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Veasey JV, Reis APC, Celestrino GA, Silva CE, Santos ES, Mendes DP, Andrade TS, Bonfietti LX, Benard G, Sousa MGT. Evidence of Clinical and Laboratory Correlation of Itraconazole Resistance in Sporothrix brasiliensis Infection: Case Report. Microorganisms 2024; 12:2132. [PMID: 39597522 PMCID: PMC11596095 DOI: 10.3390/microorganisms12112132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2024] [Revised: 10/02/2024] [Accepted: 10/16/2024] [Indexed: 11/29/2024] Open
Abstract
Sporotrichosis is a subcutaneous infection caused by fungi from the genus Sporothrix, among which Sporothrix brasiliensis displays high virulence and transmissibility. So far, classical antifungal agents have been efficient against S. brasiliensis, but here we describe the first case of therapeutic failure and a high minimum inhibitory concentration (MIC) in relation to itraconazole.
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Affiliation(s)
| | - Ana Paula Carvalho Reis
- Laboratory of Medical Mycology LIM-53, Clinical Dermatology Division, Hospital das Clínicas FMUSP, Faculdade de Medicina FMUSP, Institute of Tropical Medicine, University of São Paulo, São Paulo 05403000, Brazil; (A.P.C.R.); (G.A.C.); (C.E.S.); (E.S.S.); (D.P.M.); (G.B.)
| | - Giovanna Azevedo Celestrino
- Laboratory of Medical Mycology LIM-53, Clinical Dermatology Division, Hospital das Clínicas FMUSP, Faculdade de Medicina FMUSP, Institute of Tropical Medicine, University of São Paulo, São Paulo 05403000, Brazil; (A.P.C.R.); (G.A.C.); (C.E.S.); (E.S.S.); (D.P.M.); (G.B.)
| | - Camila Estacia Silva
- Laboratory of Medical Mycology LIM-53, Clinical Dermatology Division, Hospital das Clínicas FMUSP, Faculdade de Medicina FMUSP, Institute of Tropical Medicine, University of São Paulo, São Paulo 05403000, Brazil; (A.P.C.R.); (G.A.C.); (C.E.S.); (E.S.S.); (D.P.M.); (G.B.)
| | - Eduarda Souza Santos
- Laboratory of Medical Mycology LIM-53, Clinical Dermatology Division, Hospital das Clínicas FMUSP, Faculdade de Medicina FMUSP, Institute of Tropical Medicine, University of São Paulo, São Paulo 05403000, Brazil; (A.P.C.R.); (G.A.C.); (C.E.S.); (E.S.S.); (D.P.M.); (G.B.)
| | - Denise Polizel Mendes
- Laboratory of Medical Mycology LIM-53, Clinical Dermatology Division, Hospital das Clínicas FMUSP, Faculdade de Medicina FMUSP, Institute of Tropical Medicine, University of São Paulo, São Paulo 05403000, Brazil; (A.P.C.R.); (G.A.C.); (C.E.S.); (E.S.S.); (D.P.M.); (G.B.)
| | - Tania Sueli Andrade
- Department of Culture Collection, Adolfo Lutz Institute, Secretary of Health, Sao Paulo 01246000, Brazil
| | - Lucas Xavier Bonfietti
- Health Department, Mycology Nucleus of Instituto Adolfo Lutz, São Paulo 01246000, Brazil;
| | - Gil Benard
- Laboratory of Medical Mycology LIM-53, Clinical Dermatology Division, Hospital das Clínicas FMUSP, Faculdade de Medicina FMUSP, Institute of Tropical Medicine, University of São Paulo, São Paulo 05403000, Brazil; (A.P.C.R.); (G.A.C.); (C.E.S.); (E.S.S.); (D.P.M.); (G.B.)
| | - Maria Glória Texeira Sousa
- Laboratory of Medical Mycology LIM-53, Clinical Dermatology Division, Hospital das Clínicas FMUSP, Faculdade de Medicina FMUSP, Institute of Tropical Medicine, University of São Paulo, São Paulo 05403000, Brazil; (A.P.C.R.); (G.A.C.); (C.E.S.); (E.S.S.); (D.P.M.); (G.B.)
