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Santiso G, Messina F, Arechavala A, Marín E, Romero MDLM, Sosa MDLÁ, Rojas F, Mussin J, Contreras S, Galache V, Guerrero M, Sosa V, Chacón Y, Álvarez C, Maldonado I, Romero M, Echazarreta S, Fernández N, Relloso S, Serrano J, Giusiano G. Sporotrichosis in Argentina: clinical and epidemiological analysis. Biomedica 2023; 43:109-119. [PMID: 37721908 PMCID: PMC10588681 DOI: 10.7705/biomedica.6886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 04/13/2023] [Indexed: 09/20/2023]
Abstract
Introduction Sporotrichosis is an implantation mycosis caused by Sporothrix spp. It is distributed worldwide and can be found in vegetation and soil. The most frequent route of infection is by trauma with elements contaminated with fungal propagules. Since domestic cats are the most affected animals and can transmit this infection to humans, sporotrichosis is considered a zoonosis. Clinical presentations include nodular lymphangitis, fixed cutaneous, pulmonary (rare), and disseminated (exceptional). Objectives To analyze the epidemiology of sporotrichosis in Argentina during 2010 and 2022. To describe the clinical presentation, diagnostic methods, and treatment of cases diagnosed during this period. To know the circulating genotypes and to observe possible associations with the geographic location where the infection was acquired. Materials and methods Analytical, retrospective, and observational study. We analyzed the medical records of patients with sporotrichosis from 12 health institutions in Argentina, between 2010 and 2022. Results We present 54 cases in which the most frequent clinical form was nodular lymphangitis, and the treatment of choice was itraconazole. Conventional diagnosis was made in all cases. Culture of clinical samples was more sensitive than direct examination because it allowed the isolation of Sporothrix spp. in all 54 cases. Molecular identification was performed in 22 cases, with Sporothrix schenkii sensu stricto being the most frequently isolated species. Conclusions This study allowed to know the epidemiology of this mycosis in Argentina, as well as the availability of diagnostic methods and the treatment of choice.
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Affiliation(s)
- Gabriela Santiso
- Unidad de Micología, Hospital de Enfermedades Infecciosas Francisco Javier Muñiz, Buenos Aires, Argentina.
| | - Fernando Messina
- Unidad de Micología, Hospital de Enfermedades Infecciosas Francisco Javier Muñiz, Buenos Aires, Argentina.
| | - Alicia Arechavala
- Unidad de Micología, Hospital de Enfermedades Infecciosas Francisco Javier Muñiz, Buenos Aires, Argentina.
| | - Emmanuel Marín
- Unidad de Micología, Hospital de Enfermedades Infecciosas Francisco Javier Muñiz, Buenos Aires, Argentina.
| | | | - María de Los Ángeles Sosa
- Laboratorio Central Corrientes, Instituto de Medicina Regional, Universidad Nacional del Nordeste, Corrientes, Argentina.
| | - Florencia Rojas
- Instituto de Medicina Regional, Universidad Nacional del Nordeste, CONICET, Corrientes, Argentina.
| | - Javier Mussin
- Instituto de Medicina Regional, Universidad Nacional del Nordeste, CONICET, Corrientes, Argentina.
| | - Sonia Contreras
- Hospital de Alta Complejidad El Calafate, SAMIC, Santa Cruz, Argentina.
| | - Viviana Galache
- Hospital de Alta Complejidad El Calafate, SAMIC, Santa Cruz, Argentina.
| | - María Guerrero
- Hospital de Alta Complejidad El Calafate, SAMIC, Santa Cruz, Argentina.
| | - Vanesa Sosa
- Laboratorio de Alta Complejidad (LACMI), Hospital Madariaga, Posadas, Argentina.
| | - Yone Chacón
- Hospital Señor del Milagro, Salta, Argentina.
| | - Christian Álvarez
- Facultad de Bioquímica, Química y Farmacia, Laboratorio de Salud Pública de Tucumán, Tucumán, Argentina.
| | - Ivana Maldonado
- Laboratorio de Microbiología, Hospital Alemán, Buenos Aires, Argentina.
| | - Mercedes Romero
- CEMAR, Departamento Bioquímico, Secretaría de Salud Pública, Rosario, Argentina.
| | - Sofía Echazarreta
- Sala 9, Hospital de Enfermedades Infecciosas Francisco Javier Muñiz, Buenos Aires, Argentina.
| | - Norma Fernández
- Laboratorio de Micología, Hospital de Clínicas, Buenos Aires, Argentina.
| | - Silvia Relloso
- Laboratorio de Microbiología, Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno", Argentina.
| | - Julián Serrano
- Sección de Micología, Hospital Independencia, Santiago del Estero, Argentina.
| | - Gustavo Giusiano
- Instituto de Medicina Regional, Universidad Nacional del Nordeste, CONICET, Corrientes, Argentina.
