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Medhasi S, Sriwarom A, Permpalung N, Torvorapanit P, Plongla R, Chindamporn A, Worasilchai N. Ex vivo observation of Pythium insidiosum-antigen treated neutrophils on three Pythium insidiosum strains isolated from vascular pythiosis patients. Hum Vaccin Immunother 2024; 20:2304372. [PMID: 38314761 PMCID: PMC10854268 DOI: 10.1080/21645515.2024.2304372] [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: 10/13/2023] [Accepted: 01/08/2024] [Indexed: 02/07/2024] Open
Abstract
The mechanisms of Pythium insidiosum-antigen (PIA) immunotherapy activating a patient's immune system are unknown. We evaluated the interleukin-8 (IL-8) serum levels during P. insidiosum infection and after vaccination with PIA in vascular pythiosis cases. Furthermore, we studied the anti-P. insidiosum activity of neutrophils stimulated with various concentrations of PIA ex vivo in 3 strains of P. insidiosum isolated from vascular pythiosis patients. IL-8 serum levels were evaluated using the ELISA technique. We assessed the effect of PIA-stimulated neutrophils on the viability of zoospores using MTT assay, visualized neutrophil extracellular trap (NET) formation via microscopy, and measured the levels of double-stranded DNA (dsDNA) using PicoGreen dsDNA quantitation assay in 3 strains of P. insidiosum isolated from vascular pythiosis patients. Serum levels of IL-8 gradually lowered from the early to the end phases of vaccination with PIA among the surviving group of vascular pythiosis cases. Neutrophils stimulated with 0.01 µg/ml PIA reduced zoospore viability significantly compared to PIA-unstimulated neutrophils for strain 1 and strain 3 (p < .05). Neutrophils stimulated with 0.01, 0.1, 1, and 10 µg/ml PIA exhibited significantly lower zoospore viability than PIA-unstimulated neutrophils for strain 2 (p < .05). IL-8 can be used as a biomarker for monitoring vascular pythiosis cases treated with the PIA vaccine. Also, anti-P. insidiosum activity of PIA-stimulated neutrophils was probably due to the disruption of cellular activity in zoospores rather than the mechanisms based on the formation of NETs.
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Affiliation(s)
- Sadeep Medhasi
- Department of Transfusion Medicine and Clinical Microbiology, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
- Research Unit of Medical Mycology Diagnosis, Chulalongkorn University, Bangkok, Thailand
| | - Apichaya Sriwarom
- Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Nitipong Permpalung
- Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Pattama Torvorapanit
- Department of Medicine, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand
| | - Rongpong Plongla
- Department of Medicine, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand
| | - Ariya Chindamporn
- Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Navaporn Worasilchai
- Department of Transfusion Medicine and Clinical Microbiology, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
- Research Unit of Medical Mycology Diagnosis, Chulalongkorn University, Bangkok, Thailand
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Ong HS, Sharma N, Phee LM, Mehta JS. Atypical microbial keratitis. Ocul Surf 2023; 28:424-439. [PMID: 34768003 DOI: 10.1016/j.jtos.2021.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 10/29/2021] [Accepted: 11/01/2021] [Indexed: 01/16/2023]
Abstract
Atypical microbial keratitis refers to corneal infections caused by micro-organisms not commonly encountered in clinical practice. Unlike infections caused by common bacteria, cases of atypical microbial keratitis are often associated with worse clinical outcomes and visual prognosis. This is due to the challenges in the identification of causative organisms with standard diagnostic techniques, resulting in delays in the initiation of appropriate therapies. Furthermore, due to the comparatively lower incidence of atypical microbial keratitis, there is limited literature on effective management strategies for some of these difficult to manage corneal infections. This review highlights the current management and available evidence of atypical microbial keratitis, focusing on atypical mycobacteria keratitis, nocardia keratitis, achromobacter keratitis, and pythium keratitis. It will also describe the management of two uncommonly encountered conditions, infectious crystalline keratopathy and post-refractive infectious keratitis. This review can be used as a guide for clinicians managing patients with such challenging corneal infections.
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Affiliation(s)
- Hon Shing Ong
- Corneal and External Diseases Department, Singapore National Eye Centre, Singapore; Tissue Engineering and Cell Therapy Department, Singapore Eye Research Institute, Singapore; Department of Ophthalmology and Visual Science, Duke-National University of Singapore (NUS) Graduate Medical School, Singapore.
| | - Namrata Sharma
- Department of Ophthalmology, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Lynette M Phee
- Department of Pathology, Sengkang General Hospital, SingHealth, Singapore
| | - Jodhbir S Mehta
- Corneal and External Diseases Department, Singapore National Eye Centre, Singapore; Tissue Engineering and Cell Therapy Department, Singapore Eye Research Institute, Singapore; Department of Ophthalmology and Visual Science, Duke-National University of Singapore (NUS) Graduate Medical School, Singapore; School of Material Science & Engineering and School of Mechanical and Aerospace Engineering, Nanyang Technological University, Singapore.