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Nahal J, Coelho RA, Almeida-Silva F, Bernardes-Engemann AR, Procópio-Azevedo AC, Rabello VBDS, Loureiro RG, Freitas DFS, do Valle ACF, de Macedo PM, Oliveira MME, da Silva MBT, Zancopé-Oliveira RM, Almeida-Paes R, Gutierrez-Galhardo MC, Figueiredo-Carvalho MHG. Non-Zoonotic Transmission of Sporotrichosis: A Translational Study of Forty-Three Cases in a Zoonotic Hyperendemic Area. J Fungi (Basel) 2024; 10:610. [PMID: 39330371 PMCID: PMC11433238 DOI: 10.3390/jof10090610] [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: 07/12/2024] [Revised: 08/12/2024] [Accepted: 08/20/2024] [Indexed: 09/28/2024] Open
Abstract
Over the past two decades, zoonotic sporotrichosis transmitted by naturally infected cats has become hyperendemic in Rio de Janeiro, Brazil. Sporothrix brasiliensis is the main agent involved. However, there are other forms of transmission of sporotrichosis. The aim of this study was to evaluate and associate the epidemiological, clinical and therapeutic data and the susceptibility of Sporothrix spp. to antifungal drugs in 43 non-zoonotic sporotrichosis cases. Forty-three clinical strains of Sporothrix were identified by partial sequencing of the calmodulin gene. An antifungal susceptibility test of amphotericin B, terbinafine, itraconazole, posaconazole and isavuconazole was performed according to the broth microdilution method. Most patients were male (55.8%). Regarding the source of infection, 21 patients (48.8%) reported trauma involving plants and/or contact with soil. Sporothrix brasiliensis was the predominant species (n = 39), followed by S. globosa (n = 3) and S. schenckii (n = 1). Sporothrix brasiliensis was associated with all the sources of infection, reinforcing previous data showing the presence of this species in environmental sources, as well as with all the clinical forms, including severe cases. One clinical strain of Sporothrix brasiliensis was classified as a non-wild-type strain for amphotericin B and another for itraconazole. S. schenckii was classified as non-WT for all the antifungals tested. In this context, it is important to emphasize that non-zoonotic sporotrichosis still occurs in the state of Rio de Janeiro, with S. brasiliensis as the main etiological agent, primarily associated with infections acquired after traumatic inoculation with plants and/or soil contact, followed by S. globosa and S. schenckii. In addition, non-WT strains were found, indicating the need to monitor the antifungal susceptibility profile of these species. It is crucial to investigate other natural sources of S. brasiliensis to better understand this fungal pathogen and its environment and host cycle.
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Affiliation(s)
- Juliana Nahal
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro 21040-900, Brazil; (J.N.); (R.A.C.); (F.A.-S.); (A.R.B.-E.); (V.B.d.S.R.); (R.G.L.); (R.M.Z.-O.); (R.A.-P.)
| | - Rowena Alves Coelho
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro 21040-900, Brazil; (J.N.); (R.A.C.); (F.A.-S.); (A.R.B.-E.); (V.B.d.S.R.); (R.G.L.); (R.M.Z.-O.); (R.A.-P.)
| | - Fernando Almeida-Silva
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro 21040-900, Brazil; (J.N.); (R.A.C.); (F.A.-S.); (A.R.B.-E.); (V.B.d.S.R.); (R.G.L.); (R.M.Z.-O.); (R.A.-P.)
| | - Andréa Reis Bernardes-Engemann
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro 21040-900, Brazil; (J.N.); (R.A.C.); (F.A.-S.); (A.R.B.-E.); (V.B.d.S.R.); (R.G.L.); (R.M.Z.-O.); (R.A.-P.)
