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Ergin Ç, Kurt Ö, Türkoğlu M, Sevinç H, Akbaba G. Evaluation of novel cosmetic shampoo formulations against Malassezia species: Preliminary results of anti-dandruff shampoo formulations. J Cosmet Dermatol 2024; 23:2078-2083. [PMID: 38544350 DOI: 10.1111/jocd.16219] [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: 10/30/2023] [Revised: 12/11/2023] [Accepted: 01/16/2024] [Indexed: 05/19/2024]
Abstract
OBJECTIVES Malassezia species are common, clinically relevant, and lipid-dependent yeasts of humans. They are also the leading causes of the dandruff problem of humans, and the azoles are used primarily in their topical and systemic treatment. Resistance to azoles is an emerging problem among Malassezia sp., which indicates the need of new drug assessments that will be effective against dandruff and limit the use of azoles and other agents in treatment. Among them, the efficacy of various combinations of piroctone olamine and climbazole against Malassezia sp. is highly important. Here, we assessed the efficacies of various piroctone olamine and climbazole formulations against Malassezia sp. in comparison with ketoconazole. METHODS A total of nine formulations were included in the study, where each formulation was prepared from different concentrations of piroctone olamine and climbazole and both. All formulations contained the same ingredients as water, surfactants, hair conditioning agents, and preservatives. Malassezia furfur CBS1878, Malassezia globosa CBS7874, and Malassezia sympodialis CBS9570 were tested for antifungal susceptibility of each formulation by agar diffusion method. Sizes of the inhibition zones were compared with standard medical shampoo containing 2% ketoconazole, and the data were analyzed by Dunnett's multiple-comparison test. RESULTS For all Malassezia sp. strains, climbazole 0.5% and piroctone olamine/climbazole (0.1%/0.1% and 0.1%/0.5%) combinations were found to have the same effect as the medical shampoo containing 2% ketoconazole. Piroctone olamine/climbazole 1.0%/0.1% formulation showed the same efficacy as 2% ketoconazole on M. furfur and M. sympodialis, while 0.1%/0.5% formulation to only M. furfur. For M. globosa, none of the formulations tested were as effective as ketoconazole. CONCLUSION The species distribution of Malassezia sp. varies depending on the anatomical location on the host. According to the results of this study, climbazole and piroctone olamine combinations seem to be promising options against the dandruff problem with their high antifungal/anti dandruff efficacy.
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Affiliation(s)
- Çağrı Ergin
- Department of Medical Microbiology, Pamukkale University School of Medicine, Denizli, Turkey
| | - Özgür Kurt
- Department of Medical Microbiology, Acibadem University School of Medicine, Istanbul, Turkey
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Ehemann K, Contreras A, Celis-Ramírez AM. In vitro sensitivity of Malassezia furfur isolates from HIV-positive and negative patients to antifungal agents. BIOMEDICA : REVISTA DEL INSTITUTO NACIONAL DE SALUD 2023; 43:120-131. [PMID: 37721914 PMCID: PMC10599713 DOI: 10.7705/biomedica.6871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 05/02/2023] [Indexed: 09/20/2023]
Abstract
INTRODUCTION Malassezia is a lipophilic and lipid-dependent yeast genus belonging to the skin microbiota of humans and other animals. However, due to dysbiosis processes or other factors in the host, this yeast can cause different pathologies, ranging from skin diseases, such as seborrheic dermatitis, to fungemia. Isolation of Malassezia furfur has been reported in HIV-positive patients with or without skin lesions. Due to its opportunistic nature and its variable resistance to antifungal compounds, it is relevant to know the Malassezia sensitivity profiles. OBJECTIVE To determine the sensitivity to different antifungal agents, of clinical isolates of M. furfur obtained from HIV-positive or negative patients, with or without seborrheic dermatitis. MATERIALS AND METHODS Assessment of isolates sensitivity to itraconazole, voriconazole, fluconazole, and amphotericin B was performed by two techniques: (1) Broth microdilution using Clinical and Laboratory Standards Institute (CLSI) protocol M27-A3 with modifications; and (2) agar tests using Etest®. RESULTS Isolates obtained from HIV patients showed an increase in the minimum inhibitory concentration of fluconazole, voriconazole, and amphotericin B, compared with those of non-HIV patients. Itraconazole was the antifungal with the lowest minimum inhibitory concentration (MIC) in most isolates. CONCLUSION We observed differences in the sensitivity profiles of M. furfur isolates according to the context of the patient. High MIC of antifungals like fluconazole, commonly used for treating pathologies caused by Malassezia, were identified.
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Affiliation(s)
- Kevin Ehemann
- Grupo de Investigación Celular y Molecular de Microorganismos Patógenos, Departamento de Ciencias Biológicas, Universidad de los Andes, Bogotá, D. C., Colombia.
| | - Andrés Contreras
- Grupo de Investigación Celular y Molecular de Microorganismos Patógenos, Departamento de Ciencias Biológicas, Universidad de los Andes, Bogotá, D. C., Colombia.
| | - Adriana Marcela Celis-Ramírez
- Grupo de Investigación Celular y Molecular de Microorganismos Patógenos, Departamento de Ciencias Biológicas, Universidad de los Andes, Bogotá, D. C., Colombia.
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de Aguiar Cordeiro R, Reis AT, Lima XTV, de Andrade ARC, Aguiar ALR, Portela FVM, Pereira LMG, Moura SGB, da Silva BN, de Lima-Neto RG, Maia DCBSC, Rocha MFG, Sidrim JJC. Malassezia spp. and Candida spp. from patients with psoriasis exhibit reduced susceptibility to antifungals. Braz J Microbiol 2023; 54:169-177. [PMID: 36480120 PMCID: PMC9944151 DOI: 10.1007/s42770-022-00883-2] [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: 11/17/2021] [Accepted: 11/22/2022] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Psoriasis is a chronic inflammatory disease that affects over 125 million people worldwide. Many studies have shown the importance of the microbiome for psoriasis exacerbation. AIM Explore the fungal load and species composition of cultivable yeasts on the skin of psoriatic patients (PP) and healthy volunteers living in a tropical area and evaluate the susceptibility to antifungals. METHODOLOGY A cross-sectional study with 61 participants (35 patients and 26 healthy controls) was performed during August 2018 and May 2019. Clinical data were collected from patient interviewing and/or medical records review. Samples were collected by swabbing in up to five anatomic sites. Suggestive yeast colonies were counted and further identified by phenotypical tests, PCR-REA, and/or MALDI-TOF. Susceptibility of Malassezia spp. and Candida spp. to azoles, terbinafine, and amphotericin B was evaluated by broth microdilution. RESULTS Nearly 50% of the patients had moderate to severe psoriasis, and plaque-type psoriasis was the most common clinical form. Yeast colonies count was significantly more abundant among PP than healthy controls. Malassezia and Candida were the most abundant genus detected in all participants. Higher MIC values for ketoconazole and terbinafine were observed in Malassezia strains obtained from PP. Approximately 42% of Candida isolates from PP showed resistance to itraconazole in contrast to 12.5% of isolates from healthy controls. MIC values for fluconazole and amphotericin B were significantly different among Candida isolates from PP and healthy individuals. CONCLUSION This study showed that Malassezia and Candida strains from PP presented higher MIC values to widespread antifungal drugs than healthy individuals.
