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Lee D, Pan JH, Kim D, Heo W, Shin EC, Kim YJ, Shim YY, Reaney MJT, Ko SG, Hong SB, Cho HT, Kim TG, Lee K, Kim JK. Mycoproteins and their health-promoting properties: Fusarium species and beyond. Compr Rev Food Sci Food Saf 2024; 23:e13365. [PMID: 38767863 DOI: 10.1111/1541-4337.13365] [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: 10/17/2023] [Revised: 03/13/2024] [Accepted: 04/23/2024] [Indexed: 05/22/2024]
Abstract
Filamentous fungal mycoproteins have gained increasing attention as sustainable alternatives to animal and plant-based proteins. This comprehensive review summarizes the nutritional characteristics, toxicological aspects, and health-promoting effects of mycoproteins, focusing on those derived from filamentous fungi, notably Fusarium venenatum. Mycoproteins are characterized by their high protein content, and they have a superior essential amino acid profile compared to soybeans indicating excellent protein quality and benefits for human nutrition. Additionally, mycoproteins offer enhanced digestibility, further highlighting their suitability as a protein source. Furthermore, mycoproteins are rich in dietary fibers, which have been associated with health benefits, including protection against metabolic diseases. Moreover, their fatty acids profile, with significant proportions of polyunsaturated fatty acids and absence of cholesterol, distinguishes them from animal-derived proteins. In conclusion, the future of mycoproteins as a health-promoting protein alternative and the development of functional foods relies on several key aspects. These include improving the acceptance of mycoproteins, conducting further research into their mechanisms of action, addressing consumer preferences and perceptions, and ensuring safety and regulatory compliance. To fully unlock the potential of mycoproteins and meet the evolving needs of a health-conscious society, continuous interdisciplinary research, collaboration among stakeholders, and proactive engagement with consumers will be vital.
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Affiliation(s)
- Daseul Lee
- Department of Food and Biotechnology, Korea University, Sejong, Republic of Korea
- Agricultural Microbiology Division, National Institute of Agricultural Sciences, Rural Development Administration, Wanju, Republic of Korea
| | - Jeong Hoon Pan
- Department of Food and Nutrition, Chosun University, Gwangju, Republic of Korea
| | - Dahye Kim
- Animal Genomics and Bioinformatics Division, National Institute of Animal Science, Rural Development Administration, Wanju, Republic of Korea
| | - Wan Heo
- Department of Food Science and Engineering, Seowon University, Cheongju, Republic of Korea
| | - Eui Cheol Shin
- Department of Food Science, Gyeongsang National University, Jinju, Republic of Korea
| | - Young Jun Kim
- Department of Food and Biotechnology, Korea University, Sejong, Republic of Korea
| | - Youn Young Shim
- Department of Food and Biotechnology, Korea University, Sejong, Republic of Korea
| | - Martin J T Reaney
- Department of Food and Bioproduct Sciences, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Seong-Gyu Ko
- Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Seung-Beom Hong
- Agricultural Microbiology Division, National Institute of Agricultural Sciences, Rural Development Administration, Wanju, Republic of Korea
| | - Hyung Taek Cho
- Department of Food and Biotechnology, Korea University, Sejong, Republic of Korea
| | - Tae Gyun Kim
- Department of Food and Biotechnology, Korea University, Sejong, Republic of Korea
| | - Kangwook Lee
- Department of Food and Biotechnology, Korea University, Sejong, Republic of Korea
| | - Jae Kyeom Kim
- Department of Food and Biotechnology, Korea University, Sejong, Republic of Korea
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, Delaware, USA
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Taga F, Anzawa K, Ono H, Futatsuya T, Yamaguchi R, Takeda K, Mochizuki T, Shimizu A. Possibly the first case of onychomycosis by Fusarium lactis: Case presentation and literature review of onychomycosis by Fusarium species. J Dermatol 2023; 50:1550-1559. [PMID: 37622410 DOI: 10.1111/1346-8138.16931] [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: 02/13/2023] [Revised: 07/19/2023] [Accepted: 08/07/2023] [Indexed: 08/26/2023]
Abstract
Fusarium species (spp.) is frequently found in soil and plant residues and on plant bodies in all climatic zones worldwide. Although there have been few reports of onychomycosis caused by Fusarium spp., it is characterized by drug sensitivity and other characteristics. Here, we report what may be the first case of onychomycosis caused by Fusarium lactis. We analyzed the mycology and characterized previously reported cases of onychomycosis caused by Fusarium spp. A 73-year-old otherwise healthy woman presented with discoloration and thickening of her right thumbnail with paronychia. Direct microscopy revealed unevenly swollen hyphae, and a Grocott-stained nail specimen showed septate hyphae. Based on the morphological features and gene analysis of fungus isolated from the nail, we diagnosed onychomycosis caused by F. lactis belonging to Fusarium fujikuroi species complex. Partial nail removal and topical application of 1% luliconazole solution resolved the condition in 6 months. Minimum inhibitory concentrations for isolated F. lactis showed high sensitivity to luliconazole but not itraconazole or terbinafine. The isolated F. lactis was temperature-sensitive. A search of the literature revealed 57 cases of onychomycosis caused by Fusarium spp. with delineated clinical characteristics. Since those cases were investigated using morphological and/or molecular methods, we analyzed them by species complex as well as species. Onychomycosis caused by Fusarium spp. is predominantly found on the big toe, with Fusarium solani species complex and Fusarium oxysporum species complex accounting for over 70% of cases. Infection of only one digit with paronychia is a characteristic clinical manifestation of onychomycosis caused by Fusarium spp. Since there has been an increase in instances of molecular determination of Fusarium spp., it is deemed necessary to clarify its clinical and fungal nature. Due to its characteristic drug sensitivity and temperature-sensitive nature, new treatments are expected to be developed.
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Affiliation(s)
- Fumiaki Taga
- Department of Dermatology, Kanazawa Medical University, Kahoku, Japan
| | - Kazushi Anzawa
- Department of Dermatology, Kanazawa Medical University, Kahoku, Japan
| | - Hiroto Ono
- Department of Dermatology, Kanazawa Medical University, Kahoku, Japan
| | | | - Reimon Yamaguchi
- Department of Dermatology, Kanazawa Medical University, Kahoku, Japan
| | - Kiminobu Takeda
- Department of Dermatology, Kanazawa Medical University, Kahoku, Japan
| | - Takashi Mochizuki
- Department of Dermatology, Kanazawa Medical University, Kahoku, Japan
| | - Akira Shimizu
- Department of Dermatology, Kanazawa Medical University, Kahoku, Japan
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Lu LY, Ou JH, Hui RCY, Chuang YH, Fan YC, Sun PL. High Diversity of Fusarium Species in Onychomycosis: Clinical Presentations, Molecular Identification, and Antifungal Susceptibility. J Fungi (Basel) 2023; 9:jof9050534. [PMID: 37233245 DOI: 10.3390/jof9050534] [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: 03/14/2023] [Revised: 04/10/2023] [Accepted: 04/27/2023] [Indexed: 05/27/2023] Open
Abstract
Fusarium are uncommon but important pathogenic organisms; they cause non-dermatophyte mould (NDM) onychomycosis. Patients typically respond poorly to treatment owing to Fusarium's native resistance to multiple antifungal drugs. However, epidemiological data for Fusarium onychomycosis are lacking in Taiwan. We retrospectively reviewed the data of 84 patients with positive Fusarium nail sample cultures at Chang Gung Memorial Hospital, Linkou Branch between 2014 and 2020. We aimed to investigate the clinical presentations, microscopic and pathological characteristics, antifungal susceptibility, and species diversity of Fusarium in patients with Fusarium onychomycosis. We enrolled 29 patients using the six-parameter criteria for NDM onychomycosis to determine the clinical significance of Fusarium in these patients. All isolates were subjected to species identification by sequences and molecular phylogeny. A total of 47 Fusarium strains belonging to 13 species in four different Fusarium species complexes (with Fusarium keratoplasticum predominating) were isolated from 29 patients. Six types of histopathology findings were specific to Fusarium onychomycosis, which may be useful for differentiating dermatophytes from NDMs. The results of drug susceptibility testing showed high variation among species complexes, and efinaconazole, lanoconazole, and luliconazole showed excellent in vitro activity for the most part. This study's primary limitation was its single-centre retrospective design. Our study showed a high diversity of Fusarium species in diseased nails. Fusarium onychomycosis has clinical and pathological features distinct from those of dermatophyte onychomycosis. Thus, careful diagnosis and proper pathogen identification are essential in the management of NDM onychomycosis caused by Fusarium sp.