| | - Anna Carolina Procópio-Azevedo
- Laboratório de Pesquisa Clínica em Dermatologia Infecciosa, Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro 21040-900, Brazil; (A.C.P.-A.); (D.F.S.F.); (A.C.F.d.V.); (P.M.d.M.); (M.C.G.-G.)
| | - Vanessa Brito de Souza Rabello
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro 21040-900, Brazil; (J.N.); (R.A.C.); (F.A.-S.); (A.R.B.-E.); (V.B.d.S.R.); (R.G.L.); (R.M.Z.-O.); (R.A.-P.)
| | - Rayanne Gonçalves Loureiro
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro 21040-900, Brazil; (J.N.); (R.A.C.); (F.A.-S.); (A.R.B.-E.); (V.B.d.S.R.); (R.G.L.); (R.M.Z.-O.); (R.A.-P.)
| | - Dayvison Francis Saraiva Freitas
- Laboratório de Pesquisa Clínica em Dermatologia Infecciosa, Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro 21040-900, Brazil; (A.C.P.-A.); (D.F.S.F.); (A.C.F.d.V.); (P.M.d.M.); (M.C.G.-G.)
| | - Antonio Carlos Francesconi do Valle
- Laboratório de Pesquisa Clínica em Dermatologia Infecciosa, Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro 21040-900, Brazil; (A.C.P.-A.); (D.F.S.F.); (A.C.F.d.V.); (P.M.d.M.); (M.C.G.-G.)
| | - Priscila Marques de Macedo
- Laboratório de Pesquisa Clínica em Dermatologia Infecciosa, Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro 21040-900, Brazil; (A.C.P.-A.); (D.F.S.F.); (A.C.F.d.V.); (P.M.d.M.); (M.C.G.-G.)
| | | | - Margarete Bernardo Tavares da Silva
- Serviço de Vigilância em Saúde, Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro 21040-900, Brazil;
| | - Rosely Maria Zancopé-Oliveira
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro 21040-900, Brazil; (J.N.); (R.A.C.); (F.A.-S.); (A.R.B.-E.); (V.B.d.S.R.); (R.G.L.); (R.M.Z.-O.); (R.A.-P.)
| | - Rodrigo Almeida-Paes
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro 21040-900, Brazil; (J.N.); (R.A.C.); (F.A.-S.); (A.R.B.-E.); (V.B.d.S.R.); (R.G.L.); (R.M.Z.-O.); (R.A.-P.)
| | - Maria Clara Gutierrez-Galhardo
- Laboratório de Pesquisa Clínica em Dermatologia Infecciosa, Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro 21040-900, Brazil; (A.C.P.-A.); (D.F.S.F.); (A.C.F.d.V.); (P.M.d.M.); (M.C.G.-G.)
| | - Maria Helena Galdino Figueiredo-Carvalho
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro 21040-900, Brazil; (J.N.); (R.A.C.); (F.A.-S.); (A.R.B.-E.); (V.B.d.S.R.); (R.G.L.); (R.M.Z.-O.); (R.A.-P.)
