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Ebrahimibarogh R, Ghazanfari M, Shokohi T, Yousefiabdolmaleki E, Seyedmousavi A, Hedayati MT. Tinea capitis due to Microsporum ferrugineum: A case of unusual laboratory finding on direct microscopic examination of infected hairs and skin lesions. Med Mycol Case Rep 2024; 43:100629. [PMID: 38369987 PMCID: PMC10869255 DOI: 10.1016/j.mmcr.2024.100629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 01/23/2024] [Indexed: 02/20/2024] Open
Abstract
Tinea capitis is a chronic fungal infection of the scalp occurring commonly in children of school age, especially in developing countries. It is caused primarily by the dermatophyte members of genera Microsporum and Trichophyton. Here we report presence of free-living mycelial stage of dermatophytes, a stage of fungal growth which form in culture medias, around affected hairs and skin scrapings of scalp lesions in a 3-year-old boy presenting with alopecia and multiple scaly, non-erythematous plaques. On direct microscopy examination using 10 % potassium hydroxide, the fungal hyphae and arthrospores were detected in ectothrix form. In addition, we also observed numerous multicellular, thick-walled spindle-shaped macroconidia around hairs and skin scrapings. To our knowledge this is the first study reporting dermatophyte's macroconidia directly seen on clinical samples. Species level identification of the dermatophyte isolate growing on Mycosel™ agar was confirmed by PCR-sequencing of internal transcribed spacer of ribosomal RNA as Microsporum ferrugineum. The patient was successfully treated with systemic itraconazole combined with topical ketoconazole shampoo.
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Affiliation(s)
- Robab Ebrahimibarogh
- Student Research Committee Center, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mona Ghazanfari
- 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
| | - Ensieh Yousefiabdolmaleki
- Department of Dermatology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Amir Seyedmousavi
- Microbiology Service, Department of Laboratory Medicine, Clinical Center, National Institutes of Health, Bethesda, MD, United States
| | - Mohammad T. 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
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Pashootan N, Shams-Ghahfarokhi M, Chaichi Nusrati A, Salehi Z, Asmar M, Razzaghi-Abyaneh M. Phylogeny, Antifungal Susceptibility, and Point Mutations of SQLE Gene in Major Pathogenic Dermatophytes Isolated From Clinical Dermatophytosis. Front Cell Infect Microbiol 2022; 12:851769. [PMID: 35372131 PMCID: PMC8972121 DOI: 10.3389/fcimb.2022.851769] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 02/11/2022] [Indexed: 12/14/2022] Open
Abstract
Drug resistance is one of the major challenges to skin fungal infections, especially in tropical and subtropical infections caused by dermatophytes. This study aimed to determine the antifungal susceptibility of clinically dermatophytes and evaluate point mutations in terbinafine-resistant isolates. A total number of 123 clinical dermatophyte isolates in eight species were evaluated in terms of sensitivity to seven major antifungals. Furthermore, the point mutation in squalene epoxidase (SQLE) gene responsible for terbinafine resistance was studied. The dermatophytes species were identified by morphological characteristics and confirmed by the ITS sequencing. Also, the phylogenetic tree was drawn using the RAxML analyses for 123 dermatophytes isolates. A new XXIX genotype was also found in 4 Trichophyton mentagrophytes isolates. Based on the results obtained, terbinafine was the most effective antifungal drug followed by itraconazole and voriconazole. Trichophyton rubrum and Trichophyton tonsurans were the most susceptible species (MIC50 = 0.01, 0.09 μg/ml), and T. mentagrophytes was the most resistant species (MIC50 = 0.125 μg/ml) to terbinafine. Of the 123 dermatophytes isolates, six isolates showed reduced susceptibility to terbinafine, and only Trichophyton indotineae had a mutation in SQLE gene as a Phe397Leu substitution. Overall, the antifungal susceptibility test is necessary for managing dermatophytosis. These results help physicians to control the course of the disease and provide further insights to select effective drugs for patients with dermatophytosis, especially in tropical and subtropical regions of the world, where dermatophytosis is still a public health problem.
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Affiliation(s)
- Nasrin Pashootan
- Department of Microbiology, Faculty of Basic Sciences, Lahijan Branch, Islamic Azad University, Lahijan, Iran
| | | | - Arash Chaichi Nusrati
- Department of Microbiology, Faculty of Basic Sciences, Lahijan Branch, Islamic Azad University, Lahijan, Iran
| | - Zahra Salehi
- Department of Mycology, Pasteur Institute of Iran, Tehran, Iran
| | - Mehdi Asmar
- Department of Microbiology, Faculty of Basic Sciences, Lahijan Branch, Islamic Azad University, Lahijan, Iran
| | - Mehdi Razzaghi-Abyaneh
- Department of Mycology, Pasteur Institute of Iran, Tehran, Iran
- *Correspondence: Mehdi Razzaghi-Abyaneh, ;
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Pablo T, Mzabi A, Meo M, Decruyenaere F, Perrin M. Routine laboratory test enabling the detection of dermatophytes and the identification of Trichophyton rubrum by means of in-house duplex real-time PCR. J Microbiol Methods 2021; 185:106229. [PMID: 33887312 DOI: 10.1016/j.mimet.2021.106229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 04/15/2021] [Accepted: 04/16/2021] [Indexed: 10/21/2022]
Abstract
Dermatophytes are responsible, in majority, for fungal infections of skin, hair and nails, and Trichophyton rubrum is the most frequently isolated dermatophyte in humans. The time for dermatophyte growth in culture requires a total of two to four weeks. Molecular methods were developed to improve time to diagnosis and initiation of treatment. We present here an in-house duplex real-time PCR enabling detection of dermatophytes and simultaneous identification of T. rubrum from mycological samples and cultures. The objective of this work was to optimize the fungal DNA extraction method, the detection of dermatophytes and the identification of T. rubrum on a CFX96® (Real-Time PCR Detection System). In addition, the method comparison showed that this new method is more sensitive than the culture and microscopic observations. To conclude, this routinely used method has been accredited ISO 15189 since January 2020 in our laboratory.