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Gurnani B, Kaur K, Venugopal A, Srinivasan B, Bagga B, Iyer G, Christy J, Prajna L, Vanathi M, Garg P, Narayana S, Agarwal S, Sahu S. Pythium insidiosum keratitis - A review. Indian J Ophthalmol 2022; 70:1107-1120. [PMID: 35325996 PMCID: PMC9240499 DOI: 10.4103/ijo.ijo_1534_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Pythium insidiosum is an oomycete and is also called “parafungus” as it closely mimics fungal keratitis. The last decade saw an unprecedented surge in Pythium keratitis cases, especially from Asia and India, probably due to growing research on the microorganism and improved diagnostic and treatment modalities. The clinical features such as subepithelial infiltrate, cotton wool-like fluffy stromal infiltrate, satellite lesions, corneal perforation, endoexudates, and anterior chamber hypopyon closely resemble fungus. The classical clinical features of Pythium that distinguish it from other microorganisms are reticular dots, tentacular projections, peripheral furrowing, and early limbal spread, which require a high index of clinical suspicion. Pythium also exhibits morphological and microbiological resemblance to fungus on routine smearing, revealing perpendicular or obtuse septate or aseptate branching hyphae. Culture on blood agar or any other nutritional agar is the gold standard for diagnosis. It grows as cream-colored white colonies with zoospores formation, further confirmed using the leaf incarnation method. Due to limited laboratory diagnostic modalities and delayed growth on culture, there was a recent shift toward various molecular diagnostic modalities such as polymerase chain reaction, confocal microscopy, ELISA, and immunodiffusion. As corneal scraping (10% KOH, Gram) reveals fungal hyphae, antifungals are started before the culture results are available. Recent in vitro molecular studies have suggested antibacterials as the first-line drugs in the form of 0.2% linezolid and 1% azithromycin. Early therapeutic keratoplasty is warranted in nonresolving cases. This review aims to describe the epidemiology, clinical features, laboratory and molecular diagnosis, and treatment of Pythium insidiosum keratitis.
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Affiliation(s)
- Bharat Gurnani
- Cataract, Cornea, External Disease, Trauma and Refractive Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Pondicherry, India
| | - Kirandeep Kaur
- Pediatric and Squint Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Pondicherry, India
| | - Anitha Venugopal
- Cornea, Ocular surface, Trauma and Refractive services, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Tirunelveli, Tamil Nadu, India
| | - Bhaskar Srinivasan
- Dr G Sitalakshmi Memorial Clinic for Ocular Surface Disorders, CJ Shah Cornea Services, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Bhupesh Bagga
- Cornea Clinic, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, India
| | - Geetha Iyer
- Dr G Sitalakshmi Memorial Clinic for Ocular Surface Disorders, CJ Shah Cornea Services, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Josephine Christy
- Cataract, Cornea and Refractive Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Pondicherry, India
| | - Lalitha Prajna
- Microbiology Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Madurai, Tamil Nadu, India
| | - Murugesan Vanathi
- Cornea and Ocular Surface, Cataract and Refractive Services, Dr R P Centre, AIIMS, New Delhi, India
| | - Prashant Garg
- Director and Kallam Anji Reddy Chair of Ophthalmology Paul Dubord Chair of Cornea, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, India
| | - Shivanand Narayana
- Cataract, Cornea, External Diseases, Trauma and Refractive Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Pondicherry, India
| | - Shweta Agarwal
- Dr G Sitalakshmi Memorial Clinic for Ocular Surface Disorders, CJ Shah Cornea Services, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Srikant Sahu
- Cornea and Anterior Segment, Contact Lens, Cataract, Laser Refractive Surgery Services, Mithu Tulsi Chanrai Campus, LV Prasad Eye Institute, Bhubaneswar, Orissa, India
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Yolanda H, Krajaejun T. Global Distribution and Clinical Features of Pythiosis in Humans and Animals. J Fungi (Basel) 2022; 8:jof8020182. [PMID: 35205934 PMCID: PMC8879638 DOI: 10.3390/jof8020182] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 02/06/2022] [Accepted: 02/08/2022] [Indexed: 01/27/2023] Open
Abstract
Pythiosis is a difficult-to-treat infectious disease caused by Pythium insidiosum. The condition is unfamiliar among healthcare workers. Manifestation of pythiosis is similar to other fungal infections, leading to misdiagnosis and delayed treatment. The geographical extent of pythiosis at a global scale is unclear. This study aimed to analyze the clinical information recorded in the scientific literature to comprehensively project epidemiological characteristics, clinical features, and future trends of pythiosis. From 1980 to 2021, 4203 cases of pythiosis in humans (n = 771; 18.3%) and animals (primarily horse, dog, and cow; n = 3432; 81.7%), with an average of 103 cases/year, were recruited. Pythiosis case reports significantly increased in the last decade. Pythiosis spanned 23 tropical, subtropical, and temperate countries worldwide. Some patients acquired pythiosis from a trip to an endemic country. Strikingly, 94.3% of human cases were in India and Thailand, while 79.2% of affected animals were in the U.S.A. and Brazil. Clinical features of pythiosis varied. Vascular and ocular pythiosis were only observed in humans, whereas cutaneous/subcutaneous and gastrointestinal infections were predominant in animals. Mortality depended on host species and clinical forms: for example, none in patients with ocular pythiosis, 0.7% in cows with a cutaneous lesion, 26.8% in humans with vascular disease, 86.4% in dogs with gastrointestinal pathology, and 100% in several animals with disseminated infection. In summary, this study reports up-to-date epidemiological and clinical features of pythiosis in humans and animals. It increases awareness of this life-threatening disease, as the illness or outbreak can exist in any country, not limited to the endemic areas.