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Corzo Leon DE, Scheynius A, MacCallum DM, Munro CA. Malassezia sympodialis Mala s 1 allergen is a potential KELCH protein that cross reacts with human skin. FEMS Yeast Res 2023; 23:foad028. [PMID: 37188635 PMCID: PMC10281499 DOI: 10.1093/femsyr/foad028] [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: 11/03/2022] [Revised: 04/28/2023] [Accepted: 05/12/2023] [Indexed: 05/17/2023] Open
Abstract
Malassezia are the dominant commensal yeast species of the human skin microbiota and are associated with inflammatory skin diseases, such as atopic eczema (AE). The Mala s 1 allergen of Malassezia sympodialis is a β-propeller protein, inducing both IgE and T-cell reactivity in AE patients. We demonstrate by immuno-electron microscopy that Mala s 1 is mainly located in the M. sympodialis yeast cell wall. An anti-Mala s 1 antibody did not inhibit M. sympodialis growth suggesting Mala s 1 may not be an antifungal target. In silico analysis of the predicted Mala s 1 protein sequence identified a motif indicative of a KELCH protein, a subgroup of β-propeller proteins. To test the hypothesis that antibodies against Mala s 1 cross-react with human skin (KELCH) proteins we examined the binding of the anti-Mala s 1 antibody to human skin explants and visualized binding in the epidermal skin layer. Putative human targets recognized by the anti-Mala s 1 antibody were identified by immunoblotting and proteomics. We propose that Mala s 1 is a KELCH-like β-propeller protein with similarity to human skin proteins. Mala s 1 recognition may trigger cross-reactive responses that contribute to skin diseases associated with M. sympodialis.
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Affiliation(s)
- Dora E Corzo Leon
- School of Medicine, Medical Sciences & Nutrition University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZD, UK
| | - Annika Scheynius
- Department of Clinical Science and Education, Karolinska Institutet, and Sachs' Children and Youth Hospital, Södersjukhuset, SE-118 83 Stockholm, Sweden
| | - Donna M MacCallum
- School of Medicine, Medical Sciences & Nutrition University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZD, UK
| | - Carol A Munro
- School of Medicine, Medical Sciences & Nutrition University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZD, UK
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Chebil W, Haouas N, Eskes E, Vandecruys P, Belgacem S, Belhadj Ali H, Babba H, Van Dijck P. In Vitro Assessment of Azole and Amphotericin B Susceptibilities of Malassezia spp. Isolated from Healthy and Lesioned Skin. J Fungi (Basel) 2022; 8:jof8090959. [PMID: 36135684 PMCID: PMC9502168 DOI: 10.3390/jof8090959] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/06/2022] [Accepted: 09/10/2022] [Indexed: 12/11/2022] Open
Abstract
Malassezia yeasts have recently gained medical importance as emerging pathogens associated with a wide range of dermatological and systemic infections. Since standardized methods for in vitro antifungal susceptibility testing have not yet been established for Malassezia spp., related diseases are always treated empirically. As a result, a high rate of recurrence and decreased antifungal susceptibility have appeared. Thus, the aims of the study were to assess and analyze the in vitro susceptibility of Malassezia isolated from pityriasis versicolor (PV) lesions and healthy controls. A total of 58 Malassezia strains isolated from PV patients and healthy controls were tested. In vitro antifungal susceptibility testing was conducted using the CLSI broth microdilution with some modifications. Candida spp. criteria established in accordance with CLSI guidelines were used for data interpretation. Ketoconazole and posaconazole seemed to be the most effective molecules against Malassezia species. However, considerable percentages of itraconazole, fluconazole, and amphotericin B ‘‘resistant’’ strains (27.6%, 29.3%, and 43.1%, respectively) were revealed in this study. Malassezia furfur, M. sympodialis, and M. globosa showed different susceptibility profiles to the drugs tested. These results emphasize the importance of accurately identifying and evaluating the antifungal susceptibility of Malassezia species in order to guide a specific and effective treatment regimen.