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Affiliation(s)
- Lai-Ying Lu
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333423, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 333323, Taiwan
- Department of Dermatology and Aesthetic Medicine Center, Jen-Ai Hospital, Taichung 412224, Taiwan
| | - Jie-Hao Ou
- Department of Plant Pathology, National Chung Hsing University, Taichung 402202, Taiwan
| | - Rosaline Chung-Yee Hui
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333423, Taiwan
| | - Ya-Hui Chuang
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333423, Taiwan
| | - Yun-Chen Fan
- Department of Plant Pathology, National Chung Hsing University, Taichung 402202, Taiwan
| | - Pei-Lun Sun
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333423, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 333323, Taiwan
- Research Laboratory of Medical Mycology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 33323, Taiwan
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Conrado PCV, Vaine AA, Arita GS, Sakita KM, Gonçalves RS, Caetano W, de Souza M, Baesso ML, Malacarne LC, Razzolini E, Vicente VA, Kioshima ES, de Mendonça PDSB. Promising onychomycosis treatment with hypericin-mediated photodynamic therapy: case reports. Photodiagnosis Photodyn Ther 2023; 42:103498. [PMID: 36882144 DOI: 10.1016/j.pdpdt.2023.103498] [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: 02/01/2023] [Revised: 02/24/2023] [Accepted: 03/02/2023] [Indexed: 03/07/2023]
Abstract
BACKGROUND Onychomycosis (OM) is a common nail plate disorder caused by dermatophyte molds, yeasts, and non-dermatophyte molds, which use keratin in the nail plate as an energy source. OM is characterized by dyschromia, increased nail thickness, subungual hyperkeratosis, and onychodystrophy, and is typically treated with conventional antifungals despite frequent reports of toxicity, fungal resistance, and OM recurrence. Photodynamic therapy (PDT) with hypericin (Hyp) as a photosensitizer (PS) stands out as a promising therapeutic modality. When excited by a specific wavelength of light and in the presence of oxygen, to lead to photochemical and photobiological reactions on the selected targets. METHODS OM diagnosis was made in three suspected cases, and the causative agents were identified by classical and molecular methods, and confirmed by attenuated total reflectance-Fourier transform infrared spectroscopy (ATR-FTIR). Susceptibility of planktonic cells of the clinical isolates to conventional antifungals and PDT-Hyp was evaluated, and photoacoustic spectroscopy (PAS) of Hyp permeation in nail fragments ex vivo was analyzed. Furthermore, the patients opted to undergo PDT-Hyp treatment and were subsequently followed up. The protocol was approved by the human ethics committee (CAAE, number 14107419.4.0000.0104). RESULTS The etiological agents of OM in patients ID 01 and ID 02 belonged to the Fusarium solani species complex, being identified as Fusarium keratoplasticum (CMRP 5514) and Fusarium solani (CMRP 5515), respectively. For patient ID 03, the OM agent was identified as Trichophyton rubrum (CMRP 5516). PDT-Hyp demonstrated a fungicidal effect in vitro, with reductions of ≥3 log10 (p<0.0051 and p<0.0001), and the PAS analyses indicated that Hyp could completely permeate through both healthy and OM-affected nails. After four sessions of PDT-Hyp, mycological cure was observed in all three cases, and after seventh months, clinical cure was confirmed. PDT-Hyp showed satisfactory results in terms of efficacy and safety, and thus can be considered a promising therapy for the clinical treatment of OM.
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Affiliation(s)
- Pollyanna Cristina Vincenzi Conrado
- Program in Biosciences and Pathophysiology, Department of Clinical Analysis and Biomedicine, State University of Maringa (UEM), Maringa, Parana, Brazil
| | | | - Glaucia Sayuri Arita
- Program in Biosciences and Pathophysiology, Department of Clinical Analysis and Biomedicine, State University of Maringa (UEM), Maringa, Parana, Brazil
| | - Karina Mayumi Sakita
- Program in Biosciences and Pathophysiology, Department of Clinical Analysis and Biomedicine, State University of Maringa (UEM), Maringa, Parana, Brazil
| | | | - Wilker Caetano
- Department of Chemistry, State University of Maringa, Parana, Brazil
| | - Monique de Souza
- Department of Physics, State University of Maringa, Parana, Brazil
| | | | | | - Emanuel Razzolini
- Department of Pathology Basic, Federal University of Parana State, Curitiba, Parana, Brazil
| | | | - Erika Seki Kioshima
- Program in Biosciences and Pathophysiology, Department of Clinical Analysis and Biomedicine, State University of Maringa (UEM), Maringa, Parana, Brazil
| | - Patrícia de Souza Bonfim de Mendonça
- Program in Biosciences and Pathophysiology, Department of Clinical Analysis and Biomedicine, State University of Maringa (UEM), Maringa, Parana, Brazil.
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Nosratabadi M, Faeli L, Haghani I, Mohammadi R, Khodavaisy S, Kachuei R, Katiraee F, Aghili SR, Shokohi T, Hedayati MT, Nazeri M, Javan-Nikkhah M, Zarrinfar H, Javidnia J, Najafzadeh MJ, Salimi M, M S Al Hatmi A, Badali H, Abastabar M. In vitro antifungal susceptibility profile of Iranian Fusarium isolates: Emphasising on the potent inhibitory effect of efinaconazole compared to other drugs. Mycoses 2023; 66:258-275. [PMID: 36447396 DOI: 10.1111/myc.13550] [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: 08/27/2022] [Revised: 11/17/2022] [Accepted: 11/25/2022] [Indexed: 12/05/2022]
Abstract
BACKGROUND Fusarium species are opportunistic human pathogens that remarkably cause fungal infections ranging from superficial to fatal invasive disseminated infections. Fusarium species are notoriously resistant to the majority of antifungal agents. OBJECTIVES Therefore, detailed studies regarding in vitro susceptibility are required and may lead to a better prognosis of severe infections. METHODS We evaluated 25 antifungal drugs in vitro against 282 clinical and environmental Fusarium isolates. RESULTS Fusarium species demonstrated high MICs/MECs values to the most commonly used antifungal drugs in clinical practice. The geometric mean (GM) MICs for luliconazole (0.004 μg/ml) and lanoconazole (0.012 μg/ml) were the lowest, followed by efinaconazole (0.98 μg/ml) and amphotericin B (1.04 μg/ml). CONCLUSIONS Efinaconazole, a novel triazole, may be a promising candidate for the treatment of superficial Fusarium infections. Furthermore, the development of systemic formulations of these drugs as well as further in vitro and in vivo investigations could aid in the treatment of systemic fusariosis.
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Affiliation(s)
- Mohsen Nosratabadi
- 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
| | - Leila Faeli
- 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
| | - Rasoul Mohammadi
- Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sadegh Khodavaisy
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Kachuei
- Molecular Biology Research Center, Systems Biology and Poisonings Institute, Baqiyatallah, Tehran, Iran
| | - Farzad Katiraee
- Department of Pathobiology, Faculty of Veterinary Medicine, University of Tabriz, Tehran, 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
| | - 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
| | - 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
| | - Mehdi Nazeri
- Infectious Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohammad Javan-Nikkhah
- Department of Plant Protection, College of Agriculture and Natural Resources, University of Tehran, Karaj, Iran
| | - Hossein Zarrinfar
- Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, 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
| | - Mohammad-Javad Najafzadeh
- Department of Parasitology and Mycology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Salimi
- 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
| | - Abdullah M S Al Hatmi
- Natural & Medical Sciences Research Center, University of Nizwa, Nizwa, Oman.,Center of Expertise in Mycology, Radboud University Medical Center/Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
| | - Hamid Badali
- Department of Molecular Microbiology & Immunology, South Texas Center for Emerging Infectious Diseases, The University of Texas at San Antonio, Texas, San Antonio, USA
| | - 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
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A Practical Workflow for the Identification of Aspergillus, Fusarium, Mucorales by MALDI-TOF MS: Database, Medium, and Incubation Optimization. J Clin Microbiol 2022; 60:e0103222. [PMID: 36326257 PMCID: PMC9769873 DOI: 10.1128/jcm.01032-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
There is an increasing body of literature on the utility of MALDI-TOF MS in the identification of filamentous fungi. However, the process still lacks standardization. In this study, we attempted to establish a practical workflow for the identification of three clinically important molds: Aspergillus, Fusarium, and Mucorales using MALDI-TOF MS. We evaluated the performance of Bruker Filamentous Fungi database v3.0 for the identification of these fungi, highlighting when there would be a benefit of using an additional database, the MSI-2 for further identification. We also examined two other variables, namely, medium effect and incubation time on the accuracy of fungal identification. The Bruker database achieved correct species level identification in 85.7% of Aspergillus and 90% of Mucorales, and correct species-complex level in 94.4% of Fusarium. Analysis of spectra using the MSI-2 database would also offer additional value for species identification of Aspergillus species, especially when suspecting species with known identification limits within the Bruker database. This issue would only be of importance in selected cases where species-level identification would impact therapeutic options. Id-Fungi plates (IDFP) had almost equivalent performance to Sabouraud dextrose agar (SDA) for species-level identification of isolates and enabled an easier harvest of the isolates with occasional faster identification. Our study showed accurate identification at 24 h for Fusarium and Mucorales species, but not for Aspergillus species, which generally required 48 h.