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Affiliation(s)
- Hanna Yolanda
- Program in Translational Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand;
- Department of Parasitology, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta 14440, Indonesia
| | - Theerapong Krajaejun
- Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
- Correspondence: ; Tel.: +662-201-1452
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History and Perspective of Immunotherapy for Pythiosis. Vaccines (Basel) 2021; 9:vaccines9101080. [PMID: 34696188 PMCID: PMC8539095 DOI: 10.3390/vaccines9101080] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/27/2021] [Accepted: 09/08/2021] [Indexed: 12/24/2022] Open
Abstract
The fungus-like microorganism Pythium insidiosum causes pythiosis, a life-threatening infectious disease increasingly reported worldwide. Antimicrobial drugs are ineffective. Radical surgery is an essential treatment. Pythiosis can resume post-surgically. Immunotherapy using P. insidiosum antigens (PIA) has emerged as an alternative treatment. This review aims at providing up-to-date information of the immunotherapeutic PIA, with the focus on its history, preparation, clinical application, outcome, mechanism, and recent advances, in order to promote the proper use and future development of this treatment modality. P. insidiosum crude extract is the primary source of immunotherapeutic antigens. Based on 967 documented human and animal (mainly horses) pythiosis cases, PIA immunotherapy reduced disease morbidity and mortality. Concerning clinical outcomes, 19.4% of PIA-immunized human patients succumbed to vascular pythiosis instead of 41.0% in unimmunized cases. PIA immunotherapy may not provide an advantage in a local P. insidiosum infection of the eye. Both PIA-immunized and unimmunized horses with pythiosis showed a similar survival rate of ~70%; however, demands for surgical intervention were much lesser in the immunized cases (22.8% vs. 75.2%). The proposed PIA action involves switching the non-protective T-helper-2 to protective T-helper-1 mediated immunity. By exploring the available P. insidiosum genome data, synthetic peptides, recombinant proteins, and nucleic acids are potential sources of the immunotherapeutic antigens worth investigating. The PIA therapeutic property needs improvement for a better prognosis of pythiosis patients.
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In vivo effect of minocycline alone and in combination with immunotherapy against pythium insidiosum. Vet Microbiol 2020; 243:108616. [DOI: 10.1016/j.vetmic.2020.108616] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 02/16/2020] [Accepted: 02/20/2020] [Indexed: 11/20/2022]
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Weiblen C, Zanette RA, Ribeiro TC, Pereira Dos Santos CE, Ianiski LB, Pereira DIB, Santurio JM, Botton SDA. Intradermal injection of Pythium insidiosum protein antigens for improved diagnosis and treatment of pythiosis in an experimental model. Med Mycol 2019; 57:807-812. [PMID: 30260397 DOI: 10.1093/mmy/myy078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 08/08/2018] [Accepted: 08/27/2018] [Indexed: 11/14/2022] Open
Abstract
The oomycetous pathogen Pythium insidiosum is the causative agent of pythiosis, a life-threatening disease that affects animals and humans. This infectious disease is difficult to treat, and early and accurate diagnosis is critical for effective treatment. In this sense, this study aimed to evaluate the intradermal (ID) injection of P. insidiosum protein antigens (PiPA) for the diagnosis and treatment of pythiosis using an experimental model. For diagnostic purposes, PiPA were injected by the ID route in the following groups of rabbits: (a) control; (b) previously immunized with PiPA injected by the subcutaneous (SC) route; and (c) infected with P. insidiosum zoospores. For treatment purposes, rabbits with pythiosis were also treated with PiPA by the ID or SC routes. Mean induration sizes were different at 24 h and 72 h readings when compared to the control group. Sensitivity of the protocol was 100% at 24 h and 80% at 72 h, with 100% specificity in both readings. PiPA treatment using ID or SC routes did not result in significant differences in lesion sizes and cure rates; however, serum levels of interferon-gamma were higher in SC route. This study demonstrates the applicability of PiPA ID for diagnosis and treatment of pythiosis in an experimental model.
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Affiliation(s)
- Carla Weiblen
- Universidade Federal de Santa Maria (UFSM). aDepartamento de Medicina Veterinária Preventiva (DMVP)/ Programa de Pós Graduação em Medicina Veterinária (PPGMV)/ Centro de Ciências Rurais (CCR). bDepartamento de Microbiologia e Parasitologia (Demip)/Centro de Ciências da Saúde (CCS)
| | - Régis Adriel Zanette
- Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-Graduação em Ciências Biológicas: Farmacologia e Terapêutica
| | - Tatiana Corrêa Ribeiro
- Universidade Federal de Santa Maria (UFSM). aDepartamento de Medicina Veterinária Preventiva (DMVP)/ Programa de Pós Graduação em Medicina Veterinária (PPGMV)/ Centro de Ciências Rurais (CCR). bDepartamento de Microbiologia e Parasitologia (Demip)/Centro de Ciências da Saúde (CCS)
| | | | - Lara Baccarin Ianiski
- Universidade Federal de Santa Maria (UFSM). aDepartamento de Medicina Veterinária Preventiva (DMVP)/ Programa de Pós Graduação em Medicina Veterinária (PPGMV)/ Centro de Ciências Rurais (CCR). bDepartamento de Microbiologia e Parasitologia (Demip)/Centro de Ciências da Saúde (CCS)
| | | | - Janio Morais Santurio
- Universidade Federal de Santa Maria (UFSM). aDepartamento de Medicina Veterinária Preventiva (DMVP)/ Programa de Pós Graduação em Medicina Veterinária (PPGMV)/ Centro de Ciências Rurais (CCR). bDepartamento de Microbiologia e Parasitologia (Demip)/Centro de Ciências da Saúde (CCS)
| | - Sônia de Avila Botton
- Universidade Federal de Santa Maria (UFSM). aDepartamento de Medicina Veterinária Preventiva (DMVP)/ Programa de Pós Graduação em Medicina Veterinária (PPGMV)/ Centro de Ciências Rurais (CCR). bDepartamento de Microbiologia e Parasitologia (Demip)/Centro de Ciências da Saúde (CCS)
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Hasika R, Lalitha P, Radhakrishnan N, Rameshkumar G, Prajna NV, Srinivasan M. Pythium keratitis in South India: Incidence, clinical profile, management, and treatment recommendation. Indian J Ophthalmol 2019; 67:42-47. [PMID: 30574890 PMCID: PMC6324135 DOI: 10.4103/ijo.ijo_445_18] [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] [Indexed: 11/10/2022] Open
Abstract
PURPOSE To study the demographic profile, clinical features, treatment outcome, and ocular morbidity of microbiologically proven Pythium keratitis in South India. METHODS A retrospective analysis of clinical records of microbiologically proven Pythium keratitis at a tertiary eye care referral center in South India from January 2016 to November 2017 was performed. Demographic details, predisposing risk factors, microbiological investigations, clinical course, and visual outcome were analyzed. RESULTS Seventy-one patients with microbiologically proven Pythium keratitis were identified. The mean age was 44(±18.2) years with an increase in male preponderance and 50% were farmers. Duration of delay at time of presentation to the hospital was a mean of 14(±7.2) days. The visual acuity at baseline ranged from 6/6 to no light perception (median 2.1 logMAR). A combination of 5% natamycin and 1% voriconazole was given to 42% patients, and natamycin alone was given to 39.4% patients. 1% itraconazole eye drops alone was initiated in 7 (10%) patients and 3 among this group responded. Therapeutic keratoplasty (TPK) was performed in 48 (67.6%) patients. None of the primary grafts remained clear after a period of 1 month. Twenty-six eyes (54.2%) had graft reinfection and all these eyes either developed anterior staphyloma (4) or were eviscerated (3) and 13 eyes became phthisical. The remaining 22 patients who had TPK resulted in failed graft. Among these, re-grafts were performed in 6 patients, of which 5 were doing well at the last follow-up. CONCLUSION We report a large series of patients with Pythium keratitis. Promoting early and differential diagnosis, awareness of clinicians and specific treatment options are needed for this devastating corneal disease.