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Rojas F, de Los Ángeles Sosa M, Latorre W, Mussin J, Alegre L, Giusiano G. Malassezia species: the need to establish Epidemiological Cutoff Values. Med Mycol 2022; 60:6623669. [PMID: 35772016 DOI: 10.1093/mmy/myac048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 06/06/2022] [Accepted: 06/28/2022] [Indexed: 11/13/2022] Open
Abstract
Malassezia are common yeasts in human skin microbiome. Under certain conditions these yeasts may cause disease from skin disorders to systemic infections. In the absence of clinical breakpoints, epidemiological cutoff values (ECVs) are useful to differentiate isolates with acquired or mutational resistance. The aim of this work was to propose tentative ECVs of Malassezia furfur, M. sympodialis, M. globosa for fluconazole (FCZ), itraconazole (ITZ), voriconazole (VCZ), ketoconazole (KTZ) and amphotericin B (AMB). A total of 160 isolates (80 M. furfur, 50 M. sympodialis and 30 M. globosa) were tested. Minimal inhibitory concentrations (MICs) were determined by modified broth microdilution method (CLSI). ECVs were estimated by ECOFFinder software and two-fold dilutions beyond the mode. ITZ, KTZ and VCZ showed the lowest MICs. The highest MIC and widest ranges were for FCZ and AMB. For ITZ, KTZ and VCZ both ECVs were similar. For FCZ, AMB especially M. furfur, modal ECVs were lower than values obtained by statistical method. When MIC distribution is the only data available, ECV could provide information to help guide therapy decisions. In that drug/species combination in which different peaks in the MIC distribution were observed, difference between both ECV was greater. This is the first study that provides ECV data of 160 Malassezia yeasts. Although ECVs cannot be used as predictors of clinical response, identification of non wild-type isolates suggests that it may be less likely to respond to a given antifungal agent.
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Affiliation(s)
- Florencia Rojas
- Departamento de Micología, Instituto de Medicina Regional, Universidad Nacional del Nordeste, CONICET. Resistencia, Argentina
| | - María de Los Ángeles Sosa
- Departamento de Micología, Instituto de Medicina Regional, Universidad Nacional del Nordeste. Resistencia, Argentina
| | - Wenceslao Latorre
- Departamento de Micología, Instituto de Medicina Regional, Universidad Nacional del Nordeste, CONICET. Resistencia, Argentina
| | - Javier Mussin
- Departamento de Micología, Instituto de Medicina Regional, Universidad Nacional del Nordeste, CONICET. Resistencia, Argentina
| | - Liliana Alegre
- Departamento de Micología, Instituto de Medicina Regional, Universidad Nacional del Nordeste. Resistencia, Argentina
| | - Gustavo Giusiano
- Departamento de Micología, Instituto de Medicina Regional, Universidad Nacional del Nordeste, CONICET. Resistencia, Argentina
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Teixeira MDM, Cattana ME, Matute DR, Muñoz JF, Arechavala A, Isbell K, Schipper R, Santiso G, Tracogna F, Sosa MDLÁ, Cech N, Alvarado P, Barreto L, Chacón Y, Ortellado J, Lima CMD, Chang MR, Niño-Vega G, Yasuda MAS, Felipe MSS, Negroni R, Cuomo CA, Barker B, Giusiano G. Genomic diversity of the human pathogen Paracoccidioides across the South American continent. Fungal Genet Biol 2020; 140:103395. [PMID: 32325168 PMCID: PMC7385733 DOI: 10.1016/j.fgb.2020.103395] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 02/27/2020] [Accepted: 04/16/2020] [Indexed: 12/30/2022]
Abstract
Paracoccidioidomycosis (PCM) is a life-threatening systemic mycosis widely reported in the Gran Chaco ecosystem. The disease is caused by different species from the genus Paracoccidioides, which are all endemic to South and Central America. Here, we sequenced and analyzed 31 isolates of Paracoccidioides across South America, with particular focus on isolates from Argentina and Paraguay. The de novo sequenced isolates were compared with publicly available genomes. Phylogenetics and population genomics revealed that PCM in Argentina and Paraguay is caused by three distinct Paracoccidioides genotypes, P. brasiliensis (S1a and S1b) and P. restrepiensis (PS3). P. brasiliensis S1a isolates from Argentina are frequently associated with chronic forms of the disease. Our results suggest the existence of extensive molecular polymorphism among Paracoccidioides species, and provide a framework to begin to dissect the connection between genotypic differences in the pathogen and the clinical outcomes of the disease.