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Affiliation(s)
- Wissal Chebil
- Laboratory of Medical and Molecular Parasitology-Mycology (LR12ES08), Department of Clinical Biology B, Faculty of Pharmacy, University of Monastir, Monastir 5000, Tunisia
| | - Najoua Haouas
- Laboratory of Medical and Molecular Parasitology-Mycology (LR12ES08), Department of Clinical Biology B, Faculty of Pharmacy, University of Monastir, Monastir 5000, Tunisia
| | - Elja Eskes
- Laboratory of Molecular Cell Biology, Institute of Botany and Microbiology, Department of Biology, Faculty of Sciences, KU Leuven, Heverlee, 3001 Leuven, Belgium
| | - Paul Vandecruys
- Laboratory of Molecular Cell Biology, Institute of Botany and Microbiology, Department of Biology, Faculty of Sciences, KU Leuven, Heverlee, 3001 Leuven, Belgium
| | - Sameh Belgacem
- Laboratory of Parasitology-Mycology, Fattouma Bourguiba University Hospital, Monastir 5000, Tunisia
| | - Hichem Belhadj Ali
- Dermatology Department, Fattouma Bourguiba University Hospital, Monastir 5000, Tunisia
| | - Hamouda Babba
- Laboratory of Medical and Molecular Parasitology-Mycology (LR12ES08), Department of Clinical Biology B, Faculty of Pharmacy, University of Monastir, Monastir 5000, Tunisia
| | - Patrick Van Dijck
- Laboratory of Molecular Cell Biology, Institute of Botany and Microbiology, Department of Biology, Faculty of Sciences, KU Leuven, Heverlee, 3001 Leuven, Belgium
- Correspondence: ; Tel.: +32-16321512
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Hobi S, Cafarchia C, Romano V, Barrs VR. Malassezia: Zoonotic Implications, Parallels and Differences in Colonization and Disease in Humans and Animals. J Fungi (Basel) 2022; 8:jof8070708. [PMID: 35887463 PMCID: PMC9324274 DOI: 10.3390/jof8070708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 06/29/2022] [Accepted: 06/30/2022] [Indexed: 12/13/2022] Open
Abstract
Malassezia spp. are commensals of the skin, oral/sinonasal cavity, lower respiratory and gastrointestinal tract. Eighteen species have been recovered from humans, other mammals and birds. They can also be isolated from diverse environments, suggesting an evolutionary trajectory of adaption from an ecological niche in plants and soil to the mucocutaneous ecosystem of warm-blooded vertebrates. In humans, dogs and cats, Malassezia-associated dermatological conditions share some commonalities. Otomycosis is common in companion animals but is rare in humans. Systemic infections, which are increasingly reported in humans, have yet to be recognized in animals. Malassezia species have also been identified as pathogenetic contributors to some chronic human diseases. While Malassezia species are host-adapted, some species are zoophilic and can cause fungemia, with outbreaks in neonatal intensive care wards associated with temporary colonization of healthcare worker’s hands from contact with their pets. Although standardization is lacking, susceptibility testing is usually performed using a modified broth microdilution method. Antifungal susceptibility can vary depending on Malassezia species, body location, infection type, disease duration, presence of co-morbidities and immunosuppression. Antifungal resistance mechanisms include biofilm formation, mutations or overexpression of ERG11, overexpression of efflux pumps and gene rearrangements or overexpression in chromosome 4.
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Affiliation(s)
- Stefan Hobi
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University, Tat Chee Avenue, Kowloon, Hong Kong, China
- Correspondence: (S.H.); (V.R.B.)
| | - Claudia Cafarchia
- Department of Veterinary Medicine, University of Bari, Str. prov. per Casamassima Km 3, Valenzano, (Bari), 70010, Italy; (C.C.); (V.R.)
| | - Valentina Romano
- Department of Veterinary Medicine, University of Bari, Str. prov. per Casamassima Km 3, Valenzano, (Bari), 70010, Italy; (C.C.); (V.R.)
| | - Vanessa R. Barrs
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University, Tat Chee Avenue, Kowloon, Hong Kong, China
- Centre for Animal Health and Welfare, City University of Hong Kong, Kowloon Tong, Hong Kong, China
- Correspondence: (S.H.); (V.R.B.)
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Rojas F, de Los Ángeles Sosa M, Latorre W, Mussin J, Alegre L, Giusiano G. Malassezia species: the need to establish Epidemiological Cutoff Values. Med Mycol 2022; 60:6623669. [PMID: 35772016 DOI: 10.1093/mmy/myac048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 06/06/2022] [Accepted: 06/28/2022] [Indexed: 11/13/2022] Open
Abstract
Malassezia are common yeasts in human skin microbiome. Under certain conditions these yeasts may cause disease from skin disorders to systemic infections. In the absence of clinical breakpoints, epidemiological cutoff values (ECVs) are useful to differentiate isolates with acquired or mutational resistance. The aim of this work was to propose tentative ECVs of Malassezia furfur, M. sympodialis, M. globosa for fluconazole (FCZ), itraconazole (ITZ), voriconazole (VCZ), ketoconazole (KTZ) and amphotericin B (AMB). A total of 160 isolates (80 M. furfur, 50 M. sympodialis and 30 M. globosa) were tested. Minimal inhibitory concentrations (MICs) were determined by modified broth microdilution method (CLSI). ECVs were estimated by ECOFFinder software and two-fold dilutions beyond the mode. ITZ, KTZ and VCZ showed the lowest MICs. The highest MIC and widest ranges were for FCZ and AMB. For ITZ, KTZ and VCZ both ECVs were similar. For FCZ, AMB especially M. furfur, modal ECVs were lower than values obtained by statistical method. When MIC distribution is the only data available, ECV could provide information to help guide therapy decisions. In that drug/species combination in which different peaks in the MIC distribution were observed, difference between both ECV was greater. This is the first study that provides ECV data of 160 Malassezia yeasts. Although ECVs cannot be used as predictors of clinical response, identification of non wild-type isolates suggests that it may be less likely to respond to a given antifungal agent.
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Affiliation(s)
- Florencia Rojas
- Departamento de Micología, Instituto de Medicina Regional, Universidad Nacional del Nordeste, CONICET. Resistencia, Argentina
| | - María de Los Ángeles Sosa
- Departamento de Micología, Instituto de Medicina Regional, Universidad Nacional del Nordeste. Resistencia, Argentina
| | - Wenceslao Latorre
- Departamento de Micología, Instituto de Medicina Regional, Universidad Nacional del Nordeste, CONICET. Resistencia, Argentina
| | - Javier Mussin
- Departamento de Micología, Instituto de Medicina Regional, Universidad Nacional del Nordeste, CONICET. Resistencia, Argentina
| | - Liliana Alegre
- Departamento de Micología, Instituto de Medicina Regional, Universidad Nacional del Nordeste. Resistencia, Argentina
| | - Gustavo Giusiano
- Departamento de Micología, Instituto de Medicina Regional, Universidad Nacional del Nordeste, CONICET. Resistencia, Argentina
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Malassezia restricta Pneumonia in Solid Organ Transplant Recipients: First Report of Two Cases. J Fungi (Basel) 2021; 7:jof7121057. [PMID: 34947039 PMCID: PMC8706098 DOI: 10.3390/jof7121057] [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: 11/23/2021] [Revised: 12/08/2021] [Accepted: 12/08/2021] [Indexed: 12/04/2022] Open
Abstract
Emerging fungal infections are a major challenge in solid organ transplantation (SOT) and are associated with high morbidity and mortality. We report two cases of Malassezia restricta pneumonia in SOT recipients. Infections were diagnosed with molecular analysis and histology. Patients were treated with antifungal therapy and have fully recovered.