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3
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Ramos MLM, Almeida-Silva F, de Souza Rabello VB, Nahal J, Figueiredo-Carvalho MHG, Bernardes-Engemann AR, Poester VR, Xavier MO, Meyer W, Zancopé-Oliveira RM, Frases S, Almeida-Paes R. In vitro activity of the anthelmintic drug niclosamide against Sporothrix spp. strains with distinct genetic and antifungal susceptibility backgrounds. Braz J Microbiol 2024; 55:1359-1368. [PMID: 38466550 PMCID: PMC11153390 DOI: 10.1007/s42770-024-01301-5] [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: 10/31/2023] [Accepted: 03/07/2024] [Indexed: 03/13/2024] Open
Abstract
The drugs available to treat sporotrichosis, an important yet neglected fungal infection, are limited. Some Sporothrix spp. strains present reduced susceptibility to these antifungals. Furthermore, some patients may not be indicated to use these drugs, while others may not respond to the therapy. The anthelmintic drug niclosamide is fungicidal against the Sporothrix brasiliensis type strain. This study aimed to evaluate whether niclosamide also has antifungal activity against Sporothrix globosa, Sporothrix schenckii and other S. brasiliensis strains with distinct genotypes and antifungal susceptibility status. Minimal inhibitory and fungicidal concentrations (MIC and MFC, respectively) were determined using the microdilution method according to the CLSI protocol. The checkerboard method was employed to evaluate niclosamide synergism with drugs used in sporotrichosis treatment. Metabolic activity of the strains under niclosamide treatment was evaluated using the resazurin dye. Niclosamide was active against all S. brasiliensis strains (n = 17), but it was ineffective (MIC > 20 µM) for some strains (n = 4) of other pathogenic Sporothrix species. Niclosamide MIC values for Sporothrix spp. were similar for mycelial and yeast-like forms of the strains (P = 0.6604). Niclosamide was fungicidal (MFC/MIC ratio ≤ 2) for most strains studied (89%). Niclosamide activity against S. brasiliensis is independent of the fungal genotype or non-wild-type phenotypes for amphotericin B, itraconazole, or terbinafine. These antifungal drugs presented indifferent interactions with niclosamide. Niclosamide has demonstrated potential for repurposing as a treatment for sporotrichosis, particularly in S. brasiliensis cases, instigating in vivo studies to validate the in vitro findings.
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Affiliation(s)
- Mariana Lucy Mesquita Ramos
- Laboratório de Biofísica de Fungos, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal Do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Fernando Almeida-Silva
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Vanessa Brito de Souza Rabello
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Juliana Nahal
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | | | - Andrea Reis Bernardes-Engemann
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Vanice Rodrigues Poester
- Laboratório de Micologia, Faculdade de Medicina, Universidade Federal Do Rio Grande, Rio Grande, RS, Brazil
| | - Melissa Orzechowski Xavier
- Laboratório de Micologia, Faculdade de Medicina, Universidade Federal Do Rio Grande, Rio Grande, RS, Brazil
| | - Wieland Meyer
- Westerdijk Fungal Biodiversity Institute of the KNAW, Utrecht, The Netherlands
| | - Rosely Maria Zancopé-Oliveira
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Susana Frases
- Laboratório de Biofísica de Fungos, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal Do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
- Rede Micologia - FAPERJ, Rio de Janeiro, RJ, Brazil.
| | - Rodrigo Almeida-Paes
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil.
- Rede Micologia - FAPERJ, Rio de Janeiro, RJ, Brazil.
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Ribeiro dos Santos A, Gade L, Misas E, Litvintseva AP, Nunnally NS, Parnell LA, Rajeev M, de Souza Carvalho Melhem M, Takahashi JPF, Oliboni GM, Bonfieti LX, Araujo LS, Cappellano P, Venturini J, Lockhart SR, Sexton DJ. Bimodal distribution of azole susceptibility in Sporothrix brasiliensis isolates in Brazil. Antimicrob Agents Chemother 2024; 68:e0162023. [PMID: 38385701 PMCID: PMC10989022 DOI: 10.1128/aac.01620-23] [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: 12/08/2023] [Accepted: 01/31/2024] [Indexed: 02/23/2024] Open
Abstract
Sporothrix brasiliensis is an emerging zoonotic fungal pathogen that can be difficult to treat. Antifungal susceptibility testing was performed on the mold phase of a convenience sample of 61 Sporothrix spp. isolates from human and cat sporotrichosis cases in Brazil using the Clinical and Laboratory Standards Institute standard M38. A bimodal distribution of azole susceptibility was observed with 50% (28/56) of S. brasiliensis isolates showing elevated itraconazole minimum inhibitory concentrations ≥16 µg/mL. Phylogenetic analysis found the in vitro resistant isolates were not clonal and were distributed across three different S. brasiliensis clades. Single nucleotide polymorphism (SNP) analysis was performed to identify potential mechanisms of in vitro resistance. Two of the 28 resistant isolates (MIC ≥16 mg/L) had a polymorphism in the cytochrome P450 gene, cyp51, corresponding to the well-known G448S substitution inducing azole resistance in Aspergillus fumigatus. SNPs corresponding to other known mechanisms of azole resistance were not identified in the remaining 26 in vitro resistant isolates.
