Mariusz Sikora
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | | | | | - Lidia Rudnicka
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
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Abstract
GENERAL PURPOSE To provide information about the epidemiology, clinical features, and management of cutaneous tinea infections. TARGET AUDIENCE This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES After completing this continuing education activity, you should be better able to:1. Summarize the epidemiology related to cutaneous tinea infections.2. Describe the clinical features of cutaneous tinea infections.3. Identify features related to the diagnosis and management of cutaneous tinea infections. ABSTRACT Dermatophyte or tinea infection refers to a group of superficial fungal infections of the hair, skin, and nails. Tinea infections are most commonly caused by fungi of the genus Trichophyton, Microsporum, or Epidermophyton. Cutaneous manifestations of tinea infections are seen worldwide and classified based on the affected body site. The diagnosis of these conditions is complicated by morphologic variations in presentation and overlap with other common infectious and noninfectious entities. As a result, diagnosis and appropriate management of these conditions are essential to avoid patient morbidity. This case-based review summarizes the epidemiology, relevant clinical features, microbiology, and management considerations for commonly encountered tinea infections.
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