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Affiliation(s)
- Ravula Hasika
- Department of Cornea and Refractive Surgery Services, Aravind Eye Hospital, Madurai, Tamil Nadu, India
| | - Prajna Lalitha
- Department of Ocular Microbiology, Aravind Eye Hospital, Madurai, Tamil Nadu, India,Correspondence to: Dr. Prajna Lalitha, Department of Ocular Microbiology, Aravind Eye Hospital, Madurai - 625 020, Tamil Nadu, India. E-mail:
| | - Naveen Radhakrishnan
- Department of Cornea and Refractive Surgery Services, Aravind Eye Hospital, Madurai, Tamil Nadu, India
| | | | - N Venkatesh Prajna
- Department of Cornea and Refractive Surgery Services, Aravind Eye Hospital, Madurai, Tamil Nadu, India
| | - Muthiah Srinivasan
- Department of Cornea and Refractive Surgery Services, Aravind Eye Hospital, Madurai, Tamil Nadu, India
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Ledur PC, Tondolo JSM, Jesus FPK, Verdi CM, Loreto ÉS, Alves SH, Santurio JM. Dendritic cells pulsed with Pythium insidiosum (1,3)(1,6)-β-glucan, Heat-inactivated zoospores and immunotherapy prime naïve T cells to Th1 differentiation in vitro. Immunobiology 2017; 223:294-299. [PMID: 29074300 DOI: 10.1016/j.imbio.2017.10.033] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 10/14/2017] [Indexed: 11/30/2022]
Abstract
Pythiosis is a life-threatening disease caused by the fungus-like microorganism Pythium insidiosum that can lead to death if not treated. Since P. insidiosum has particular cell wall characteristics, pythiosis is difficult to treat, as it does not respond well to traditional antifungal drugs. In our study, we investigated a new immunotherapeutic approach with potential use in treatment and in the acquisition of immunity against pythiosis. Dendritic cells from both human and mouse, pulsed with P. insidiosum heat-inactivated zoospore, (1,3)(1,6)-β-glucan and the immunotherapeutic PitiumVac® efficiently induced naïve T cell differentiation in a Th1 phenotype by the activation of specific Th1 cytokine production in vitro. Heat-inactivated zoospores showed the greatest Th1 response among the tested groups, with a significant increase in IL-6 and IFN-γ production in human cells. In mice cells, we also observed a Th17 pathway induction, with an increase on the IL-17A levels in lymphocytes cultured with β-glucan pulsed DCs. These results suggest a potential use of DCs pulsed with P. insidiosum antigens as a new therapeutic strategy in the treatment and acquisition of immunity against pythiosis.
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Affiliation(s)
- Pauline C Ledur
- Programa de Pós-graduação em Farmacologia, Centro de Ciências da Saúde, Universidade Federal de Santa Maria, Santa Maria, Brazil
| | - Juliana S M Tondolo
- Programa de Pós-graduação em Farmacologia, Centro de Ciências da Saúde, Universidade Federal de Santa Maria, Santa Maria, Brazil
| | - Francielli P K Jesus
- Programa de Pós-Graduação em Ciências Farmacêuticas, Centro de Ciências da Saúde, Universidade Federal de Santa Maria, RS, Brazil
| | - Camila M Verdi
- Programa de Pós-graduação em Farmacologia, Centro de Ciências da Saúde, Universidade Federal de Santa Maria, Santa Maria, Brazil
| | - Érico S Loreto
- Programa de Pós-graduação em Farmacologia, Centro de Ciências da Saúde, Universidade Federal de Santa Maria, Santa Maria, Brazil
| | - Sydney H Alves
- Programa de Pós-Graduação em Química Orgânica, Laboratório de Processos Tecnológicos e Catálise, Universidade Federal do Rio Grande do Sul, RS, Brazil
| | - Janio M Santurio
- Programa de Pós-graduação em Farmacologia, Centro de Ciências da Saúde, Universidade Federal de Santa Maria, Santa Maria, Brazil.