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Affiliation(s)
- Amanda Ribeiro dos Santos
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, USA
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lalitha Gade
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Elizabeth Misas
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, USA
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Natalie S. Nunnally
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lindsay A. Parnell
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Malavika Rajeev
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Marcia de Souza Carvalho Melhem
- School of Medicine, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil
- Graduate Program in Tropical Diseases, Universidade Estadual Paulista, Botucatu, SP, Brazil
- Parasitology and Mycology Center, Instituto Adolfo Lutz, São Paulo, SP, Brazil
| | - Juliana Possato Fernandes Takahashi
- School of Medicine, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil
- Parasitology and Mycology Center, Instituto Adolfo Lutz, São Paulo, SP, Brazil
| | - Gabriel Manzi Oliboni
- Graduate Program in Sciences, Coordenadoria de Controle de Doenças, Secretary of Health, São Paulo, Brazil
| | | | - Lisandra Siufi Araujo
- Central Public Health Laboratory of Mato Grosso do Sul, Secretary of Health, Campo Grande, MS, Brazil
| | | | - James Venturini
- School of Medicine, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Shawn R. Lockhart
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - D. Joseph Sexton
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Almeida-Silva F, Coelho RA, Bernardes-Engemann AR, Fichman V, Freitas DF, Galhardo MC, Corrêa-Junior D, Frases S, Zancopé-Oliveira RM, Almeida-Paes R. In vitro isavuconazole activity against Sporothrix brasiliensis suggests its efficacy in some severe sporotrichosis cases. Future Microbiol 2023; 18:1041-1048. [PMID: 37721514 DOI: 10.2217/fmb-2023-0094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2023] Open
Abstract
Background: Sporothrix brasiliensis causes sporotrichosis, an important infection in some groups of patients. Aims: This work was designed to investigate the effects of isavuconazole against this species. Methods: An antifungal susceptibility test was performed to compare MIC values with other antifungal drugs used to treat sporotrichosis. A checkerboard assay was performed to understand isavuconazole interactions. Furthermore, isavuconazole growth inhibition on an itraconazole-resistant strain was tested. Results: Isavuconazole had similar MICs to other azoles against S. brasiliensis, presenting fungistatic activity. Isavuconazole did not interact in vitro with antifungals or immunosuppressive drugs and inhibited the growth of an itraconazole-resistant strain. Conclusion: Isavuconazole inhibits S. brasiliensis, its pharmacologic characteristics make it a candidate for patients with sporotrichosis and it may be useful to combat sporotrichosis caused by resistant isolates.
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Affiliation(s)
- Fernando Almeida-Silva
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Rowena A Coelho
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Andréa R Bernardes-Engemann
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Vivian Fichman
- Departamento de Dermatologia, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Dayvison Fs Freitas
- Laboratório de Pesquisa Clínica em Dermatologia Infecciosa, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Maria Cg Galhardo
- Laboratório de Pesquisa Clínica em Dermatologia Infecciosa, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Dario Corrêa-Junior
- Laboratório de Biofísica de Fungos, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Susana Frases
- Laboratório de Biofísica de Fungos, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- Rede Micologia RJ, FAPERJ, Rio de Janeiro, Brazil
| | - Rosely M Zancopé-Oliveira
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Rodrigo Almeida-Paes
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
- Rede Micologia RJ, FAPERJ, Rio de Janeiro, Brazil
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de Sousa BIC, Ferreira LCF, de Lima MMR, Netto JDSB, Astacio GSM, Bernardes-Engemann AR, de Macedo PM, Gutierrez-Galhardo MC, Freitas DFS. Osteoarticular Sporotrichosis of the Knee Caused by Sporothrix brasiliensis: Two Similar Cases with Different Outcomes. J Fungi (Basel) 2023; 9:956. [PMID: 37888212 PMCID: PMC10607728 DOI: 10.3390/jof9100956] [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: 08/23/2023] [Revised: 09/17/2023] [Accepted: 09/20/2023] [Indexed: 10/28/2023] Open