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da Silva GO, Farias BCS, da Silva RB, Teixeira EH, Cordeiro RDA, Hissa DC, Melo VMM. Effects of lipopeptide biosurfactants on clinical strains of Malassezia furfur growth and biofilm formation. Med Mycol 2021; 59:1191-1201. [PMID: 34424316 DOI: 10.1093/mmy/myab051] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 07/23/2021] [Accepted: 08/19/2021] [Indexed: 01/02/2023] Open
Abstract
Lipopeptide biosurfactants (LBs) are biological molecules with low toxicity that have aroused growing interest in the pharmaceutical industry. Their chemical structure confers antimicrobial and antibiofilm properties against different species. Despite their potential, few studies have demonstrated their capability against Malassezia spp., commensal yeasts which can cause dermatitis and serious infections. Thus, the aim of this study was to evaluate the antifungal activity of biosurfactants produced by new strains of Bacillus subtilis TIM10 and B. vallismortis TIM68 against M. furfur and their potential for removal and inhibition of yeast biofilms. Biosurfactants were classified as lipopeptides by FTIR, and their composition was characterized by ESI-Q-TOF/MS, showing ions for iturin, fengycin, and surfactin, with a greater abundance of surfactin. Through the broth microdilution method, both biosurfactants inhibited the growth of clinical M. furfur strains. Biosurfactant TIM10 showed greater capacity for growth inhibition, with no statistical difference compared to those obtained by the commercial antifungal fluconazole for M. furfur 153DR5 and 154DR8 strains. At minimal inhibitory concentrations (MIC-2), TIM10 and TIM68 were able to inhibit biofilm formation, especially TIM10, with an inhibition rate of approximately 90%. In addition, both biosurfactants were able to remove pre-formed biofilm. Both biosurfactants showed no toxicity against murine fibroblasts, even at concentrations above MIC-2. Our results show the effectiveness of LBs in controlling the growth and biofilm formation of M. furfur clinical strains and highlight the potential of these agents to compose new formulations for the treatment of these fungi.
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Affiliation(s)
- Gabrielly Oliveira da Silva
- Laboratório de Ecologia Microbiana e Biotecnologia (LEMBiotech). Departamento de Biologia, Federal University of Ceara, Avenida Humberto Monte 2977, Fortaleza - CE 60455-760, Brazil
| | - Bárbara Cibelle Soares Farias
- Laboratório de Ecologia Microbiana e Biotecnologia (LEMBiotech). Departamento de Biologia, Federal University of Ceara, Avenida Humberto Monte 2977, Fortaleza - CE 60455-760, Brazil
| | - Renally Barbosa da Silva
- Laboratório Integrado de Biomoléculas (LIBS). Departamento de Patologia e Medicina Legal, Federal University of Ceara, Rua Coronel Nunes de Melo, Fortaleza - CE 60430-275, Brazil
| | - Edson Holanda Teixeira
- Laboratório Integrado de Biomoléculas (LIBS). Departamento de Patologia e Medicina Legal, Federal University of Ceara, Rua Coronel Nunes de Melo, Fortaleza - CE 60430-275, Brazil
| | - Rossana de Aguiar Cordeiro
- Departamento de Patologia e Medicina Legal, Federal University of Ceara, Rua Coronel Nunes de Melo, Fortaleza - CE 60430-275, Brazil
| | - Denise Cavalcante Hissa
- Laboratório de Recursos Genéticos (LARGEN). Departamento de Biologia, Federal University of Ceara, Avenida Humberto Monte 2977, Fortaleza - CE 60455-760, Brazil
| | - Vânia Maria Maciel Melo
- Laboratório de Ecologia Microbiana e Biotecnologia (LEMBiotech). Departamento de Biologia, Federal University of Ceara, Avenida Humberto Monte 2977, Fortaleza - CE 60455-760, Brazil
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Sanchez Armengol E, Harmanci M, Laffleur F. Current strategies to determine antifungal and antimicrobial activity of natural compounds. Microbiol Res 2021; 252:126867. [PMID: 34521051 DOI: 10.1016/j.micres.2021.126867] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/01/2021] [Accepted: 09/06/2021] [Indexed: 11/24/2022]
Abstract
Fungal and microbial infections are increasingly common diseases affecting not only humans, but also animals. Despite the fact that there are wide ranges of antifungal drugs that can be used as therapy against different types of mycosis, the large-scale needed for new antifungal and antimicrobial agents is undeniable. The reasons for a great demand for new agents are low effectiveness due to the development of resistance, host toxicity and various side effects of currently used therapeutics. In order to develop novel drugs against fungal infections, scientists need to search for new molecules that show antimicrobial activity. However, there are various methods to determine antifungal and antimicrobial activity such as diffusion methods, bioautography methods, dilution methods and other frequently used methods. This review aims to explain the methodologies mentioned, to highlight the functioning, usage, advantages and disadvantages and to compare the techniques using different sources of the last years. Additionally, some of the currently investigated natural compounds such as essential oils, which show promising results in the medication of fungal diseases, are mentioned.
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Affiliation(s)
- Eva Sanchez Armengol
- Department of Pharmaceutical Technology, Institute of Pharmacy, University of Innsbruck, Innrain 80-82, 6020, Innsbruck, Austria
| | - Melisa Harmanci
- Department of Pharmaceutical Technology, Institute of Pharmacy, University of Innsbruck, Innrain 80-82, 6020, Innsbruck, Austria
| | - Flavia Laffleur
- Department of Pharmaceutical Technology, Institute of Pharmacy, University of Innsbruck, Innrain 80-82, 6020, Innsbruck, Austria.
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Rhimi W, Theelen B, Boekhout T, Aneke CI, Otranto D, Cafarchia C. Conventional therapy and new antifungal drugs against Malassezia infections. Med Mycol 2021; 59:215-234. [PMID: 33099634 DOI: 10.1093/mmy/myaa087] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 09/14/2020] [Accepted: 09/29/2020] [Indexed: 12/18/2022] Open
Abstract
Malassezia yeasts are commensal microorganisms occurring on the skin of humans and animals causing dermatological disorders or systemic infections in severely immunocompromised hosts. Despite attempts to control such yeast infections with topical and systemic antifungals, recurrence of clinical signs of skin infections as well as treatment failure in preventing or treating Malassezia furfur fungemia have been reported most likely due to wrong management of these infections (e.g., due to early termination of treatment) or due to the occurrence of resistant phenomena. Standardized methods for in vitro antifungal susceptibility tests of these yeasts are still lacking, thus resulting in variable susceptibility profiles to azoles among Malassezia spp. and a lack of clinical breakpoints. The inherent limitations to the current pharmacological treatments for Malassezia infections both in humans and animals, stimulated the interest of the scientific community to discover new, effective antifungal drugs or substances to treat these infections. In this review, data about the in vivo and in vitro antifungal activity of the most commonly employed drugs (i.e., azoles, polyenes, allylamines, and echinocandins) against Malassezia yeasts, with a focus on human bloodstream infections, are summarized and their clinical implications are discussed. In addition, the usefulness of alternative compounds is discussed.