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He H, Liu H, Chen X, Wu J, He M, Zhong X. Diagnosis and Treatment of Pythium Insidiosum Corneal Ulcer in a Chinese Child: A Case Report and Literature Review. AMERICAN JOURNAL OF CASE REPORTS 2016; 17:982-988. [PMID: 28025573 PMCID: PMC5207016 DOI: 10.12659/ajcr.901158] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Patient: Male, 7 Final Diagnosis: Pythium insidiosum Symptoms: Painful vision loss • red eye Medication:— Clinical Procedure: Application of multiple antifungal medicines followed by the penetrating keratoplasty Specialty: Ophthalmology
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Affiliation(s)
- Hong He
- Hainan Eye Hospital and Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Haikou, Hainan, China (mainland)
| | - Hongshan Liu
- Hainan Eye Hospital and Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Haikou, Hainan, China (mainland)
| | - Xiaolian Chen
- Hainan Eye Hospital and Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Haikou, Hainan, China (mainland)
| | - Jiaochan Wu
- Hainan Eye Hospital and Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Haikou, Hainan, China (mainland)
| | - Miao He
- Zhongshan Ophthalmic Center and State Key Laboratory of Ophthalmology, Sun Yat-sen Universityq, Guangzhou, Guangdong, China (mainland)
| | - Xingwu Zhong
- Hainan Eye Hospital and Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Haikou, Hainan, China (mainland).,Zhongshan Ophthalmic Center and State Key Laboratory of Ophthalmology, Sun Yat-sen Universityq, Guangzhou, Guangdong, China (mainland)
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11
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Valente J, Fonseca A, Denardi L, Dal Ben V, Maia Filho F, Zambrano C, Braga C, Alves S, Botton S, Brayer Pereira D. In vitro
activity of antifungals in combination with essential oils against the oomycete Pythium insidiosum. J Appl Microbiol 2016; 121:998-1003. [DOI: 10.1111/jam.13234] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 06/14/2016] [Accepted: 07/11/2016] [Indexed: 11/30/2022]
Affiliation(s)
- J.S. Valente
- Universidade Federal de Pelotas (UFPel); Pelotas RS Brazil
| | - A.O.S. Fonseca
- Universidade Federal de Pelotas (UFPel); Pelotas RS Brazil
| | - L.B. Denardi
- Universidade Federal de Santa Maria (UFSM); Santa Maria RS Brazil
| | - V.S. Dal Ben
- Universidade Federal de Pelotas (UFPel); Pelotas RS Brazil
| | | | - C.G. Zambrano
- Universidade Federal de Pelotas (UFPel); Pelotas RS Brazil
| | - C.Q. Braga
- Universidade Federal de Pelotas (UFPel); Pelotas RS Brazil
| | - S.H. Alves
- Universidade Federal de Santa Maria (UFSM); Santa Maria RS Brazil
| | - S.A. Botton
- Universidade Federal de Santa Maria (UFSM); Santa Maria RS Brazil
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Hilton R, Tepedino K, Glenn C, Merkel K. Swamp cancer: a case of human pythiosis and review of the literature. Br J Dermatol 2016; 175:394-7. [DOI: 10.1111/bjd.14520] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2016] [Indexed: 01/30/2023]
Affiliation(s)
- R.E. Hilton
- University of Florida College of Medicine; Gainesville FL U.S.A
| | - K. Tepedino
- Department of Dermatology; University of Florida; Gainesville FL U.S.A
| | - C.J. Glenn
- Department of Dermatology; University of Florida; Gainesville FL U.S.A
| | - K.L. Merkel
- Dermatology Section; Department of Veterans Affairs Medical Center; North Florida/South Georgia Veterans Health System; Gainesville FL U.S.A
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Reanpang T, Orrapin S, Orrapin S, Arworn S, Kattipatanapong T, Srisuwan T, Vanittanakom N, Lekawanvijit SP, Rerkasem K. Vascular Pythiosis of the Lower Extremity in Northern Thailand. INT J LOW EXTR WOUND 2015; 14:245-50. [DOI: 10.1177/1534734615599652] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Pythiosis is a disease caused by Pythium insidiosum, a fungus-like organism. P. insidiosum is pathogenic in mammals, particularly in horses, dogs, and humans. Human pythiosis can be classified into 4 types: (1) cutaneous/subcutaneous, (2) ocular, (3) vascular, and (4) disseminated pythiosis. Vascular pythiosis is a rare disease but a serious limb- and life-threatening infection. We reviewed 22 cases over a 10-year period in Maharaj Nakorn Chiang Mai/Chiang Mai University Hospital. The survival rate was around 63.6% during our follow-up period. The only effective treatment was complete excision of the infected tissue, which was done mainly by major amputation, such as above-knee amputation. This report raises awareness of this disease, which needs preemptive diagnosis and appropriate treatment.
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Affiliation(s)
- Termpong Reanpang
- Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Saritphat Orrapin
- Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Saranat Orrapin
- Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Supapong Arworn
- Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | | | - Tanop Srisuwan
- Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Nongnuch Vanittanakom
- Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Suree P. Lekawanvijit
- Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Kittipan Rerkasem
- Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Research Institute of Health Science, Chiang Mai University, Thailand
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Fonseca AO, Pereira DI, Botton SA, Pötter L, Sallis ES, Júnior SF, Filho FS, Zambrano CG, Maroneze BP, Valente JS, Baptista CT, Braga CQ, Ben VD, Meireles MC. Treatment of experimental pythiosis with essential oils of Origanum vulgare and Mentha piperita singly, in association and in combination with immunotherapy. Vet Microbiol 2015; 178:265-9. [DOI: 10.1016/j.vetmic.2015.05.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Revised: 05/14/2015] [Accepted: 05/25/2015] [Indexed: 11/28/2022]
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Zanette RA, Bitencourt PER, Kontoyiannis DP, Fighera RA, Flores MM, Kommers GD, Silva PS, Ludwig A, Moretto MB, Alves SH, Santurio JM. Complex interaction of deferasirox and Pythium insidiosum: iron-dependent attenuation of growth in vitro and immunotherapy-like enhancement of immune responses in vivo. PLoS One 2015; 10:e0118932. [PMID: 25738758 PMCID: PMC4349436 DOI: 10.1371/journal.pone.0118932] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Accepted: 01/07/2015] [Indexed: 12/22/2022] Open
Abstract
Pythium insidiosum iron acquisition mechanisms are unknown. We previously showed that the iron chelator deferasirox had weak activity in vitro and in rabbits with experimental pythiosis. Here we show that deferasirox causes damage to P. insidiosum hyphae in vitro, but that activity is diminished in the presence of exogenous iron. The tissue activity of the proinflammatory enzyme adenosine deaminase and the histological pattern observed in pythiosis lesions of rabbits treated with deferasirox were similar to the ones in animals treated with immunotherapy.