Abstract
Sporotrichosis is the most frequent subcutaneous or implantation mycosis in Latin America, and its transmission occurs as a result of traumatic inoculation into the skin by organic matter containing the thermodimorphic fungi of the genus Sporothrix. Although cutaneous forms are more common, another important site is the osteoarticular system, whose hematogenous involvement is commonly associated with disseminated forms, especially in people who have an immunosuppressive condition, such as HIV/AIDS, chronic steroid use, and alcohol abuse. We present two cases of osteoarticular sporotrichosis of the knee caused by Sporothrix brasiliensis and followed up at our institution, with different outcomes. In the cases presented here, aging, anatomical sites, comorbidities, subtherapeutic serum levels, low adherence to treatment, and late diagnosis for different reasons may explain the observed outcomes. Early diagnosis of Sporothrix infection is critical in preventing complications, including death. We also highlight the importance of multidisciplinary follow-up and adherence to treatment for a favorable outcome.
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Affiliation(s)
- Bruno Ivanovinsky Costa de Sousa
- Vice-Direção de Ensino, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro 21040-360, RJ, Brazil
| | - Livia Cristina Fonseca Ferreira
- Vice-Direção de Ensino, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro 21040-360, RJ, Brazil
| | - Marcella Morgado Ramiro de Lima
- Vice-Direção de Ensino, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro 21040-360, RJ, Brazil
| | - Juliana dos Santos Barbosa Netto
- Laboratório de Pesquisa Clínica em DST/AIDS, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro 21040-360, RJ, Brazil
| | - Guis Saint-Martin Astacio
- Serviço de Imagem, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro 21040-360, RJ, Brazil
| | - Andréa Reis Bernardes-Engemann
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro 21040-360, RJ, Brazil
| | - Priscila Marques de Macedo
- Laboratório de Pesquisa Clínica em Dermatologia Infecciosa, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro 21040-360, RJ, Brazil
| | - Maria Clara Gutierrez-Galhardo
- Laboratório de Pesquisa Clínica em Dermatologia Infecciosa, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro 21040-360, RJ, Brazil
| | - Dayvison Francis Saraiva Freitas
- Laboratório de Pesquisa Clínica em Dermatologia Infecciosa, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro 21040-360, RJ, Brazil
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Rodrigues AM, Gonçalves SS, de Carvalho JA, Borba-Santos LP, Rozental S, de Camargo ZP. Current Progress on Epidemiology, Diagnosis, and Treatment of Sporotrichosis and Their Future Trends. J Fungi (Basel) 2022; 8:776. [PMID: 35893145 PMCID: PMC9331723 DOI: 10.3390/jof8080776] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 07/14/2022] [Accepted: 07/16/2022] [Indexed: 01/19/2023] Open
Abstract
Sporotrichosis, a human and animal disease caused by Sporothrix species, is the most important implantation mycosis worldwide. Sporothrix taxonomy has improved in recent years, allowing important advances in diagnosis, epidemiology, and treatment. Molecular epidemiology reveals that S. brasiliensis remains highly prevalent during the cat-transmitted sporotrichosis outbreaks in South America and that the spread of S. brasiliensis occurs through founder effects. Sporothrix globosa and S. schenckii are cosmopolitan on the move, causing major sapronoses in Asia and the Americas, respectively. In this emerging scenario, one-health approaches are required to develop a creative, effective, and sustainable response to tackle the spread of sporotrichosis. In the 21st century, it has become vital to speciate Sporothrix, and PCR is the main pillar of molecular diagnosis, aiming at the detection of the pathogen DNA from clinical samples through multiplex assays, whose sensitivity reaches remarkably three copies of the target. The treatment of sporotrichosis can be challenging, especially after the emergence of resistance to azoles and polyenes. Alternative drugs arising from discoveries or repositioning have entered the radar of basic research over the last decade and point to several molecules with antifungal potential, especially the hydrazone derivatives with great in vitro and in vivo activities. There are many promising developments for the near future, and in this review, we discuss how these trends can be applied to the Sporothrix-sporotrichosis system to mitigate the advance of an emerging and re-emerging disease.