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Affiliation(s)
- Thomas Pablo
- Bacteriology, Mycology, Antibiotic Resistance and Hospital Hygiene Service, Department of Microbiology, Laboratoire National de Santé, Dudelange, Luxembourg
| | - Alexandre Mzabi
- Bacteriology, Mycology, Antibiotic Resistance and Hospital Hygiene Service, Department of Microbiology, Laboratoire National de Santé, Dudelange, Luxembourg.
| | - Marie Meo
- Bacteriology, Mycology, Antibiotic Resistance and Hospital Hygiene Service, Department of Microbiology, Laboratoire National de Santé, Dudelange, Luxembourg
| | - Frédéric Decruyenaere
- Bacteriology, Mycology, Antibiotic Resistance and Hospital Hygiene Service, Department of Microbiology, Laboratoire National de Santé, Dudelange, Luxembourg
| | - Monique Perrin
- Bacteriology, Mycology, Antibiotic Resistance and Hospital Hygiene Service, Department of Microbiology, Laboratoire National de Santé, Dudelange, Luxembourg
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Zareshahrabadi Z, Totonchi A, Rezaei-Matehkolaei A, Ilkit M, Ghahartars M, Arastehfar A, Motamedi M, Nouraei H, Sharifi Lari M, Mohammadi T, Zomorodian K. Molecular identification and antifungal susceptibility among clinical isolates of dermatophytes in Shiraz, Iran (2017-2019). Mycoses 2020; 64:385-393. [PMID: 33295089 DOI: 10.1111/myc.13226] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 11/28/2020] [Accepted: 12/02/2020] [Indexed: 12/22/2022]
Abstract
Dermatophytosis is a common superficial mycotic infection affecting individual's quality of life worldwide. The present study aimed to perform species-level identification and evaluate the antifungal susceptibility patterns of dermatophytes isolated in Shiraz, Iran. This cross-sectional study was conducted on clinical samples collected during 2017-2019 from 307 patients suspected of having dermatophytosis. The isolates were identified by direct microscopy, culture and internal transcribed spacer ribosomal DNA sequencing, and their antifungal susceptibility patterns were determined by the microdilution method. Among 307 patients, dermatophytosis was diagnosed by microscopy in 190 (61.8%) subjects and confirmed in 130 (42.3%) cases by both microscopy and culture. It was found out tinea pedis was the most common clinical manifestation, and Trichophyton mentagrophytes was the most prevalent species (28.4%), followed by T tonsurans (23.8%), Microsporum canis (11.5%), T interdigitale (10%), T verrucosum (6.9%), T rubrum (6.9%), T benhamiae (4.6%), T violaceum (3%), T simii (3%), Epidermophyton floccosum (0.7%) and M ferrugineum (0.7%). Moreover, it was revealed that luliconazole with a geometric mean (GM) minimum inhibitory concentration (MIC) of 0.03 μg ml-1 was the most effective agent against all tested isolates. Regardless of species, 30% of isolates responded to high MICs of griseofulvin (MIC90 > 2 μg ml-1 ). The increasing prevalence of nonindigenous species of T simii, T benhamiae and M ferrugineum in Shiraz, Iran, was a notable finding. In addition, infections due to zoophilic species showed an increasing trend. These epidemiological data, along with antifungal susceptibility patterns, may have implications for clinical decision-making and successful treatment.
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Affiliation(s)
- Zahra Zareshahrabadi
- Department of Medical Mycology and Parasitology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Totonchi
- Department of Medical Mycology and Parasitology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Rezaei-Matehkolaei
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Macit Ilkit
- Division of Mycology, Department of Microbiology, Faculty of Medicine, University Çukurova, Adana, Turkey
| | - Mehdi Ghahartars
- Department of Dermatology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amir Arastehfar
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, New Jersey, USA
| | - Marjan Motamedi
- Department of Medical Mycology and Parasitology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hasti Nouraei
- Department of Medical Mycology and Parasitology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Milad Sharifi Lari
- Department of Medical Mycology and Parasitology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Tooba Mohammadi
- Department of Medical Mycology and Parasitology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kamiar Zomorodian
- Department of Medical Mycology and Parasitology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.,Basic Sciences in Infectious Diseases Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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