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Sobhy N, Talla Eweed H, Omar SS. Fractional CO2 laser - assisted methylene blue photodynamic therapy is a potential alternative therapy for onychomycosis in the era of antifungal resistance. Photodiagnosis Photodyn Ther 2022; 40:103149. [PMID: 36228978 DOI: 10.1016/j.pdpdt.2022.103149] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/05/2022] [Accepted: 10/07/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Treatment of onychomycosis is challenging by virtue of the impact of nail disfigurement, the location of the fungi within the nail and reported antifungal resistance worldwide. Light-based technologies are promising primary or adjunctive therapeutic modalities. We aimed to compare the efficacy of photodynamic therapy and fractional CO2 laser monotherapy either alone or in combination for onychomycosis. PATIENTS AND METHODS This prospective randomized comparative study was conducted on 51 onychomycosis patients divided into three groups. In group A, patients were treated using 6 photodynamic therapy sessions using methylene blue and IPL (560 to 700 nm, fluence 12 J/cm2). Group B patients were treated using 6 bimonthly fractional CO2 laser sessions (10,600 nm, 1.600 mj energy and 0.6 mm density) and group C patients were treated using 6 combined fractional CO2 laser and photodynamic therapy sessions. Patients were evaluated mycologically, dermoscopically and clinically by calculation of proximal nail diameter percentage at baseline, monthly, at the end of treatment and after a 6-month follow-up period post-treatment. RESULTS Candida was the most commonly isolated organismin in 64.7%, 70.6% and 70.6% of the pateints in groups A, B and C, respectively. The dermoscopic findings in the total dystrophic onychomycosis was subungual hyperkeratosis in 6 patients (100%), longitudinal streaks and striae in 1 patient (16.7%). In dorsolateral subungual onychomycosis, jagged proximal edge in 31 patients (70.5%), and pigmentation in 30 patients (68.2%) were noted. In proximal subungual onychomycosis irregular matt patches were seen in 1 patient (100%). Proximal nail diameter percentage showed statistically significant improvement after treatment and 6 months follow up in the 3 studied groups. Mean increase of proximal nail diameter after treatment was highest in group C (52.94 ± 20.24), followed by group B (43.82 ± 21.03) and least in group A (35.29 ± 17.0). This difference was statistically significant (p = 0.044). Reported side effects were mild-moderate pain, discoloration and paronychia. CONCLUSION We conclude that fractional CO2 laser and photodynamic monotherapy, and their combination achieve high success rates, good patient satisfaction and safety profile. Fractional CO2-assisted photodynamic therapy is associated with the highest improvement over either fractional CO2 or photodynamic therapy alone.
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Affiliation(s)
- Nagat Sobhy
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Alexandria University, Elkhartoum Square 21521, Egypt
| | - Heba Talla Eweed
- Bakkous Dermatology Clinic, Ministry of Health, Alexandria, Egypt
| | - Salma Samir Omar
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Alexandria University, Elkhartoum Square 21521, Egypt.
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Efficacy of Propolis Gel on Mature Biofilm Formed by Neocosmospora keratoplastica Isolated from Onychomycosis. J Fungi (Basel) 2022; 8:jof8111216. [DOI: 10.3390/jof8111216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/06/2022] [Accepted: 11/15/2022] [Indexed: 11/18/2022] Open
Abstract
This article describes Neocosmospora keratoplastica as an etiological onychomycosis agent. Ex vivo studies were initially performed to demonstrate the ability of this species to grow and form a well-organized characteristic biofilm on sterilized healthy nails. Based on the history of excellent results, both for antifungal and antibiofilm, of propolis resin gum, we evaluated its activity using artificially formed biofilm. In vitro, the minimal biofilm eradication concentration of the propolis extract (PE) was 375 µg of total polyphenol content (TPC) per mL, while for the propolis gel (PG) it was 450 µg of TPC per mL. In biofilm exposed to the propolis products, a decrease in hyphae and conidia was evident, accompanied by a disorganization of the extracellular matrix. Additionally, this low concentration of PE was able to significantly reduce the number of colony-forming units and the metabolic activity. Furthermore, the treatment of a 15-year nail infection due to N. keratoplastica was carried out exclusively using a topical treatment with a gel containing propolis (30%) with a daily dosage. This treatment achieved complete remission of the onychomycosis in 12 months. It is important to point out that some inconveniences previously reported by other patients treated with propolis extract were eliminated, increasing adherence to treatment.
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Guo P, Chen J, Tan Y, Xia L, Zhang W, Li X, Jiang Y, Li R, Chen C, Liao K, Peng Y. Comparison of molecular and MALDI-TOF MS identification and antifungal susceptibility of clinical Fusarium isolates in Southern China. Front Microbiol 2022; 13:992582. [PMID: 36386677 PMCID: PMC9664484 DOI: 10.3389/fmicb.2022.992582] [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: 07/12/2022] [Accepted: 08/22/2022] [Indexed: 12/04/2023] Open
Abstract
BACKGROUND Fusarium species are opportunistic causative agents of superficial and disseminated human infections. Fast and accurate identification and targeted antifungal therapy give help to improve the patients' prognosis. OBJECTIVES This study aimed to evaluate the effectiveness of matrix-assisted laser desorption ionisation time of flight mass spectrometry (MALDI-TOF MS) for Fusarium identification, and investigate the epidemiology and antifungal susceptibility profiles of clinical Fusarium isolates in Southern China. METHODS There were 95 clinical Fusarium isolates identified by DNA sequencing of translation elongation factor 1-alpha (TEF1α) and MALDI-TOF MS, respectively. Antifungal susceptibility testing of isolates was performed by broth microdilution according to the CLSI approved standard M38-A3 document. RESULTS Seven species complexes (SC) with 17 Fusarium species were identified. The most prevalent SC was the F. solani SC (70.5%, 67/95), followed by the F. fujikuroi SC (16.8%, 16/95). F. keratoplasticum within the F. solani SC was the most prevalent species (32.6%, 31/95). There were 91.6% (87/95) of isolates identified by MALDI-TOF MS at the SC level. In most of species, amphotericin B and voriconazole showed lower MICs compared to itraconazole and terbinafine. The F. solani SC showed higher MICs to these antifungal agents compared to the other SCs. There were 10.5% (10/95) of strains with high MICs for amphotericin B (≥8 μg/ml), terbinafine (≥32 μg/ml) and itraconazole (≥32 μg/ml) simultaneously, mostly focusing on F. keratoplasticum (9/10). CONCLUSION MALDI-TOF MS exhibited good performance on the identification of Fusarium strains at the SC level. The F. solani SC was the most prevalent clinical SC in Southern China. The MICs varied significantly among different species or SCs to different antifungal agents.