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Affiliation(s)
- Wafa Rhimi
- Dipartimento di Medicina Veterinaria, Università degli Studi "Aldo Moro", Bari, Italy
| | - Bart Theelen
- Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
| | - Teun Boekhout
- Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands.,Institute for Biodiversity and Ecosystem Dynamics (IBED), University of Amsterdam, Amsterdam, The Netherlands
| | - Chioma Inyang Aneke
- Dipartimento di Medicina Veterinaria, Università degli Studi "Aldo Moro", Bari, Italy.,Department of Veterinary Pathology and Microbiology, University of Nigeria, Nsukka, Nigeria
| | - Domenico Otranto
- Dipartimento di Medicina Veterinaria, Università degli Studi "Aldo Moro", Bari, Italy.,Faculty of Veterinary Sciences, Bu-Ali Sina University, Hamedan, Iran
| | - Claudia Cafarchia
- Dipartimento di Medicina Veterinaria, Università degli Studi "Aldo Moro", Bari, Italy
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Rhimi W, Inyang Aneke C, Mosca A, Otranto D, Cafarchia C. In Vitro Azole and Amphotericin B Susceptibilities of Malassezia furfur from Bloodstream Infections Using E-Test and CLSI Broth Microdilution Methods. Antibiotics (Basel) 2020; 9:E361. [PMID: 32604712 PMCID: PMC7345317 DOI: 10.3390/antibiotics9060361] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 06/22/2020] [Accepted: 06/24/2020] [Indexed: 11/16/2022] Open
Abstract
The number of reports of Malassezia furfur bloodstream infections is constantly increasing and there is a need for more simple antifungal susceptibility methods for their management. In this study, a total of 39 M. furfur isolates collected from hospitalized patients with fungemia were screened for antifungal susceptibility to azole and amphotericin B (AmB) using Clinical and Laboratory Standards Institute broth microdilution (CLSI BMD) and E-test in Sabouraud dextrose agar + 1% Tween80 (SDAt) and mDixon agar (DIX). Essential agreement (EA) and discrepancies between the two methods were evaluated after 48 h and 72 h reading times. Itraconazole (ITZ) and posaconazole (POS) displayed the lowest MIC values whereas fluconazole (FLZ) and AmB the highest, regardless of the methods and the reading time. The EA between BMD was >95% for FLZ and voriconazole (VOR) regardless of the media in the E-tests and reading time. The EA between BMD with E-test for AmB was >97% only when E-test in SDAt was used. The EA between BMD and E-test for ITZ and POS varied according to the media in E-test procedures and the reading time and was higher than 66.6% (POS) or 72% (ITZ) only when SABt was used. Substantial discrepancies for ITZ and POS were >5.1% regardless of the media and the reading time. This study suggests that the E-test in SABt represents an alternative method to CLSI BMD to evaluate the susceptibility of M. furfur to FLZ, VOR and AmB and not for ITZ and POS.
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Affiliation(s)
- Wafa Rhimi
- Dipartimento di Medicina Veterinaria, Università degli Studi "Aldo Moro", 70010 Bari, Italy
| | - Chioma Inyang Aneke
- Dipartimento di Medicina Veterinaria, Università degli Studi "Aldo Moro", 70010 Bari, Italy
- Department of Veterinary Pathology and Microbiology, University of Nigeria, Nsukka 410001, Nigeria
| | - Adriana Mosca
- Dipartimento Interdisciplinare di Medicina, Università degli Studi di Bari, 70124 Bari, Italy
| | - Domenico Otranto
- Dipartimento di Medicina Veterinaria, Università degli Studi "Aldo Moro", 70010 Bari, Italy
- Faculty of Veterinary Sciences, Bu-Ali Sina University, Hamedan 65174, Iran
| | - Claudia Cafarchia
- Dipartimento di Medicina Veterinaria, Università degli Studi "Aldo Moro", 70010 Bari, Italy
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13
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Park M, Cho YJ, Lee YW, Jung WH. Genomic Multiplication and Drug Efflux Influence Ketoconazole Resistance in Malassezia restricta. Front Cell Infect Microbiol 2020; 10:191. [PMID: 32426297 PMCID: PMC7203472 DOI: 10.3389/fcimb.2020.00191] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 04/09/2020] [Indexed: 12/24/2022] Open
Abstract
Malassezia restricta is an opportunistic fungal pathogen on human skin; it is associated with various skin diseases, including seborrheic dermatitis and dandruff, which are usually treated using ketoconazole. In this study, we clinically isolated ketoconazole-resistant M. restricta strains (KCTC 27529 and KCTC 27550) from patients with dandruff. To understand the mechanisms of ketoconazole resistance in the isolates, their genomes were sequenced and compared with the susceptible reference strain M. restricta KCTC 27527. Using comparative genome analysis, we identified tandem multiplications of the genomic loci containing ATM1 and ERG11 homologs in M. restricta KCTC 27529 and KCTC 27550, respectively. Additionally, we found that the copy number increase of ATM1 and ERG11 is reflected in the increased expression of these genes; moreover, we observed that overexpression of these homologs caused ketoconazole resistance in a genetically tractable fungal pathogen, Cryptococcus neoformans. In addition to tandem multiplications of the genomic region containing the ATM1 homolog, the PDR5 homolog, which encodes the drug efflux pump protein was upregulated in M. restricta KCTC 27529 compared to the reference strain. Biochemical analysis confirmed that drug efflux was highly activated in M. restricta KCTC 27529, implying that upregulation of the PDR5 homolog may also contribute to ketoconazole resistance in the strain. Overall, our results suggest that multiplication of the genomic loci encoding genes involved in ergosterol synthesis, mitochondrial iron metabolism, and oxidative stress response and overexpression of the drug efflux pumps are the mechanisms underlying ketoconazole resistance in M. restricta.