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Affiliation(s)
- Marcus de Melo Teixeira
- Northern Arizona University, Flagstaff, AZ, USA; Universidade de Brasília, Brasilia, Brazil.
| | - Maria Emilia Cattana
- Northern Arizona University, Flagstaff, AZ, USA; Hospital Dr. Julio C. Perrando, Resistencia, Chaco, Argentina
| | - Daniel R Matute
- Biology Department, University of North Carolina, Chapel Hill, NC, USA
| | - José F Muñoz
- Broad Institute of MIT and Harvard, Cambridge, USA
| | | | - Kristin Isbell
- Biology Department, University of North Carolina, Chapel Hill, NC, USA
| | | | | | | | | | | | - Primavera Alvarado
- Servicio Autónomo Instituto de Biomedicina Dr. Jacinto Convit, Caracas, Venezuela
| | - Laura Barreto
- Instituto Superior de Formación Docente Salome Ureña, Santo Domingo, Dominican Republic
| | - Yone Chacón
- Hospital Señor del Milagro, Salta, Argentina
| | | | | | | | | | | | | | | | | | | | - Gustavo Giusiano
- Universidad Nacional del Nordeste, Resistencia, Chaco, Argentina.
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Fernández MS, Rojas FD, Cattana ME, Mussin JE, de Los Ángeles Sosa M, Benzoni CD, Giusiano GE. Protothecosis in a patient with T cell lymphocytic leukemia. Rev Argent Microbiol 2017; 49:224-226. [PMID: 28554708 DOI: 10.1016/j.ram.2017.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 02/03/2017] [Accepted: 02/24/2017] [Indexed: 11/18/2022] Open
Abstract
Human protothecosis is a rare infection caused by algae of the genus Prototheca. Prototheca wickerhamii has been recognized as the main species that causes infection in immunocompromised hosts with deficits in innate or cellular immunity. We report a case of persisting subcutaneous protothecosis in a patient with T-cell large granular lymphocyte leukemia, who also presented a history of disseminated histoplasmosis.
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Affiliation(s)
- Mariana S Fernández
- Universidad Nacional del Nordeste, CONICET, Instituto de Medicina Regional, Departamento de Micología, Resistencia, Chaco, Argentina.
| | - Florencia D Rojas
- Universidad Nacional del Nordeste, Instituto de Medicina Regional, Departamento de Micología, Resistencia, Chaco, Argentina
| | - María E Cattana
- Universidad Nacional del Nordeste, CONICET, Instituto de Medicina Regional, Departamento de Micología, Resistencia, Chaco, Argentina
| | - Javier E Mussin
- Universidad Nacional del Nordeste, CONICET, Instituto de Medicina Regional, Departamento de Micología, Resistencia, Chaco, Argentina
| | - María de Los Ángeles Sosa
- Universidad Nacional del Nordeste, Instituto de Medicina Regional, Departamento de Micología, Resistencia, Chaco, Argentina
| | - Carlos D Benzoni
- Sanatorio Frangioli 2000, Servicio de Infectología, Resistencia, Chaco, Argentina
| | - Gustavo E Giusiano
- Universidad Nacional del Nordeste, CONICET, Instituto de Medicina Regional, Departamento de Micología, Resistencia, Chaco, Argentina
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Cattana ME, Fernández MS, Rojas FD, Sosa MDLÁ, Giusiano G. [Genotypes and epidemiology of clinical isolates of Cryptococcus neoformans in Corrientes, Argentina]. Rev Argent Microbiol 2015; 47:82-3. [PMID: 25638353 DOI: 10.1016/j.ram.2014.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 09/01/2014] [Accepted: 09/08/2014] [Indexed: 11/28/2022] Open
Affiliation(s)
- María E Cattana
- Área Micología, Instituto de Medicina Regional, Universidad Nacional del Nordeste, Resistencia, Chaco, Argentina.