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Affiliation(s)
- Penghao Guo
- Department of Clinical Laboratory, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jianlong Chen
- Department of Clinical Laboratory, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yiwei Tan
- Department of Clinical Laboratory, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Li Xia
- Department of Clinical Laboratory, Jieyang People’s Hospital, Jieyang, China
| | - Weizheng Zhang
- Department of Clinical Laboratory, Guangzhou No.11 People’s Hospital, Guangzhou, China
| | - Xiaojie Li
- Department of Clinical Laboratory, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Yujie Jiang
- Department of Clinical Laboratory, Central Hospital of Guangdong Nongken, Zhanjiang, China
| | - Ruiying Li
- Department of Clinical Laboratory, The First Affiliated Hospital, Guangdong Pharmaceutical University, Guangzhou, China
| | - Chunmei Chen
- Department of Clinical Laboratory, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China
| | - Kang Liao
- Department of Clinical Laboratory, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yaqin Peng
- Department of Clinical Laboratory, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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Nosratabadi M, Akhtari J, Faeli L, Haghani I, Aghili SR, Shokohi T, Hedayati MT, Zarrinfar H, Mohammadi R, Najafzadeh MJ, Khodavaisy S, Al-Harrasi A, Javan-Nikkhah M, Kachuei R, Salimi M, Fattahi M, Badali H, Al Hatmi AMS, Abastabar M. In Vitro Antifungal Susceptibility Profile of Miltefosine against a Collection of Azole and Echinocandins Resistant Fusarium Strains. J Fungi (Basel) 2022; 8:jof8070709. [PMID: 35887464 PMCID: PMC9315751 DOI: 10.3390/jof8070709] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 06/02/2022] [Accepted: 06/07/2022] [Indexed: 02/01/2023] Open
Abstract
Fusarium species are filamentous fungi that cause a variety of infections in humans. Because they are commonly resistant to many antifungal drugs currently available in clinical settings, research into alternative targets in fungal cells and therapeutic approaches is required. The antifungal activity of miltefosine and four comparators, amphotericin B, voriconazole, itraconazole, and caspofungin, were tested in vitro against a collection of susceptible and resistant clinical (n = 68) and environmental (n = 42) Fusarium isolates. Amphotericin B (0.8 μg/mL) had the lowest geometric mean (GM) MICs/MECs values followed by miltefosine (1.44 μg/mL), voriconazole (2.15 μg/mL), caspofungin (7.23 μg/mL), and itraconazole (14.19 μg/mL). Miltefosine was the most effective agent against Fusarium isolates after amphotericin B indicating that miltefosine has the potential to be studied as a novel treatment for Fusarium infections.
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Affiliation(s)
- Mohsen Nosratabadi
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari 4816983663, Iran; (M.N.); (L.F.); (I.H.); (S.R.A.); (T.S.); (M.T.H.); (M.S.)
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari 4816983663, Iran
| | - Javad Akhtari
- Department of Medical Nanotechnology, School of Advanced Technologies in Medicine, Mazandaran University of Medical Sciences, Sari 4816983663, Iran;
| | - Leila Faeli
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari 4816983663, Iran; (M.N.); (L.F.); (I.H.); (S.R.A.); (T.S.); (M.T.H.); (M.S.)
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari 4816983663, Iran
| | - Iman Haghani
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari 4816983663, Iran; (M.N.); (L.F.); (I.H.); (S.R.A.); (T.S.); (M.T.H.); (M.S.)
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari 4816983663, Iran
| | - Seyed Reza Aghili
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari 4816983663, Iran; (M.N.); (L.F.); (I.H.); (S.R.A.); (T.S.); (M.T.H.); (M.S.)
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari 4816983663, Iran
| | - Tahereh Shokohi
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari 4816983663, Iran; (M.N.); (L.F.); (I.H.); (S.R.A.); (T.S.); (M.T.H.); (M.S.)
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari 4816983663, Iran
| | - Mohammad Taghi Hedayati
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari 4816983663, Iran; (M.N.); (L.F.); (I.H.); (S.R.A.); (T.S.); (M.T.H.); (M.S.)
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari 4816983663, Iran
| | - Hossein Zarrinfar
- Allergy Research Center, Mashhad University of Medical Sciences, Mashhad 9176699199, Iran;
| | - Rasoul Mohammadi
- Department of Medical Parasitology and Mycology, Infectious Diseases and Tropical Medicine Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan 8174673461, Iran;
| | - Mohammad Javad Najafzadeh
- Department of Parasitology and Mycology, School of Medicine, Mashhad University of Medical Sciences, Mashhad 9176699199, Iran;
| | - Sadegh Khodavaisy
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran 1717613151, Iran;
| | - Ahmed Al-Harrasi
- Natural & Medical Sciences Research Center, University of Nizwa, Nizwa 616, Oman;
| | - Mohammad Javan-Nikkhah
- Department of Plant Protection, College of Agriculture and Natural Resources, University of Tehran, Karaj 3158777871, Iran;
| | - Reza Kachuei
- Molecular Biology Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran 1435916471, Iran;
| | - Maryam Salimi
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari 4816983663, Iran; (M.N.); (L.F.); (I.H.); (S.R.A.); (T.S.); (M.T.H.); (M.S.)
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari 4816983663, Iran
| | - Mahsa Fattahi
- Centre for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran 1416613675, Iran;
| | - Hamid Badali
- South Texas Center for Emerging Infectious Diseases, Department of Molecular Microbiology and Immunology, The University of Texas at San Antonio, San Antonio, TX 78249, USA;
| | - Abdullah M. S. Al Hatmi
- Natural & Medical Sciences Research Center, University of Nizwa, Nizwa 616, Oman;
- Center of Expertise in Mycology, Radboud University Medical Center/Canisius Wilhelmina Hospital, 6532 SZ Nijmegen, The Netherlands
- Correspondence: (A.M.S.A.H.); (M.A.); Tel.: +968-25446654 (A.M.S.A.H.); +98-9112111347 (M.A.); Fax: +968-25446612 (A.M.S.A.H.); +98-33543248 (M.A.)
| | - Mahdi Abastabar
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari 4816983663, Iran; (M.N.); (L.F.); (I.H.); (S.R.A.); (T.S.); (M.T.H.); (M.S.)
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari 4816983663, Iran
- Correspondence: (A.M.S.A.H.); (M.A.); Tel.: +968-25446654 (A.M.S.A.H.); +98-9112111347 (M.A.); Fax: +968-25446612 (A.M.S.A.H.); +98-33543248 (M.A.)
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11
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da Rosa Monte Machado G, Neiva Lavorato S, Lopes W, Henning Vainstein M, Lettieri Teixeira M, José Alves R, de Andrade SF, Meneghello Fuentefria A. A chloroacetamide derivative as a potent candidate for fusariosis treatment. Braz J Microbiol 2022; 53:1289-1295. [PMID: 35648381 DOI: 10.1007/s42770-022-00771-9] [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: 05/25/2021] [Accepted: 12/24/2021] [Indexed: 11/27/2022] Open
Abstract
Fusariosis has presented a significant increase in their incidence in the last years. This epidemiological panorama probably is due to the increasing profile of refractory susceptibility of Fusarium spp. to available drugs, especially in immunocompromised individuals. Thus, the development of new compounds with effectiveness on these organisms is a necessity. This study evaluated the antifungal potential of a chloroacetamide derivative (4-BFCA) against resistant Fusarium strains. As a result, the compound was effective against all strains (MIC range 12.5-50 μg/mL). The time kill assay demonstrated that 4-BFCA presents a concentration-dependent fungicidal action. Although its action mechanism has not yet been elucidated, it was possible to observe its efficacy through damages and alterations provoked along the hyphae of Fusarium spp. 4-BFCA maintained a high survival rate of Tenebrio molitor larvae, suggesting that it does not cause acute systemic toxicity on this host at the concentration evaluated. In addition, 4-BFCA was 83.33% effective in combating a fungal infection in vivo on the chorioallantoid membrane of embryonated eggs. Our results are very promising and arouse interest to investigate the action of 4-BFCA on Fusarium strains since it acts as a possible candidate for the development of new therapies for the treatment of fusariosis.