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Affiliation(s)
- Minji Park
- Department of Systems Biotechnology, Chung-Ang University, Anseong, South Korea
| | - Yong-Joon Cho
- School of Biological Sciences and Research Institute of Basic Sciences, Seoul National University, Seoul, South Korea
| | - Yang Won Lee
- Department of Dermatology, School of Medicine, Konkuk University, Seoul, South Korea.,Research Institute of Medicine, Konkuk University, Seoul, South Korea
| | - Won Hee Jung
- Department of Systems Biotechnology, Chung-Ang University, Anseong, South Korea
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14
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Li W, Zhang ZW, Luo Y, Liang N, Pi XX, Fan YM. Molecular epidemiology, in vitro susceptibility and exoenzyme screening of Malassezia clinical isolates. J Med Microbiol 2020; 69:436-442. [PMID: 32068525 DOI: 10.1099/jmm.0.001161] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Introduction. Malassezia folliculitis (MF) and pityriasis versicolor (PV) are common dermatoses caused by Malassezia species. Their molecular epidemiology, drug susceptibility and exoenzymes are rarely reported in China.Aim. To investigate the molecular epidemiology, drug susceptibility and enzymatic profile of Malassezia clinical isolates.Methodology. Malassezia strains were recovered from MF and PV patients and healthy subjects (HS) and identified by sequencing analysis. The minimum inhibitory concentrations (MICs) of nine antifungals (posaconazole, voriconazole, itraconazole, fluconazole, ketoconazole, miconazole, bifonazole, terbinafine and caspofungin) and tacrolimus, the interactions between three antifungals (itraconazole, ketoconazole and terbinafine) and tacrolimus, and the extracellular enzyme profile were evaluated using broth and checkerboard microdilution and the Api-Zym system, respectively.Results. Among 392 Malassezia isolates from 729 subjects (289 MF, 218 PV and 222 HS), Malassezia furfur and Malassezia globosa accounted for 67.86 and 18.88 %, respectively. M. furfur was the major species in MF and PV patients and HS. Among 60M. furfur and 50M. globosa strains, the MICs for itraconazole, posaconazole, voriconazole and ketoconazole were <1 μg ml-1. M. furfur was more susceptible to itraconazole, terbinafine and bifonazole but tolerant to miconazole compared with M. globosa (P<0.05). Synergistic effects between terbinafine and itraconazole or between tacrolimus and itraconazole, ketoconazole or terbinafine occurred in 6, 7, 6 and 9 out of 37 strains, respectively. Phosphatases, lipases and proteases were mainly secreted in 51 isolates.Conclusions. Itraconazole, posaconazole, voriconazole and ketoconazole are theagents against which there is greatest susceptibility. Synergistic effects between terbinafine and itraconazole or tacrolimas and antifungals may be irrelevant to clinical application. Overproduction of lipases could enhance the skin inhabitation of M. furfur.
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Affiliation(s)
- Wei Li
- Department of Dermatology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, PR China
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15
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Saunte DML, Gaitanis G, Hay RJ. Malassezia-Associated Skin Diseases, the Use of Diagnostics and Treatment. Front Cell Infect Microbiol 2020; 10:112. [PMID: 32266163 PMCID: PMC7098993 DOI: 10.3389/fcimb.2020.00112] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 02/28/2020] [Indexed: 11/13/2022] Open
Abstract
Yeasts of the genus, Malassezia, formerly known as Pityrosporum, are lipophilic yeasts, which are a part of the normal skin flora (microbiome). Malassezia colonize the human skin after birth and must therefore, as commensals, be normally tolerated by the human immune system. The Malassezia yeasts also have a pathogenic potential where they can, under appropriate conditions, invade the stratum corneum and interact with the host immune system, both directly but also through chemical mediators. The species distribution on the skin and the pathogenetic potential of the yeast varies between different Malassezia related diseases such as head and neck dermatitis, seborrheic dermatitis, pityriasis versicolor, and Malassezia folliculitis. The diagnostic methods used to confirm the presence of Malassezia yeasts include direct microcopy, culture based methods (often a combination of morphological features of the isolate combined with biochemical test), molecular based methods such as Polymerase Chain Reaction techniques, and Matrix Assisted Laser Desorption/Ionization—Time Of Flight mass spectrometry and the chemical imprint method Raman spectroscopy. Skin diseases caused by Malassezia are usually treated with antifungal therapy and if there are associated inflammatory skin mechanisms this is often supplemented by anti-inflammatory therapy. The aim of this paper is to provide an overview of Malassezia related skin disease, diagnostic methods and treatment options.
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Affiliation(s)
- Ditte M L Saunte
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark.,Department of Clinical Medicine, Health Sciences Faculty, University of Copenhagen, Copenhagen, Denmark
| | - George Gaitanis
- Department of Skin and Venereal Diseases, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece.,DELC Clinic, Biel/Bienne, Switzerland
| | - Roderick James Hay
- St. Johns Institute of Dermatology, Kings College London, London, United Kingdom
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16
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Mussin JE, Roldán MV, Rojas F, Sosa MDLÁ, Pellegri N, Giusiano G. Antifungal activity of silver nanoparticles in combination with ketoconazole against Malassezia furfur. AMB Express 2019; 9:131. [PMID: 31432275 PMCID: PMC6702292 DOI: 10.1186/s13568-019-0857-7] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 08/13/2019] [Indexed: 12/03/2022] Open
Abstract
Malassezia furfur is lipophilic and lipid-dependent yeast, inhabitant of human skin microbiota associated with several dermal disorders. In recent years, along with the advances in nanotechnology and the incentive to find new antimicrobial drugs, there has been a growing interest in the utilization of nanoparticles for the treatment of skin microbial infections. This work aimed to study the in vitro inhibitory activity of silver nanoparticles (AgNP) against 41 M. furfur clinical isolates, visualize the interaction between AgNP-Malassezia, evaluate the synergism with ketoconazole (KTZ) and to produce an antimicrobial gel of AgNP–KTZ. The synthesized AgNP were randomly distributed around the yeast surface and showed a fungicidal action with low minimal inhibitory concentration values. AgNP showed no antagonistic effect with KTZ. The broad-spectrum antimicrobial property with fungicidal action of AgNP and its accumulation in affected areas with a sustained release profile, added to the great antifungal activity of KTZ against Malassezia infections and other superficial mycoses, allowed us to obtain a gel based on carbopol formulated with AgNP–KTZ with the potential to improve the topical therapy of superficial malasseziosis, reduce the number of applications and, also, prevent the recurrence.