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Affiliation(s)
- Régis A. Zanette
- Graduate Program in Pharmacology, Health Science Center, Federal University of Santa Maria (UFSM), Santa Maria, RS, Brazil
| | - Paula E. R. Bitencourt
- Graduate Program in Pharmaceutical Sciences, Health Science Center, UFSM, Santa Maria, RS, Brazil
| | - Dimitrios P. Kontoyiannis
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, United States of America
| | - Rafael A. Fighera
- Graduate Program in Veterinary Medicine, Health Science Center, UFSM, Santa Maria, RS, Brazil
| | - Mariana M. Flores
- Graduate Program in Veterinary Medicine, Health Science Center, UFSM, Santa Maria, RS, Brazil
| | - Glaucia D. Kommers
- Graduate Program in Veterinary Medicine, Health Science Center, UFSM, Santa Maria, RS, Brazil
| | - Priscila S. Silva
- Graduate Program in Pharmaceutical Sciences, Health Science Center, UFSM, Santa Maria, RS, Brazil
| | - Aline Ludwig
- Graduate Program in Pharmacology, Health Science Center, Federal University of Santa Maria (UFSM), Santa Maria, RS, Brazil
| | - Maria B. Moretto
- Graduate Program in Pharmaceutical Sciences, Health Science Center, UFSM, Santa Maria, RS, Brazil
| | - Sydney H. Alves
- Graduate Program in Pharmacology, Health Science Center, Federal University of Santa Maria (UFSM), Santa Maria, RS, Brazil
- Graduate Program in Pharmaceutical Sciences, Health Science Center, UFSM, Santa Maria, RS, Brazil
| | - Janio M. Santurio
- Graduate Program in Pharmacology, Health Science Center, Federal University of Santa Maria (UFSM), Santa Maria, RS, Brazil
- * E-mail:
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Zanette R, Jesus F, Pilotto M, Weiblen C, Pötter L, Ferreiro L, Alves S, Santurio J. Micafungin alone and in combination therapy with deferasirox against Pythium insidiosum. J Mycol Med 2015; 25:91-4. [DOI: 10.1016/j.mycmed.2014.09.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Accepted: 09/20/2014] [Indexed: 10/24/2022]
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Pan JH, Kerkar SP, Siegenthaler MP, Hughes M, Pandalai PK. A complicated case of vascular Pythium insidiosum infection treated with limb-sparing surgery. Int J Surg Case Rep 2014; 5:677-80. [PMID: 25194603 PMCID: PMC4189057 DOI: 10.1016/j.ijscr.2014.05.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2014] [Revised: 05/02/2014] [Accepted: 05/29/2014] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Pythiosis is a serious life- and limb-threatening infection endemic to Thailand, but rarely seen in the Western hemisphere. Here, we present a unique case of vascular pythiosis initially managed with limb-sparing vascular bypass grafts complicated by a pseudoaneurysm in our repair. PRESENTATION OF CASE The patient is a 17 year-old Jamaican male with severe aplastic anemia. He sustained a minor injury to his left leg while fishing in Jamaica, which evolved to become an exquisitely tender inguinal swelling. His physical exam and imaging were significant for arteriovenous fistula with limb ischemia. Pathology obtained during surgery for an extra-anatomic vascular bypass showed extensive invasion by Pythium insidiosum. He later developed a pseudoaneurysm at the site of proximal anastomosis and required urgent intervention. DISCUSSION This patient presented with a rare, but classic case of vascular pythiosis, which was unrecognized at the time of presentation. A variety of therapeutic modalities have been used to treat this disease, including antibiotics, antifungals, and immunotherapy, but the ultimate management of vascular pythiosis is surgical source control. CONCLUSION A high index of suspicion in susceptible patients is needed for timely diagnosis of vascular pythiosis to achieve optimal source control.
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Affiliation(s)
- Jenny H Pan
- Surgery Branch, National Cancer Institute, National Institutes of Health (NIH), Bethesda, MD 20892, USA
| | - Sid P Kerkar
- Center for Cancer Research, National Cancer Institute, National Institutes of Health (NIH), Bethesda, MD 20892, USA
| | - Michael P Siegenthaler
- National Institute of Health (NIH), Heart Center at Suburban Hospital, Bethesda, MD 20814, USA
| | - Marybeth Hughes
- Surgery Branch, National Cancer Institute, National Institutes of Health (NIH), Bethesda, MD 20892, USA
| | - Prakash K Pandalai
- Surgery Branch, National Cancer Institute, National Institutes of Health (NIH), Bethesda, MD 20892, USA.
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Loreto &ES, Tondolo JSM, Zanette RA, Alves SH, Santurio JM. Update on pythiosis immunobiology and immunotherapy. World J Immunol 2014; 4:88-97. [DOI: 10.5411/wji.v4.i2.88] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Revised: 05/06/2014] [Accepted: 06/11/2014] [Indexed: 02/05/2023] Open
Abstract
Pythiosis is an invasive, ulcerative, pyogranulomatous disease caused by Pythium insidiosum, a fungus-like oomycete that has been reported to affect humans, horses, dogs, and other mammals mainly in tropical and subtropical areas of the world. The disease is characterized by an eosinophilic granulomatous and a Th2 immune response which in turn helps to protect the fungus from the host cells. Pythiosis can present clinically in subcutaneous, gastrointestinal, and vascular tissues or in a systemically disseminated form depending on the species and site of infection. Changes in iron metabolism and anemia are commonly observed. The diagnosis is accomplished through clinical and pathological features, laboratory characteristics of cultures, serological and molecular tests. Treatment includes radical surgery, antimicrobial drugs, immunotherapy or a combination of these treatments. Immunotherapy is a practical and non-invasive alternative for treating pythiosis which is believed to promote a switch from a Th2 to Th1 immune response, resulting in a favorable clinical response. This therapy has demonstrated cure rates above 70% and 55% in horses and humans but low cure rates in dogs and cats. Despite the curative properties of this type of immunotherapy, the antibodies that are produced do not prevent host reinfection. Thus, development of effective adjuvants and new diagnostic techniques for early disease diagnosis are of utmost importance. The aim of this review was to promote pythiosis awareness and to provide an update about the immunotherapy and immunobiology of this disease.