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Affiliation(s)
- Gabriella da Rosa Monte Machado
- Graduate Program in Agricultural Microbiology and Environment, Federal University of Rio Grande Do Sul, Sarmento Leite no 500 - Farroupilha, Porto Alegre, RS, 90050-170, Brazil. .,Laboratório de Pesquisa Em Micologia Aplicada, Faculdade de Farmácia, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil.
| | - Stefânia Neiva Lavorato
- Center for Biological and Health Sciences, Federal University of Oeste da Bahia, Rua da Prainha no 1326 Morada Nobre, Barreiras, BA, 47810-047, Brazil
| | - William Lopes
- Biotechnology Center, Federal University of Rio Grande Do Sul, Bento Gonçalves no 9500 - Campus do Vale, Porto Alegre, RS, 91501-970, Brazil
| | - Marilene Henning Vainstein
- Biotechnology Center, Federal University of Rio Grande Do Sul, Bento Gonçalves no 9500 - Campus do Vale, Porto Alegre, RS, 91501-970, Brazil
| | - Mário Lettieri Teixeira
- Pharmacology Laboratory, Federal Catarinense Institute, Highway SC 283 - Fragosos, Campus Concórdia, Concórdia, SC, 89703-720, Brazil
| | - Ricardo José Alves
- Department of Pharmaceutical Products, Faculty of Pharmacy, Federal University of Minas Gerais, Presidente Antônio Carlos no 6627 - Campus Pampulha, Belo Horizonte, Belo Horizonte, MG, 31270-901, Brazil
| | - Saulo Fernandes de Andrade
- Graduate Program in Agricultural Microbiology and Environment, Federal University of Rio Grande Do Sul, Sarmento Leite no 500 - Farroupilha, Porto Alegre, RS, 90050-170, Brazil
| | - Alexandre Meneghello Fuentefria
- Graduate Program in Agricultural Microbiology and Environment, Federal University of Rio Grande Do Sul, Sarmento Leite no 500 - Farroupilha, Porto Alegre, RS, 90050-170, Brazil
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12
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Uemura EVG, Barbosa MDS, Simionatto S, Al-Harrasi A, Al-Hatmi AMS, Rossato L. Onychomycosis Caused by Fusarium Species. J Fungi (Basel) 2022; 8:jof8040360. [PMID: 35448591 PMCID: PMC9027400 DOI: 10.3390/jof8040360] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 03/25/2022] [Accepted: 03/29/2022] [Indexed: 02/04/2023] Open
Abstract
Onychomycosis is a nail fungal infection that produces nail discolouration, thickness, and separation from the nail bed. The species of the Fusarium genus that cause onychomycosis are emerging and the number of cases has increased throughout the years. Microscopic examination, as well as cultures, are required for the accurate diagnosis of onychomycosis. The goal of treatment is to eliminate the organism that causes the disease and restore the nail’s normal appearance. Here, we provide an overview of the onychomycosis cases that have been reported in literature over the last 24 years, which have been caused by the Fusarium species. We performed a review on the onychomycosis cases caused by the Fusarium species from January 1997 to January 2021. Patients aged between 40 and 49 years made up 30.23% of the cases. The most common aetiologic species was Fusarium solani species complex (FSSC), which accounted for 44.11% of the cases, followed by F. fujikuroi species complex (FFSC), which accounted for 17.64%; 14.70% of the cases were due to F. dimerum species complex (FDSC) and 14.70% of the cases were due F. oxysporum species complex (FOSC). Europe accounted for 29.06% of the cases caused by FOSC, whereas Africa accounted for 46.67% of the cases due to FSSC. The clinical presentation of onychomycosis due to Fusarium spp. is commonly the distal–lateral pattern of onychomycosis. Identification of the infectious agent in onychomycosis cases due to Fusarium is crucial in deciding the proper treatment. Although antifungal susceptibility tests have only been performed in a few cases, susceptibility testing can help with patient management.
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Affiliation(s)
- Eduardo Vinicius Grego Uemura
- Faculdade de Ciências da Saúde, Universidade Federal da Grande Dourados, Dourados 79862-000, MS, Brazil; (E.V.G.U.); (M.d.S.B.); (S.S.)
| | - Marcelo dos Santos Barbosa
- Faculdade de Ciências da Saúde, Universidade Federal da Grande Dourados, Dourados 79862-000, MS, Brazil; (E.V.G.U.); (M.d.S.B.); (S.S.)
- Laboratório de Pesquisa em Ciências da Saúde, Universidade Federal da Grande Dourados, Dourados 79862-000, MS, Brazil
| | - Simone Simionatto
- Faculdade de Ciências da Saúde, Universidade Federal da Grande Dourados, Dourados 79862-000, MS, Brazil; (E.V.G.U.); (M.d.S.B.); (S.S.)
| | - Ahmed Al-Harrasi
- Natural & Medical Sciences Research Center, University of Nizwa, Nizwa 616, Oman; (A.A.-H.); (A.M.S.A.-H.)
| | - Abdullah M. S. Al-Hatmi
- Natural & Medical Sciences Research Center, University of Nizwa, Nizwa 616, Oman; (A.A.-H.); (A.M.S.A.-H.)
- Centre of Expertise in Mycology, Radboud University Medical Centre/Canisius Wilhelmina Hospital, 6532 SZ Nijmegen, The Netherlands
| | - Luana Rossato
- Faculdade de Ciências da Saúde, Universidade Federal da Grande Dourados, Dourados 79862-000, MS, Brazil; (E.V.G.U.); (M.d.S.B.); (S.S.)
- Correspondence: ; Tel.: +55-11-971224947
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13
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Veiga FF, de Castro-Hoshino LV, Sato F, Baesso ML, Silva S, Negri M, Svidzinski TIE. Characterization of a biofilm formed by Fusarium oxysporum on the human nails. Int J Dermatol 2021; 61:191-198. [PMID: 34235733 DOI: 10.1111/ijd.15747] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 04/06/2021] [Accepted: 06/10/2021] [Indexed: 01/26/2023]
Abstract
BACKGROUND Fusarium spp. has been considered as an onychomycosis agent, but little is known about the etiopathogenesis of fusarial onychomycosis; thus, the objective of this study was to characterize the fungal-nail interaction and the consequences of the nail infection process by Fusarium oxysporum using the human nail, in an ex␣vivo model. METHODS The kinetic of biofilm production and infection by F. oxysporum using the nail as the only nutritional source were evaluated by scanning electron microscopy, number of culturable cells, metabolic activity, characterization of extracellular matrix, spectroscopy and histopathology analyses. RESULTS After evaluating the biofilm kinetic over 7 days using different parameters and techniques, it was possible to characterize the Fusarium-nail interaction. CONCLUSIONS This study is a part of a big project aiming to clarify the fusarial pathogenesis and contributes to proving F. oxysporum is able to adapt, grow, develop, and form a biofilm on healthy human nails, which are crucial steps for the invasion process.
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Affiliation(s)
- Flavia Franco Veiga
- Departamento de Análises Clínicas e Biomedicina, Universidade Estadual de Maringá (UEM), Maringá, Brazil
| | | | - Francielle Sato
- Departamento de Física, Universidade Estadual de Maringá (UEM), Maringá, Brazil
| | | | - Sónia Silva
- CEB - Centre of Biological Engineering, LIBRO - Laboratório de Investigação em Biofilmes Rosário Oliveira, University of Minho, Braga, Portugal
| | - Melyssa Negri
- Departamento de Análises Clínicas e Biomedicina, Universidade Estadual de Maringá (UEM), Maringá, Brazil
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14
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Song Y, Liu X, Yang Z, Meng X, Xue R, Yu J, Al-Hatmi AMS, de Hoog GS, Li R. Molecular and MALDI-ToF MS differentiation and antifungal susceptibility of prevalent clinical Fusarium species in China. Mycoses 2021; 64:1261-1271. [PMID: 34173979 DOI: 10.1111/myc.13345] [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: 05/01/2021] [Revised: 06/19/2021] [Accepted: 06/22/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Fusarium species are emerging causative agents of superficial and disseminated human infections. Early diagnosis and treatment contribute to better prognosis of severe infection. OBJECTIVES To detect the effectiveness of matrix-assisted laser desorption ionisation time of flight mass spectrometry (MALDI-ToF MS) for Fusarium identification, and evaluate the susceptibility profiles to clinical available antifungals. METHODS All 203 clinical Fusarium isolates and 25 environmental isolates were identified by using translation elongation factor 1-alpha (TEF1) and RNA polymerase subunit II (RPB2) sequencing and MALDI-ToF MS. Antifungal susceptibility testing was determined by a microdilution method following the CLSI approved standard M38-A3 document. RESULTS Correct identification rates at the species and genus levels were 89.04% (203/228) and 95.18% (217/228), respectively, using Bruker Filamentous Fungi Library 1.0 combined with the novel database. Seven species complexes with 19 Fusarium species were identified, including F. solani (59.21%, n = 135), F. verticillioides (17.54%, n = 40), F. proliferatum (6.58%, n = 15) and F. oxysporum (4.39%, n = 10). Four uncommon species complexes (F. incarnatum-equiseti SC, F. dimerum SC, F. redolens SC and F. sporotrichioides SC) were also identified. A high degree of antifungal resistance was observed. Fusarium isolates exhibited lower MICs to luliconazole and terbinafine compared with amphotericin B and voriconazole, which in turn were significantly more active than amorolfine, fluconazole and itraconazole. CONCLUSIONS MALDI-ToF MS showed good performance in Fusarium species with an adapted Bruker library and expanded database. Fusarium isolates exhibited lower MICs to luliconazole and terbinafine compared to amphotericin B and voriconazole.