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Affiliation(s)
- Anderson Messias Rodrigues
- Laboratory of Emerging Fungal Pathogens, Department of Microbiology, Immunology, and Parasitology, Discipline of Cellular Biology, Federal University of São Paulo (UNIFESP), Sao Paulo 04023062, Brazil; (J.A.d.C.); (Z.P.d.C.)
- Department of Medicine, Discipline of Infectious Diseases, Federal University of São Paulo (UNIFESP), Sao Paulo 04023062, Brazil
| | - Sarah Santos Gonçalves
- Infectious Diseases Postgraduate Program, Center for Research in Medical Mycology, Federal University of Espírito Santo (UFES), Vitoria 29043900, Brazil;
| | - Jamile Ambrósio de Carvalho
- Laboratory of Emerging Fungal Pathogens, Department of Microbiology, Immunology, and Parasitology, Discipline of Cellular Biology, Federal University of São Paulo (UNIFESP), Sao Paulo 04023062, Brazil; (J.A.d.C.); (Z.P.d.C.)
- Department of Medicine, Discipline of Infectious Diseases, Federal University of São Paulo (UNIFESP), Sao Paulo 04023062, Brazil
| | - Luana P. Borba-Santos
- Cell Biology and Parasitology Program, Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941902, Brazil; (L.P.B.-S.); (S.R.)
| | - Sonia Rozental
- Cell Biology and Parasitology Program, Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941902, Brazil; (L.P.B.-S.); (S.R.)
| | - Zoilo Pires de Camargo
- Laboratory of Emerging Fungal Pathogens, Department of Microbiology, Immunology, and Parasitology, Discipline of Cellular Biology, Federal University of São Paulo (UNIFESP), Sao Paulo 04023062, Brazil; (J.A.d.C.); (Z.P.d.C.)
- Department of Medicine, Discipline of Infectious Diseases, Federal University of São Paulo (UNIFESP), Sao Paulo 04023062, Brazil
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Human sporotrichosis: recommendations from the Brazilian Society of Dermatology for the clinical, diagnostic and therapeutic management. An Bras Dermatol 2022; 97:757-777. [PMID: 36155712 PMCID: PMC9582924 DOI: 10.1016/j.abd.2022.07.001] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 07/22/2022] [Accepted: 07/26/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The increase in the zoonotic epidemic of sporotrichosis caused by Sporothrix brasiliensis, which started in the late 1990s in Rio de Janeiro and is now found in almost all Brazilian states, has been equally advancing in neighboring countries of Brazil. Changes in the clinical-epidemiological profile, advances in the laboratory diagnosis of the disease, and therapeutic difficulties have been observed throughout these almost 25 years of the epidemic, although there is no national consensus. The last international guideline dates from 2007. OBJECTIVES Update the clinical classification, diagnostic methods and recommendations on the therapeutic management of patients with sporotrichosis. METHODS Twelve experts in human sporotrichosis were selected from different Brazilian regions, and divided into three work groups: clinical, diagnosis and treatment. The bibliographic research was carried out on the EBSCOHost platform. Meetings took place via electronic mail and remote/face-to-face and hybrid settings, resulting in a questionnaire which pointed out 13 divergences, resolved based on the opinion of the majority of the participants. RESULTS The clinical classification and laboratory diagnosis were updated. Therapeutic recommendations were made for the different clinical forms. CONCLUSION Publication of the first national recommendation, carried out by the Brazilian Society of Dermatology, aimed at the Brazilian scientific community, especially dermatologists, infectologists, pediatricians, family medicine personnel, and laboratory professionals who work in the management of human sporotrichosis.
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