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Hahtapornsawan S, Wongwanit C, Chinsakchai K, Hongku K, Sermsathanasawadi N, Ruangsetakit C, Mutirangura P. Suprainguinal vascular pythiosis: effective long-term outcome of aggressive surgical eradication. Ann Vasc Surg 2014; 28:1797.e1-6. [PMID: 24911809 DOI: 10.1016/j.avsg.2014.04.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2013] [Revised: 04/06/2014] [Accepted: 04/16/2014] [Indexed: 10/25/2022]
Abstract
Vascular pythiosis, a vascular infectious disease in hemoglobinopathy patients, caused by Pythium insidiosum, has an endemic area in tropical and subtropical countries. According to literature review, suprainguinal vascular pythiosis leads to 100% of mortality. The authors report a 35-year-old thalassemic patient who presented with a right inflammatory pulsatile groin mass and right limb ischemia. The computerized tomography angiography indicated a false aneurysm at the right external iliac artery and thrombosed entire right leg arteries. The management comprised antifungal agent, immunotherapy, and surgical removal of all infected arteries (high up to the right common iliac artery and above-knee amputation). The patient was found in a good condition at 36 months after the follow-up period.
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Affiliation(s)
| | - Chumpol Wongwanit
- Department of Surgery, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Khamin Chinsakchai
- Department of Surgery, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Kiatisak Hongku
- Department of Surgery, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | | | | | - Pramook Mutirangura
- Department of Surgery, Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Pereira DIB, Botton SA, Azevedo MI, Motta MAA, Lobo RR, Soares MP, Fonseca AOS, Jesus FPK, Alves SH, Santurio JM. Canine gastrointestinal pythiosis treatment by combined antifungal and immunotherapy and review of published studies. Mycopathologia 2013; 176:309-15. [PMID: 23918089 DOI: 10.1007/s11046-013-9683-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Accepted: 07/22/2013] [Indexed: 01/18/2023]
Abstract
Pythium insidiosum is an oomycete, a fungal like microorganism, which infects mammals, causing pythiosis in animals and humans, especially in tropical and subtropical regions around the world. The treatment for this infection is very difficult, and therapeutic options commonly comprise surgery, immunotherapy and antimicrobial drugs. The present report describes the clinical healing of a dog with gastrointestinal pythiosis by treatment with a combination of antifungals and immunotherapy, as well as reviews the cases reported in the literature that used some type of therapy for canine pythiosis. A 2.5-year-old male beagle initially showed sporadic vomiting episodes, and this symptom became more frequent 5 months after the onset of clinical signs. Celiotomy procedure found thickness of the stomach wall extending to the pylorus and duodenum. A biopsy was performed, and the diagnosis of pythiosis was made by mycological, histopathological analyses and molecular identification. Therapy was based on an association of terbinafine plus itraconazole during 12 months and immunotherapy for 2.5 months. The healing of the dog reported here allows us to propose the use of immunotherapy associated with antifungal therapy to treat canine gastrointestinal pythiosis. However, additional studies should be performed on a larger number of patients to establish a standard treatment protocol for canine pythiosis.
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Affiliation(s)
- Daniela I B Pereira
- Laboratório de Micologia, Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas (UFPel), Prédio 18, Sala 14, Campus Capão do Leão, Pelotas, RS, 96010-900, Brazil,
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Fatal Disseminated Pythium insidiosum Infection in a Child With Diamond-Blackfan Anemia. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2013. [DOI: 10.1097/ipc.0b013e318278f3b5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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22
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Carrera MV, Peixoto RM, Gouveia GV, Pessoa CR, Jesus FP, Santurio JM, Botton SA, Costa MM. Pitiose em ovinos nos estados de Pernambuco e Bahia. PESQUISA VETERINARIA BRASILEIRA 2013. [DOI: 10.1590/s0100-736x2013000400011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
A pitiose é uma doença infecciosa causada pelo oomiceto aquático P. insidiosum que acomete animais e o homem, especialmente habitantes de áreas úmidas. A enfermidade apresenta como característica principal a formação de lesões com aspecto granulomatoso nos hospedeiros. Neste trabalho, relatou-se a ocorrência da pitiose em ovinos nos estados de Pernambuco (PE) e Bahia (BA), Nordeste do Brasil, bem como foi avaliada a eficácia de um imunoterápico frente a esta enfermidade. Amostras de sangue de 53 ovinos foram coletadas, sendo 49 animais oriundos de propriedades localizadas em PE e quatro animais provenientes da BA. Sete ovinos demonstraram sinais clínicos de pitiose ovina. Um dos animais foi submetido à eutanásia e sua cabeça e linfonodo submandibular foram coletados e enviados para análises laboratoriais. Seis ovinos foram submetidos à imunoterapia, sendo mantidos nas instalações do setor de ovinocultura da Univasf/Petrolina-PE durante o tratamento. As técnicas de ELISA, cultura fúngica e reação em cadeia da polimerase (PCR) foram utilizadas como métodos diagnósticos da pitiose ovina, sendo eficientes para confirmação dos casos clínicos no rebanho. Ao exame microscópico do material coletado da cavidade nasal de um animal eutanasiado, observou-se uma área focalmente extensa de necrose com presença de infiltrado difuso de neutrófilos íntegros e degenerados margeando a cartilagem. Somente um animal apresentou cura clínica, indicando uma eficiência no tratamento da pitiose de 16,7% (1/6). O aumento de casos de pitiose tem sido denotado em diversos municípios de PE e da BA. Neste contexto, o emprego do imunoterápico pode ser uma alternativa a ser pesquisada. Portanto, estudos futuros devem ser realizados para investigar o efeito da imunoterapia aplicada à pitiose em ovinos.