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Affiliation(s)
- Yinggai Song
- Department of Dermatology and Venerology, Peking University First Hospital, Beijing, China.,Research Center for Medical Mycology, Peking University, Beijing, China.,National Clinical Research Center for Skin and Immune Diseases, Beijing, China.,Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China
| | - Xiao Liu
- Department of Dermatology and Venerology, Peking University First Hospital, Beijing, China.,Research Center for Medical Mycology, Peking University, Beijing, China.,National Clinical Research Center for Skin and Immune Diseases, Beijing, China.,Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China
| | - Zhining Yang
- Department of Clinical Laboratory, Shanxi Provincial People's Hospital, Shanxi, China
| | - Xingye Meng
- Department of Dermatology and Venerology, Peking University First Hospital, Beijing, China.,Research Center for Medical Mycology, Peking University, Beijing, China.,National Clinical Research Center for Skin and Immune Diseases, Beijing, China.,Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China
| | - Ruoning Xue
- Department of Dermatology and Venerology, Peking University First Hospital, Beijing, China.,Research Center for Medical Mycology, Peking University, Beijing, China.,National Clinical Research Center for Skin and Immune Diseases, Beijing, China.,Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China
| | - Jin Yu
- Department of Dermatology and Venerology, Peking University First Hospital, Beijing, China.,Research Center for Medical Mycology, Peking University, Beijing, China.,National Clinical Research Center for Skin and Immune Diseases, Beijing, China.,Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China
| | | | - G Sybren de Hoog
- Research Center for Medical Mycology, Peking University, Beijing, China.,Natural and Medical Sciences Research Center, Nizwa, Oman.,Center of Expertise in Mycology of Radboud University Medical Center/Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
| | - Ruoyu Li
- Department of Dermatology and Venerology, Peking University First Hospital, Beijing, China.,Research Center for Medical Mycology, Peking University, Beijing, China.,National Clinical Research Center for Skin and Immune Diseases, Beijing, China.,Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China
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15
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Conrado PCV, Sakita KM, Arita GS, Gonçalves RS, Cesar GB, Caetano W, Hioka N, Voidaleski MF, Vicente VA, Svidzinski TIE, Bonfim-Mendonça PS, Kioshima ES. Hypericin-P123-photodynamic therapy in an ex vivo model as an alternative treatment approach for onychomycosis caused by Fusarium spp. Photodiagnosis Photodyn Ther 2021; 35:102414. [PMID: 34186264 DOI: 10.1016/j.pdpdt.2021.102414] [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: 03/23/2021] [Revised: 05/28/2021] [Accepted: 06/22/2021] [Indexed: 10/21/2022]
Abstract
BackgroundFusarium has been considered an opportunistic pathogen, causing several infections in humans, including onychomycosis. In addition, a high resistance to conventional antifungals has been linked to this genus. Photodynamic Therapy (PDT), known as a non-invasive therapy, can be an alternative treatment for fungal infections, based on the excitation of a photosensitizing compound (PS) by a specific length of light, causing damage to the target. The aim of this study was to evaluate the effects of a formulation of Hypericin (Hyp) encapsulated in Pluronic™ (P123), via photodynamic therapy (PDT), on planktonic cells and biofilms in Fusarium spp. using in vitro and ex vivo assays. Materials & Methods epidemiology studies about Fusarium spp. in onychomycosis was perfomed, carried out molecular identification, compared the antifungal activity of the conventional antifungals with PDT with encapsulated Hypericin (Hyp-P123), carried out detection of reactive oxygen species, and measured the antibiofilm effect of the Hyp-P123-PDT in vitro and in an ex vivo model of onychomycosis. Results Hyp-P123-PDT exhibited a fungicidal effect in vitro with reductions ≥ 3 log10. ROS generation increased post-Hyp-P123-PDT in Fusarium spp. Hyp-P123-PDT showed a potent inhibitory effect on adhesion-phase and mature biofilms in vitro tests and an ex vivo model of onychomycosis (p<0.0001). Conclusion Hyp-P123-PDT had a potent effect against Fusarium spp., suggesting that photodynamic therapy with Hyp-P123 is a safe and promising treatment for onychomycosis in clinical practice.
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Affiliation(s)
- Pollyanna C V Conrado
- Department of Analysis Clinics and Biomedicine, State University of Maringa, Parana, Brazil
| | - Karina M Sakita
- Department of Analysis Clinics and Biomedicine, State University of Maringa, Parana, Brazil
| | - Glaucia S Arita
- Department of Analysis Clinics and Biomedicine, State University of Maringa, Parana, Brazil
| | | | - Gabriel B Cesar
- Department of Chemistry, State University of Maringa, Parana, Brazil
| | - Wilker Caetano
- Department of Chemistry, State University of Maringa, Parana, Brazil
| | - Noboru Hioka
- Department of Chemistry, State University of Maringa, Parana, Brazil
| | - Morgana F Voidaleski
- Department of Pathology Basic, State Federal University of Parana, Parana, Brazil
| | - Vania A Vicente
- Department of Pathology Basic, State Federal University of Parana, Parana, Brazil
| | | | | | - Erika S Kioshima
- Department of Analysis Clinics and Biomedicine, State University of Maringa, Parana, Brazil.
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16
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Phaitoonwattanakij S, Leeyaphan C, Lertrujiwanit K, Bunyaratavej S. Predisposing factors, clinical features and treatment outcomes of Fusarium onychomycosis and comparison of its characteristics with Neoscytalidium onychomycosis. J Mycol Med 2021; 31:101165. [PMID: 34171603 DOI: 10.1016/j.mycmed.2021.101165] [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: 01/09/2021] [Revised: 06/01/2021] [Accepted: 06/02/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Fusarium spp. are common organisms causing onychomycosis. Research on the clinical presentations and treatment of this condition is limited. OBJECTIVE This study evaluated the demographic data, clinical characteristics, and treatment outcomes of Fusarium onychomycosis. METHODS A retrospective study was conducted at Siriraj Hospital, Thailand. Patients with onychomycosis, at least 2 repeated positive mycological cultures for Fusarium spp., and a photo at diagnosis (January 2014-December 2019) were included. Demographic data and clinical characteristics of Fusarium onychomycosis were analyzed and compared with those of Neoscytalidium onychomycosis, the other common nondermatophytes onychomycosis in tropical countries. RESULTS Seventeen patients with twenty-four nails were analyzed. Fusarium onychomycosis was significantly related to a history of pedicure (p = 0.04). Predominant lateral involvements of subungual hyperkeratosis onychomycosis, but without concurrent foot infections, were significantly found in Fusarium onychomycosis (p < 0.001 for each). Among the treatments, urea was 80% effective. Topical amphotericin B was 75% effective. Both amorolfine 5% nail lacquer and long-pulsed 1064-nm neodymium:yttrium-aluminum-garnet laser were 66.7% effective. Lastly a combination of long-pulsed 1064-nm neodymium:yttrium-aluminum-garnet laser and amorolfine 5% nail lacquer was 50% effective. CONCLUSIONS Important predisposing factors and clinical manifestations of Fusarium onychomycosis were a history of pedicure and predominant lateral-nail involvement, but no concomitant fungal foot infections. Topical treatment (urea cream, amphotericin B, or amorolfine nail lacquer) showed excellent outcomes.
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Affiliation(s)
| | - Charussri Leeyaphan
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
| | - Kamonpan Lertrujiwanit
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Sumanas Bunyaratavej
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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17
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Das L, Dahiya D, Gupta K, Prakash M, Malhotra B, Rastogi A, Choudhary H, Rudramurthy SM, Dutta P. Eumycetoma of the Foot due to Fusarium solani in a Person with Diabetes Mellitus: Report of a Case and Review of Literature. Mycopathologia 2021; 186:277-288. [PMID: 33687638 DOI: 10.1007/s11046-020-00524-y] [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: 10/10/2020] [Accepted: 12/21/2020] [Indexed: 10/20/2022]
Abstract
Eumycetomas are chronic suppurative granulomas caused by fungi characterised by invasive tumefactive lesions, sinuses and discharging grains. Herein, we describe a case of pedal eumycetoma due to Fusarium solani sensu stricto in a person with diabetes mellitus. A 45-year-old gentleman presented with an insidious onset swelling over his right foot with nodules and discharging grains. He had received itraconazole and anti-tuberculous therapy elsewhere, without response. Re-evaluation included a biopsy which confirmed eumycetoma and newly diagnosed diabetes. Surgical excision followed by histopathological, microbiological and multigene sequencing analyses [translation elongation factor, calmodulin and internal transcribed spacer region of rDNA] of the mould on culture were performed. Histopathology revealed septate fungal hyphae amidst a dense inflammatory infiltrate (Splendore-Hoeppli) reaction. Oral voriconazole was started and good glycemic control attained. Tissue growth sequences showed > 99% similarity with Fusarium solani sensu stricto. Antifungal susceptibility testing showed lowest MIC to voriconazole (0.5 mg/L). The patient showed excellent response to combined therapeutic modality with a near-complete resolution in size of lesion and obliteration of sinuses following 4 months of therapy and is planned for prolonged voriconazole therapy till complete radiological resolution. Diabetes predisposes to fungal infections of foot but eumycetomas are uncommon. Combined surgery and antifungals can improve morbidity and avoid amputations.