| | - Mariana S Fernández
- Área Micología, Instituto de Medicina Regional, Universidad Nacional del Nordeste, Resistencia, Chaco, Argentina
| | - Florencia D Rojas
- Área Micología, Instituto de Medicina Regional, Universidad Nacional del Nordeste, Resistencia, Chaco, Argentina
| | | | - Gustavo Giusiano
- Área Micología, Instituto de Medicina Regional, Universidad Nacional del Nordeste, Resistencia, Chaco, Argentina
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Fernández M, Cattana M, Rojas F, Sosa MDLÁ, Aguirre C, Vergara M, Giusiano G. [Aspergillus species in hospital environments with pediatric patients in critical condition]. Rev Iberoam Micol 2013; 31:176-81. [PMID: 24120420 DOI: 10.1016/j.riam.2013.09.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Revised: 07/31/2013] [Accepted: 09/10/2013] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Aspergillus is a group of opportunistic fungi that cause infections, with high morbimortality in immunosuppressed patients. Aspergillus fumigatus is the most frequent species in these infections, although the incidence of other species has increased in the last few years. AIMS To evaluate the air fungal load and the diversity of Aspergillus species in hospitals with pediatric patients in critical condition. METHODS The Intensive Care Unit and Burns Unit of a pediatric hospital were sampled every 15 days during the autumn and spring seasons. The air samples were collected with SAS Super 100(®) and the surface samples were collected by swab method. RESULTS The UFC/m(3) counts found exceeded the acceptable levels. The UFC/m(3) and the diversity of Aspergillus species found in the Intensive Care Unit were higher than those found in the Burns Unit. The fungal load and the diversity of species within the units were higher than those in control environments. The use of both methods -SAS and swab- allowed the detection of a higher diversity of species, with 96 strains of Aspergillus being isolated and 12 species identified. The outstanding findings were Aspergillus sydowii, Aspergillus niger, Aspergillus flavus, Aspergillus terreus and Aspergillus parasiticus, due to their high frequency. Aspergillus fumigatus, considered unacceptable in indoor environments, was isolated in both units. CONCLUSIONS Aspergillus was present with high frequency in these units. Several species are of interest in public health for being potential pathogenic agents. Air control and monitoring are essential in the prevention of these infections.
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Affiliation(s)
- Mariana Fernández
- Departamento de Micología, Instituto de Medicina Regional, Universidad Nacional del Nordeste, Resistencia, Argentina.
| | - María Cattana
- Departamento de Micología, Instituto de Medicina Regional, Universidad Nacional del Nordeste, Resistencia, Argentina
| | - Florencia Rojas
- Departamento de Micología, Instituto de Medicina Regional, Universidad Nacional del Nordeste, Resistencia, Argentina
| | - María de Los Ángeles Sosa
- Departamento de Micología, Instituto de Medicina Regional, Universidad Nacional del Nordeste, Resistencia, Argentina
| | | | - Marta Vergara
- Hospital Pediátrico Juan Pablo II, Corrientes, Argentina
| | - Gustavo Giusiano
- Departamento de Micología, Instituto de Medicina Regional, Universidad Nacional del Nordeste, Resistencia, Argentina
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Fernández MS, Rojas FD, Cattana ME, Sosa MDLÁ, Mangiaterra ML, Giusiano GE. Aspergillus terreus complex: an emergent opportunistic agent of Onychomycosis. Mycoses 2013; 56:477-81. [PMID: 23448599 DOI: 10.1111/myc.12061] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Revised: 01/09/2013] [Accepted: 01/18/2013] [Indexed: 11/29/2022]
Abstract
The incidence of onychomycosis due to non-dermatophyte moulds (NDM) is increasing. Aspergillus terreus is relatively undocumented as an agent of this fungal infection. The aim of this work is to show the prevalence of onychomycosis caused by A. terreus and to describe its clinical features. Nail samples were collected for microscopic examination and culturing in selective media. All cases of onychomycosis due to NDM were confirmed by a second sample. Aspergillus terreus isolates were identified through their morphological characteristics and using molecular methods. A total of 2485 samples were obtained. Positive cultures were obtained in 1639 samples. From 124 NDM confirmed cultures, 23 were identified as A. terreus (18.5%). Superficial white onychomycosis was the most frequent clinical pattern. A high percentage was found in fingernails. The prevalence of A. terreus in this study considerably exceeded the percentages reported by other authors. Onychomycosis due to A. terreus presents similar clinical patterns to those caused by dermatophytes, but is difficult to eradicate and is associated with less predictable treatment outcomes. Better knowledge of the aetiology of A. terreus may be important for accomplishing more accurate and effective treatment.
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Affiliation(s)
- Mariana S Fernández
- Departamento de Micología, Instituto de Medicina Regional, Universidad Nacional del Nordeste, Resistencia, Argentina
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