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17
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Malassezia furfur promoting growth of Staphylococcus epidermidis by increasing pH when cultured in a lipid-free environment. Chin Med J (Engl) 2019; 132:873-876. [PMID: 30897602 PMCID: PMC6595851 DOI: 10.1097/cm9.0000000000000152] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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18
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Pedrosa AF, Lisboa C, Faria-Ramos I, Silva R, Ricardo E, Teixeira-Santos R, Miranda I, Rodrigues AG. Epidemiology and susceptibility profile to classic antifungals and over-the-counter products of Malassezia clinical isolates from a Portuguese University Hospital: a prospective study. J Med Microbiol 2019; 68:778-784. [PMID: 30907722 DOI: 10.1099/jmm.0.000966] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
PURPOSE Clinical epidemiological data about the distinct Malassezia species remain scarce. The recurrence of Malassezia-related skin diseases, despite long-term use of antifungals, raises concern about the hypothetical emergence of antifungal resistance. We aimed to assess the distribution of Malassezia species among patients from a University Hospital with pityriasis versicolor, seborrheic dermatitis and healthy volunteers, and to evaluate the susceptibility profile to classic antifungals and over-the-counter compounds, searching for clinical associations. METHODOLOGY The enrollment of volunteers was conducted at the Dermatology Department of a University Hospital over a 3 year period. Malassezia culture isolates were identified to the species-level by sequencing. The drug susceptibility profile was assessed according to a broth microdilution assay, as recommended by the Clinical Laboratory Standards Institute. RESULTS A total of 86 Malassezia isolates were recovered from 182 volunteers. Malassezia sympodialis was the most frequent isolated species. We found high MIC values and a wide MIC range in the case of tested azoles, and very low terbinafine MIC values against most isolates. Previous topical corticosteroid therapy was associated with a significant increase of MIC values of fluconazole and of terbinafine. CONCLUSION Conversely to other European studies, M. sympodialis was the most common isolated species, which might be related to geographic reasons. The impact of previous topical corticotherapy upon the antifungal susceptibility profile was hereby demonstrated. In vitro susceptibility test results suggest that terbinafine might be a valid alternative for Malassezia-related skin diseases nonresponsive to azoles.
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Affiliation(s)
- Ana Filipa Pedrosa
- Department of Dermatology and Venereology, Centro Hospitalar S. João EPE, Porto, Portugal.,CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine of the University of Porto, Portugal.,Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Portugal
| | - Carmen Lisboa
- Department of Dermatology and Venereology, Centro Hospitalar S. João EPE, Porto, Portugal.,CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine of the University of Porto, Portugal.,Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Portugal
| | - Isabel Faria-Ramos
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Portugal
| | - Raquel Silva
- Department of Medical Sciences - iBiMED & IEETA, University of Aveiro, Aveiro, Portugal
| | - Elisabete Ricardo
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Portugal.,CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine of the University of Porto, Portugal
| | - Rita Teixeira-Santos
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Portugal.,CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine of the University of Porto, Portugal
| | - Isabel Miranda
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Portugal
| | - Acácio Gonçalves Rodrigues
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Portugal.,CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine of the University of Porto, Portugal.,Burn Unit, Department of Plastic and Reconstructive Surgery, Centro Hospitalar S. João EPE, Porto, Portugal
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19
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Epidemiology of antifungal susceptibility: Review of literature. J Mycol Med 2019; 28:574-584. [PMID: 29773435 DOI: 10.1016/j.mycmed.2018.04.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 04/26/2018] [Accepted: 04/27/2018] [Indexed: 11/24/2022]
Abstract
Fungal infections are a major cause of morbidity and mortality despite the latest developments of diagnostic tools and therapeutic options. Early initiation of the appropriate antifungal therapy has been demonstrated to have a direct impact on the patient's outcome. Antifungal susceptibility testing methods are available to detect antifungal resistance and to determine the best treatment for a specific fungus. American and European standards have been developed, as well as equivalent commercial systems, which are more appropriate for clinical laboratories. These studies have allowed the development of interpretative breakpoints against the most frequent agents of fungal infections in the world. Surveillance of antifungal susceptibility patterns can provide the local drug resistance data to the clinicians, which can further aid better management of patients. Antifungal susceptibility tests have become essential tools to identify resistance to antifungals, to know the local and global disease epidemiology and to guide the treatment of fungal diseases. The distribution of species and the prevalence of antifungal resistance in fungi isolates varied among different areas. Here we summarize the epidemiology of antifungal susceptibility pattern of different fungal species.
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20
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Arce M, Gutiérrez-Mendoza D. Pityriasis Versicolor: Treatment Update. CURRENT FUNGAL INFECTION REPORTS 2018. [DOI: 10.1007/s12281-018-0328-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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21
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Pedrosa AF, Lisboa C, Rodrigues AG. Malassezia infections with systemic involvement: Figures and facts. J Dermatol 2018; 45:1278-1282. [PMID: 30264900 DOI: 10.1111/1346-8138.14653] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 08/14/2018] [Indexed: 11/29/2022]
Abstract
Malassezia are lipophilic and commensal yeasts capable of inducing skin disease among susceptible hosts. However, severely immunocompromised patients and preterm infants admitted to intensive care units are particularly at risk of developing Malassezia systemic infections. Patients often have central venous catheters which are usually the portal of entry for colonization and infection. In addition to the clinically non-specific findings, a delay in the laboratorial diagnosis may occur as there is often the need to add lipid supplementation to culture in order to support these organisms' growth. Herein, we report three unrelated cases of Malassezia bloodstream infection at a university hospital during a 2-year period, followed by a discussion of the clinical results and comparison with the most recently available published data on epidemiology and risk factors, pathogenesis, diagnosis, susceptibility profile and treatment.