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Affiliation(s)
- Liza Das
- Department of Endocrinology, PGIMER, 1012, Nehru Hospital Extension Block, Chandigarh, 160012, India
| | - Divya Dahiya
- Department of General Surgery, PGIMER, Chandigarh, India
| | - Kirti Gupta
- Department of Histopathology, PGIMER, Chandigarh, India
| | | | - Bhanu Malhotra
- Department of Endocrinology, PGIMER, 1012, Nehru Hospital Extension Block, Chandigarh, 160012, India
| | - Ashu Rastogi
- Department of Endocrinology, PGIMER, 1012, Nehru Hospital Extension Block, Chandigarh, 160012, India
| | - Hansraj Choudhary
- Department of Medical Microbiology, PGIMER, Nehru Hospital, Research Block A, Chandigarh, India
| | | | - Pinaki Dutta
- Department of Endocrinology, PGIMER, 1012, Nehru Hospital Extension Block, Chandigarh, 160012, India.
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18
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Reinel D. Non-dermatophyte fungi in onychomycosis-Epidemiology and consequences for clinical practice. Mycoses 2021; 64:694-700. [PMID: 33539562 DOI: 10.1111/myc.13251] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 01/31/2021] [Accepted: 02/01/2021] [Indexed: 12/22/2022]
Abstract
Onychomycoses are difficult-to-treat fungal infections with a high recurrence rate that relates to the anatomic and pathophysiological conditions in the nail organ and the required extended duration of treatment. Clinical-epidemiological studies demonstrated that non-dermatophyte molds and yeasts are the primary causative agents in 20%-30% of onychomycoses. Mixed infections with dermatophytes are observed as well. Therefore, the causative agents should be determined by fungal culture and the antifungal treatment regimen should reliably cover non-dermatophytes, if appropriate. Systemic-topical combination therapy involving a broad-spectrum, locally applied antifungal may increase the mycological and clinical cure rates compared to monotherapy with systemic drugs.
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19
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Souza L, Nouér SA, Morales H, Simões B, Solza C, Queiroz-Telles F, Nucci M. Epidemiology of invasive fungal disease in haematologic patients. Mycoses 2020; 64:252-256. [PMID: 33141969 DOI: 10.1111/myc.13205] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 10/27/2020] [Accepted: 10/30/2020] [Indexed: 12/15/2022]
Abstract
Invasive fungal disease (IFD) is frequent in patients with haematologic malignancies and in recipients of haematopoietic cell transplantation (HCT). An epidemiologic study conducted in Brazil reported a high incidence of IFD in haematologic patients, and invasive fusariosis was the leading IFD. A limitation of that study was that galactomannan was not available for at least half of the study period. In order to characterise the epidemiology and burden of IFD in three cohorts, HCT, acute myeloid leukaemia (AML) or myelodysplasia (MDS), and acute lymphoid leukaemia (ALL), we conducted a prospective multicentre cohort study in four haematologic Brazilian centres. From August 2015 to July 2016, all patients receiving induction chemotherapy for newly diagnosed or relapsed AML, MDS or ALL, and all HCT recipients receiving conditioning regimen were followed during the period of neutropenia following chemotherapy or the conditioning regimen. During a 1-year period, 192 patients were enrolled: 122 HCT recipients (71 allogeneic, 51 autologous), 46 with AML, and 24 with ALL. The global incidence of IFD was 13.0% (25 cases, 11 proven and 14 probable). Invasive aspergillosis (14 cases) was the leading IFD, followed by candidemia (6 cases) and fusariosis (3 cases). The incidence of IFD was 26.1% in AML/MDS, 16.7% in ALL, 11.3% in allogeneic HCT, and 2.0% in autologous HCT. The burden of IFD in haematologic patients in Brazil is high, with a higher frequency in AML and ALL. Invasive aspergillosis is the leading IFD, followed by invasive candidiasis and fusariosis.
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Affiliation(s)
- Luciana Souza
- Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Simone A Nouér
- Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Hugo Morales
- Hospital das Clínicas, Universidade Federal do Paraná, Curitiba, Brazil
| | - Belinda Simões
- Hospital das Clínicas, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Cristiana Solza
- Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Marcio Nucci
- Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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20
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de Chaves MA, Ferreira do Amaral T, Monteiro da Silva Rodrigues Coutinho N, Fernanda Andrzejewski Kaminski T, Teixeira ML, Flavio Souza de Oliveira L, de Andrade SF, Fuentefria AM. Synergistic association of clioquinol with antifungal drugs against biofilm forms of clinical Fusarium isolates. Mycoses 2020; 63:1069-1082. [PMID: 32662568 DOI: 10.1111/myc.13142] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 07/08/2020] [Accepted: 07/09/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND The influence of biofilm on the complexity of fungal diseases has been reported in recent years, especially in non-invasive mycoses such as keratitis and onychomycosis. The difficulty in treating cases of fusariosis in the human medical clinic exemplifies this situation, because when Fusarium spp. are present in the form of biofilm, the permeation of antifungal agents is compromised. OBJECTIVES This study proposes an association of clioquinol, an inhibitor of fungal cells with antifungal drugs prescribed to combat fusariosis in humans. METHODS Susceptibility was assessed by microdilution in broth. Formation of biofilm by staining with violet crystal. Inhibition and removal of biofilm using the MTT colorimetric reagent. Time-kill combination, hypoallergenicity test, cytotoxicity test and toxicity prediction by computer analysis were also performed. RESULTS Clioquinol associated with voriconazole and ciclopirox inhibited biofilm formation. Possibly, clioquinol acts in the germination and elongation of hyphae, while voriconazole prevents cell adhesion and ciclopirox the formation of the extracellular polymeric matrix. The CLIO-VRC association reduced the biofilm formation by more than 90%, while the CLIO-CPX association prevented over 95%. None of the association was irritating, and over 90% of the leucocytes remained viable. Computational analysis does not reveal toxicity relevant to CLIO, whereas VRC and CPX showed some risks for systemic use, but suitable for topical formulations. CONCLUSIONS The combination of CLIO-VRC or CLIO-CPX proved to be a promising association strategy in the medical clinic, both in combating fungal keratitis and onychomycosis, since they prevent the initial process of establishing an infection, the formation of biofilm.
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Affiliation(s)
- Magda Antunes de Chaves
- Programa de Pós-Graduação em Microbiologia Agrícola e do Ambiente, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | | | | | - Mário Lettieri Teixeira
- Laboratório de Bioquímica e Toxicologia, Instituto Federal de Santa Catarina, Concórdia, Brazil
| | | | - Saulo Fernandes de Andrade
- Programa de Pós-Graduação em Microbiologia Agrícola e do Ambiente, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Alexandre Meneghello Fuentefria
- Programa de Pós-Graduação em Microbiologia Agrícola e do Ambiente, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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21
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Rosa PDD, Ramirez-Castrillon M, Borges R, Aquino V, Meneghello Fuentefria A, Zubaran Goldani L. Epidemiological aspects and characterization of the resistance profile of Fusarium spp. in patients with invasive fusariosis. J Med Microbiol 2019; 68:1489-1496. [PMID: 31419209 DOI: 10.1099/jmm.0.001059] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Introduction. The remarkable intrinsic resistance of Fusarium species to most antifungal agents results in high mortality rates in the immunocompromised population.Aims. This study aimed to investigate the epidemiology, clinical features and antifungal susceptibility of Fusarium isolates in patients with invasive fusariosis.Methodology. A total of 27 patients admitted to a referral hospital from January 2008 to June 2017 were evaluated. Antifungal susceptibility testing of isolates was performed by broth microdilution according to the Clinical and Laboratory Standards Institute guidelines.Results. Haematological malignancy was the predominant underlying condition, with an incidence of invasive fusariosis of 14.8 cases per 1000 patients with acute lymphoid leukaemia and 13.1 cases per 1000 patients with acute myeloid leukaemia. The Fusarium solani species complex (FSSC) was the most frequent agent group, followed by the Fusarium oxysporum species complex (FOSC). Voriconazole showed the best activity against Fusarium, followed by amphotericin B. Itraconazole showed high minimum inhibitory concentration values, indicating in vitro resistance. Clinical FSSC isolates were significantly (P<0.05) more resistant to amphotericin B and voriconazole than FOSC isolates.Conclusion. The present antifungal susceptibility profiles indicate a high incidence of fusariosis in patients with haematological malignancy. Species- and strain-specific differences in antifungal susceptibility exist within Fusarium in this setting.
