Molecular identification and antifungal susceptibility of 75 clinical isolates of Trichophyton spp. from southern Brazil

BACKGROUND

Dermatophytoses affect more than 20% of the world's population and is caused by filamentous fungi, mainly of the genus Trichophyton. The species identification through microscopic direct examination and culture methods is challenging, with molecular presenting high sensitivity and specificity. Although there are several therapy options for dermatophyte infections, treatment failures and antifungal resistance are growing concerns.

OBJECTIVE

This study aimed to identify clinical isolates of Trichophyton spp. from southern Brazil using molecular methods and determine their in-vitro antifungal susceptibility.

MATERIAL AND METHODS

Seventy-five isolates were identified through sequencing of the ITS region. The exposure to seven antifungals drugs was performed according to protocol M28-A2 of the Clinical and Laboratory Standards Institute (CLSI).

RESULTS

Sixty-one isolates (81%) were identified as T. interdigitale, which differs from the epidemiological data present in the literature. Thirteen isolates were identified as T. rubrum and one as T. tonsurans. Terbinafine was the most effective antifungal, followed by itraconazole and voriconazole, which is in accordance with the results reported in previous studies.

CONCLUSIONS

The use of molecular methods to identify Trichophyton spp. clinical isolates and the performance of susceptibility tests are relevant to epidemiological data, identification of the emergence of antifungal resistance, and to help to translate the in-vitro antifungal susceptibility results into clinical practice.

Onychomycosis caused by Arthrinium arundinis in leprosy patient: Case report

We report a case of a 56-year-old Brazilian woman, with relapsing lepromatous leprosy, and onychomycosis caused by a non-dermatophyte filamentous fungi. The pathogenic fungi was identified as Arthrinium arundinis and treated with chemical abrasion of the nail with 40% urea and application of terbinafine cream. Onychomycosis caused by Arthrinium species is rare, and this is the second reported case.

Sporotrichosis by Sporothrix schenckii senso stricto with itraconazole resistance and terbinafine sensitivity observed in vitro and in vivo: Case report

We report a case of a patient with lymphocutaneous sporotrichosis in the right upper limb. The fungus was identified as Sporothrix schenckii senso stricto by calmodulin gene sequencing. The initial treatment was itraconazole (200 mg/day), but in vitro antifungal susceptibility demonstrated high resistant to this and another six antifungals, with exception to terbinafine. The lesions did not regress with itraconazole treatment. Thus, 500 mg/day of terbinafine was prescribed and clinical cure was obtained after four months.

Epidemiology of sporotrichosis: A study of 304 cases in Brazil

BACKGROUND

Sporotrichosis is an infection caused by Sporothrix schenckii . It primarily involves the skin and lymphatic channels, but dissemination may occur.

OBJECTIVE

We sought to describe clinical and epidemiologic features of cases of sporotrichosis observed in southern Brazil, and to review the literature. Methods We conducted a retrospective analysis of medical records over a 35-year period, from 1967 to 2002.

RESULTS

In all, 304 cases of sporotrichosis confirmed by fungal culture, histopathologic examination, and/or remission of lesions with potassium iodide were reviewed. No statistical difference was found between the number of patients with fixed cutaneous sporotrichosis and those with the lymphangitic type. Multifocal and extracutaneous involvement was verified. The upper extremity was the most affected site. Unusual sites, such as the penis and pubic region, were also involved.

CONCLUSION

Sporotrichosis is endemic in the study area. There is much to be learned about S schenckii . More studies and therapeutic options are still needed.