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Affiliation(s)
- Ana Filipa Pedrosa
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal.,Department of Dermatology and Venereology, Centro Hospitalar São João EPE, Porto, Portugal.,CINTESIS, Centre for Health Technology and Services Research, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Carmen Lisboa
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal.,Department of Dermatology and Venereology, Centro Hospitalar São João EPE, Porto, Portugal.,CINTESIS, Centre for Health Technology and Services Research, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Acácio Gonçalves Rodrigues
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal.,CINTESIS, Centre for Health Technology and Services Research, Faculty of Medicine of the University of Porto, Porto, Portugal.,Burn Unit, Department of Plastic and Reconstructive Surgery, Centro Hospitalar São João EPE, Porto, Portugal
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22
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Putting It All Together to Understand the Role of Malassezia spp. in Dandruff Etiology. Mycopathologia 2018; 183:893-903. [PMID: 29946996 DOI: 10.1007/s11046-018-0283-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 06/21/2018] [Indexed: 01/01/2023]
Abstract
Dandruff is a common scalp condition causing both a discomfort and an undesired social image. Various studies dating from early 1900s have investigated the condition, but understanding of underlying mechanisms and etiology of the condition is still in its infancy. Formation of dandruff is a common but complex event which has been associated with numerous causal factors. Physiological conditions such as pH, water content, or sebum secretion are some of the host-related factors. An imbalance between these factors can disturb the physiological equilibrium of the scalp that can lead to dandruff formation. However, severity of the condition is strongly related to the lipophilic yeast of the skin microbiota, Malassezia spp. On the other hand, there are recent publications highlighting the role of other scalp microbiota members on dandruff formation. This review investigates the processes leading to the formation of dandruff to provide an etiological description of the condition, with a focus on Malassezia spp.
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23
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Theelen B, Cafarchia C, Gaitanis G, Bassukas ID, Boekhout T, Dawson TL. Malassezia ecology, pathophysiology, and treatment. Med Mycol 2018. [DOI: 10.1093/mmy/myx134] [Citation(s) in RCA: 117] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Affiliation(s)
- Bart Theelen
- Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
| | - Claudia Cafarchia
- Dipartimento di Medicina Veterinaria, Università degli Studi di Bari Aldo Moro, Bari, Italy
| | - Georgios Gaitanis
- Department of Skin and Venereal Diseases, Faculty of Medicine, School of Health Sciences, University of Ioannina, Greece
| | - Ioannis Dimitrios Bassukas
- Department of Skin and Venereal Diseases, Faculty of Medicine, School of Health Sciences, University of Ioannina, Greece
| | - Teun Boekhout
- Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
- Institute for Biodiversity and Ecosystem Dynamics (IBED), University of Amsterdam, The Netherlands
- Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Thomas L Dawson
- Agency for Science, Technology, and Research (A*STAR), Institute for Medical Biology, (IMB), Singapore
- Center for Cell Death, Injury and Regeneration, Departments of Drug Discovery and Biomedical Sciences and Biochemistry and Molecular Biology, Medical University of South Carolina, Charleston, South Carolina, USA
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24
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Carreira A, Ferreira JB, Pereira I, Ferreira J, Filipe P, Ferreira RB, Monteiro S. Blad-containing oligomer: a novel fungicide used in crop protection as an alternative treatment for tinea pedis and tinea versicolor. J Med Microbiol 2018; 67:198-207. [PMID: 29388537 DOI: 10.1099/jmm.0.000675] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
PURPOSE The lack of novel antifungal drugs and the increasing incidence and severity of fungal infections are major concerns worldwide. Herein, we tested the activity of the Blad-containing oligomer (BCO), a new antifungal molecule already in use for agriculture, on Malassezia spp. and dermatophytes, the causal agents of human tinea versicolor and tinea pedis. Given the lack of a standard method for Malassezia susceptibility testing and the plethora of published methods, we also developed an improved method for this genus. METHODOLOGY The efficacy of BCO was assessed in vitro and compared to that of the drugs currently utilized in the treatment of tinea versicolor (fluconazole and itraconazole) and tinea pedis (itraconazole and terbinafine). For dermatophytes, the standard microdilution broth-based method was used, with small adjustments, and several broth formulations and inocula sizes were tested to develop an improved susceptibility method for Malassezia spp. RESULTS We successfully developed a microdilution broth-based method with considerable advantages over other available methods, and used it for all in vitro susceptibility tests of Malassezia spp. isolates. We report that, on a molar basis, BCO was more effective than fluconazole or itraconazole on most strains of Malassezia spp. isolated from clinical samples (n=29). By contrast, BCO was less effective than itraconazole or terbinafine on the common dermatophytes Trichophyton rubrum and Trichophyton interdigitale. CONCLUSION These data place BCO as a promising drug for the treatment of Malassezia-associated skin diseases. Further in vivo studies are now required to ascertain its applicability in the clinical setting.
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Affiliation(s)
- Alexandra Carreira
- CEV, SA, Parque Industrial de Cantanhede/Biocant-Park, lote 120, 3060-197 Cantanhede, Portugal
| | - João Boavida Ferreira
- Hospital de Santa Maria, Faculdade de Medicina de Lisboa, Clínica Dermatológica Universitária, Avenida Prof. Egas Moniz, 1699 Lisboa Codex, Portugal
| | - Iliana Pereira
- CEV, SA, Parque Industrial de Cantanhede/Biocant-Park, lote 120, 3060-197 Cantanhede, Portugal
| | - João Ferreira
- Hospital de Santa Maria, Faculdade de Medicina de Lisboa, Clínica Dermatológica Universitária, Avenida Prof. Egas Moniz, 1699 Lisboa Codex, Portugal.,Unidade de Investigação em Dermatologia, Instituto de Medicina Molecular, Avenida Prof. Egas Moniz, 1699 Lisboa Codex, Portugal
| | - Paulo Filipe
- Hospital de Santa Maria, Faculdade de Medicina de Lisboa, Clínica Dermatológica Universitária, Avenida Prof. Egas Moniz, 1699 Lisboa Codex, Portugal.,Unidade de Investigação em Dermatologia, Instituto de Medicina Molecular, Avenida Prof. Egas Moniz, 1699 Lisboa Codex, Portugal
| | - Ricardo Boavida Ferreira
- LEAF - Linking Landscape, Environment, Agriculture and Food, Instituto Superior de Agronomia, Universidade de Lisboa, 1349-017 Lisboa, Portugal
| | - Sara Monteiro
- CEV, SA, Parque Industrial de Cantanhede/Biocant-Park, lote 120, 3060-197 Cantanhede, Portugal
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