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Affiliation(s)
| | - Rodolfo M. Peixoto
- Instituto Federal de Educação, Ciência e Tecnologia do Sertão Pernambucano, Brasil
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Tondolo JSM, Loreto ÉS, Denardi LB, Mario DAN, Alves SH, Santurio JM. A simple, rapid and inexpensive screening method for the identification of Pythium insidiosum. J Microbiol Methods 2013; 93:52-4. [DOI: 10.1016/j.mimet.2013.02.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Revised: 02/05/2013] [Accepted: 02/08/2013] [Indexed: 10/27/2022]
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Thongsri Y, Aromdee C, Yenjai C, Kanokmedhakul S, Chaiprasert A, Hamal P, Prariyachatigul C. Detection of diketopiperazine and pyrrolnitrin, compounds with anti-Pythium insidiosum activity, in a Pseudomonas stutzeri environmental strain. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2012; 158:378-83. [PMID: 23149469 DOI: 10.5507/bp.2012.090] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Accepted: 09/06/2012] [Indexed: 11/23/2022] Open
Abstract
AIMS Screening of bacterial flora for strains producing metabolites with inhibitory effects on the human pathogenic oomycete Pythium insidiosum. Separation and characterization of extracts from Pseudomonas stutzeri with anti-Pythium inhibitory activity. Search for genes with anti-Pythium effect within the genome of P. stutzeri. METHODS A total of 88 bacterial strains were isolated from water resources in northeastern Thailand. Two screening methods were used to establish their inhibitory effects on P. insidiosum. One strain, P. stutzeri ST1302 was randomly chosen, and the extract with anti-P. insidiosum activity was fractionated and subfractionated using liquid column chromatography and purified by thin layer chromatography. The chemical structure of purified fractions was determined by Fourier transform infrared spectroscopy, nuclear magnetic resonance and mass spectrometry. Further, search for genes involved in the anti-Pythium activity (phenazine-1-carboxylic acid, 2,4-diacetylphloroglucinol, pyoluteorin and pyrrolnitrin) was undertaken in this P. stutzeri strain using primers described in the literature. RESULTS Anti-P. insidiosum activity was detected in 16 isolates (18.2%). In P. stutzeri ST1302, a subfraction labeled PYK7 exhibited strong activity against this oomycete. It was assigned to the diketopiperazines as cyclo(D-Pro-L-Val). In the search for genes, one gene region was successfully amplified. This corresponded to pyrrolnitrin. The results suggest the possibility of using the related metabolites against P. insidiosum. This is the first report on the inhibitory effects of P. stutzeri against this oomycete. The results may contribute to the development of antimicrobial drugs/probiotics against pythiosis.
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In vitro and in vivo susceptibility of two-drug and three-drug combinations of terbinafine, itraconazole, caspofungin, ibuprofen and fluvastatin against Pythium insidiosum. Vet Microbiol 2012; 157:137-42. [DOI: 10.1016/j.vetmic.2011.12.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2011] [Revised: 12/01/2011] [Accepted: 12/05/2011] [Indexed: 11/22/2022]
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Molecular diagnosis of subcutaneous Pythium insidiosum infection by use of PCR screening and DNA sequencing. J Clin Microbiol 2012; 50:1480-3. [PMID: 22205808 DOI: 10.1128/jcm.06126-11] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Pythium insidiosum is an emerging human pathogen classified among brown algae and diatoms that can cause significant morbidity and mortality in otherwise healthy individuals. Here we describe a pediatric patient with pythiosis acquired in the southern United States, diagnosed by molecular screening and DNA sequencing of internal transcribed spacer region 1.
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Chakrabarti A, Singh R. The emerging epidemiology of mould infections in developing countries. Curr Opin Infect Dis 2012; 24:521-6. [PMID: 21799406 DOI: 10.1097/qco.0b013e32834ab21e] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW The present review describes the emerging trends of mould infections in developing countries, and highlights the major epidemiological differences from the developed countries. RECENT FINDINGS The limited data available from developing countries suggest an alarming increase in invasive mould infections, especially aspergillosis and mucormycosis, and also a difference in risk factors and causative agents between the developed and developing world. Sino-orbital, cerebral and ophthalmic infections due to Aspergillus flavus are the major clinical types in aspergillosis, after pulmonary aspergillosis. Aspergillus and Fusarium spp. are frequent causes of trauma-associated keratitis in agricultural workers. Rhino-orbito-cerebral presentation associated with uncontrolled diabetes is the predominant mucormycosis. Isolated renal mucormycosis has emerged as a new clinical entity. Apophysomyces elegans and Mucor irregularis are emerging species in these regions and uncommon agents such as Rhizopus homothallicus have also been reported. Many pathogens are geographically restricted, with Pythium insidionum, Rhinocladiella mackenziei and M. irregularis being described almost exclusively from Thailand, Middle East and China, respectively. SUMMARY Despite limited studies, certain peculiarities have been observed in invasive mould infections in developing countries, including a high incidence of ophthalmic lesions, mucormycosis and aspergillosis; few different clinical presentations; and a varied spectrum of pathogens involved in such lesions.
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Affiliation(s)
- Arunaloke Chakrabarti
- Division of Mycology, Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
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