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Affiliation(s)
- Priscila Dallé da Rosa
- Experimental Research Center, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.,Graduate Program in Medicine: Medical Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | - Rafael Borges
- Experimental Research Center, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Valério Aquino
- Department of Microbiology, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | | | - Luciano Zubaran Goldani
- Experimental Research Center, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.,Graduate Program in Medicine: Medical Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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22
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Herkert PF, Al-Hatmi AMS, de Oliveira Salvador GL, Muro MD, Pinheiro RL, Nucci M, Queiroz-Telles F, de Hoog GS, Meis JF. Molecular Characterization and Antifungal Susceptibility of Clinical Fusarium Species From Brazil. Front Microbiol 2019; 10:737. [PMID: 31024507 PMCID: PMC6467941 DOI: 10.3389/fmicb.2019.00737] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 03/25/2019] [Indexed: 01/06/2023] Open
Abstract
Fusarium is widely distributed in the environment and is involved with plant and animal diseases. In humans, several species and species complexes (SC) are related to fusariosis, i.e., F. solani SC, F. oxysporum SC, F. fujikuroi SC, F. dimerum, F. chlamydosporum, F. incarnatum-equiseti, and F. sporotrichoides. We aimed to investigate the susceptibility of Fusarium clinical isolates to antifungals and azole fungicides and identify the species. Forty-three clinical Fusarium isolates were identified by sequencing translation elongation factor 1-alpha (TEF1α) gene. Antifungal susceptibility testing was performed to the antifungals amphotericin B, itraconazole, voriconazole, posaconazole, and isavuconazole, and the azole fungicides difenoconazole, tebuconazole, and propiconazole. The isolates were recovered from patients with median age of 36 years (range 2-78 years) of which 21 were female. Disseminated fusariosis was the most frequent clinical form (n = 16, 37.2%) and acute lymphoblastic leukemia (n = 7; 16.3%) was the most commonly underlying condition. A few species described in Fusarium solani SC have recently been renamed in the genus Neocosmospora, but consistent naming is yet not possible. Fusarium keratoplasticum FSSC 2 (n = 12) was the prevalent species, followed by F. petroliphilum FSSC 1 (n = 10), N. gamsii FSSC 7 (n = 5), N. suttoniana FSSC 20 (n = 3), F. solani sensu stricto FSSC 5 (n = 2), Fusarium sp. FSSC 25 (n = 2), Fusarium sp. FSSC 35 (n = 1), Fusarium sp. FSSC18 (n = 1), F. falciforme FSSC 3+4 (n = 1), F. pseudensiforme (n = 1), and F. solani f. xanthoxyli (n = 1). Amphotericin B had activity against most isolates although MICs ranged from 0.5 to 32 μg mL-1. Fusarium keratoplasticum showed high MIC values (8->32 μg mL-1) for itraconazole, voriconazole, posaconazole, and isavuconazole. Among agricultural fungicides, difenoconazole had the lowest activity against FSSC with MICs of >32 μg mL-1 for all isolates.
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Affiliation(s)
- Patricia F Herkert
- Instituto Carlos Chagas, Fundação Oswaldo Cruz, Curitiba, Brazil.,Instituto Nacional de Ciência e Tecnologia de Inovação em Doenças de Populações Negligenciadas, Brasília, Brazil.,Centre of Expertise in Mycology Radboudumc/CWZ, Nijmegen, Netherlands
| | - Abdullah M S Al-Hatmi
- Centre of Expertise in Mycology Radboudumc/CWZ, Nijmegen, Netherlands.,Department of Medical Mycology, Westerdijk Fungal Biodiversity Institute, Utrecht, Netherlands.,Directorate General of Health Services, Ministry of Health, Ibri Hospital, Ibri, Oman
| | | | - Marisol D Muro
- Laboratory of Mycology, Hospital de Clínicas, Federal University of Paraná, Curitiba, Brazil
| | - Rosângela L Pinheiro
- Laboratory of Mycology, Hospital de Clínicas, Federal University of Paraná, Curitiba, Brazil
| | - Márcio Nucci
- Department of Internal Medicine, Hematology Service, University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Flávio Queiroz-Telles
- Infectious Diseases Unit, Department of Public Health, Hospital de Clínicas, Federal University of Paraná, Curitiba, Brazil
| | - G Sybren de Hoog
- Centre of Expertise in Mycology Radboudumc/CWZ, Nijmegen, Netherlands.,Department of Medical Mycology, Westerdijk Fungal Biodiversity Institute, Utrecht, Netherlands.,Postgraduate Program in Microbiology, Parasitology and Pathology, Biological Sciences, Department of Basic Pathology, Federal University of Paraná, Curitiba, Brazil
| | - Jacques F Meis
- Centre of Expertise in Mycology Radboudumc/CWZ, Nijmegen, Netherlands.,Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, Netherlands
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23
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Haghani I, Shams-Ghahfarokhi M, Dalimi Asl A, Shokohi T, Hedayati MT. Molecular identification and antifungal susceptibility of clinical fungal isolates from onychomycosis (uncommon and emerging species). Mycoses 2018; 62:128-143. [DOI: 10.1111/myc.12854] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Revised: 09/15/2018] [Accepted: 09/17/2018] [Indexed: 12/14/2022]
Affiliation(s)
- Iman Haghani
- Department of Mycology; Faculty of Medical Sciences; Tarbiat Modares University; Tehran Iran
| | | | - Abdolhossein Dalimi Asl
- Department of Medical Parasitology; Faculty of Medical Sciences; Tarbiat Modares University; Tehran Iran
| | - Tahereh Shokohi
- Department of Medical Mycology; Invasive Fungi Research Center; School of Medicine; Mazandaran University of Medical Sciences; Sari Iran
| | - Mohammad Taghi Hedayati
- Department of Medical Mycology; Invasive Fungi Research Center; School of Medicine; Mazandaran University of Medical Sciences; Sari Iran
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24
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Dallé da Rosa P, Nunes A, Borges R, Batista B, Meneghello Fuentefria A, Goldani LZ. In vitro susceptibility and multilocus sequence typing of Fusarium isolates causing keratitis. J Mycol Med 2018; 28:482-485. [PMID: 29779647 DOI: 10.1016/j.mycmed.2018.05.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 04/28/2018] [Accepted: 05/03/2018] [Indexed: 01/07/2023]
Abstract
Fungal keratitis is recognized as a significant cause of ocular morbidity and blindness especially in developing countries. In this study, we aimed to present the molecular identification and susceptibility of Fusarium isolates causing fungal keratitis in a university hospital in southern Brazil. The samples were identified using the second largest subunit of the RNA polymerase gene (RPB2) and the translation elongation factor 1-alpha (TEF1), while the antifungal susceptibility was tested by the broth microdilution method according to the Clinical and Laboratory Standards Institute (CLSI) methodology. The majority of the isolates belonged to the Fusarium solani species complex (F. solani, F. keratoplasticum and F. falciforme) and Fusarium oxysporum species complex. Antifungal susceptibility has shown that amphotericin B and natamycin were the most effective antifungals across all isolates, followed by voriconazole. Variation among Fusarium complexes in their antifungal sensitivities was observed in our study. The identification of Fusarium species from human samples is important not only from an epidemiological viewpoint, but also for choosing the appropriate antifungal agent for difficult-to-treat Fusarium infections such as keratitis.
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Affiliation(s)
- P Dallé da Rosa
- Programa de Pós-graduação em Medicina: Ciências Médicas, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - A Nunes
- Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - R Borges
- Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - B Batista
- Programa de Pós-graduação em Ciências Farmacêuticas, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - A Meneghello Fuentefria
- Programa de Pós-graduação em Ciências Farmacêuticas, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - L Z Goldani
- Programa de Pós-graduação em Medicina: Ciências Médicas, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
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