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Ribeiro Dos Santos A, Misas E, Min B, Le N, Bagal UR, Parnell LA, Sexton DJ, Lockhart SR, de Souza Carvalho Melhem M, Takahashi JPF, Oliboni GM, Bonfieti LX, Cappellano P, Sampaio JLM, Araujo LS, Alves Filho HL, Venturini J, Chiller TM, Litvintseva AP, Chow NA. Emergence of zoonotic sporotrichosis in Brazil: a genomic epidemiology study. THE LANCET. MICROBE 2024; 5:e282-e290. [PMID: 38432234 DOI: 10.1016/s2666-5247(23)00364-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 10/20/2023] [Accepted: 10/27/2023] [Indexed: 03/05/2024]
Abstract
BACKGROUND Zoonotic sporotrichosis is a neglected fungal disease, whereby outbreaks are primarily driven by Sporothrix brasiliensis and linked to cat-to-human transmission. To understand the emergence and spread of sporotrichosis in Brazil, the epicentre of the current epidemic in South America, we aimed to conduct whole-genome sequencing (WGS) to describe the genomic epidemiology. METHODS In this genomic epidemiology study, we included Sporothrix spp isolates from sporotrichosis cases from Brazil, Colombia, and the USA. We conducted WGS using Illumina NovaSeq on isolates collected by three laboratories in Brazil from humans and cats with sporotrichosis between 2013 and 2022. All isolates that were confirmed to be Sporothrix genus by internal transcribed spacer or beta-tubulin PCR sequencing were included in this study. We downloaded eight Sporothrix genome sequences from the National Center for Biotechnology Information (six from Brazil, two from Colombia). Three Sporothrix spp genome sequences from the USA were generated by the US Centers for Disease Control and Prevention as part of this study. We did phylogenetic analyses and correlated geographical and temporal case distribution with genotypic features of Sporothrix spp isolates. FINDINGS 72 Sporothrix spp isolates from 55 human and 17 animal sporotrichosis cases were included: 67 (93%) were from Brazil, two (3%) from Colombia, and three (4%) from the USA. Cases spanned from 1999 to 2022. Most (61 [85%]) isolates were S brasiliensis, and all were reported from Brazil. Ten (14%) were Sporothrix schenckii and were reported from Brazil, USA, and Colombia. For S schenckii isolates, two distinct clades were observed wherein isolates clustered by geography. For S brasiliensis isolates, five clades separated by more than 100 000 single-nucleotide polymorphisms were observed. Among the five S brasiliensis clades, clades A and C contained isolates from both human and cat cases, and clade A contained isolates from six different states in Brazil. Compared with S brasiliensis isolates, larger genetic diversity was observed among S schenckii isolates from animal and human cases within a clade. INTERPRETATION Our results suggest that the ongoing epidemic driven by S brasiliensis in Brazil represents several, independent emergence events followed by animal-to-animal and animal-to human transmission within and between Brazilian states. These results describe how S brasiliensis can emerge and spread within a country. FUNDING Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Brazil; the São Paulo Research Foundation; Productivity in Research fellowships by the National Council for Scientific and Technological Development, and Ministry of Science and Technology of Brazil.
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Affiliation(s)
- Amanda Ribeiro Dos Santos
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA; School of Medicine, Universidade Federal de Mato Grosso do Sul, Campo Grande, Brazil
| | - Elizabeth Misas
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Brian Min
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ngoc Le
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ujwal R Bagal
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lindsay A Parnell
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - D Joseph Sexton
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Shawn R Lockhart
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Marcia de Souza Carvalho Melhem
- School of Medicine, Universidade Federal de Mato Grosso do Sul, Campo Grande, Brazil; Parasitology and Mycology Center, Instituto Adolfo Lutz, São Paulo, Brazil
| | - Juliana Possatto Fernandes Takahashi
- School of Medicine, Universidade Federal de Mato Grosso do Sul, Campo Grande, Brazil; Parasitology and Mycology Center, Instituto Adolfo Lutz, São Paulo, Brazil
| | - Gabriel Manzi Oliboni
- Coordenadoria de Controle de Doenças, Secretaria de Estado de Saúde, São Paulo, Brazil
| | | | | | | | - Lisandra Siufi Araujo
- School of Medicine, Universidade Federal de Mato Grosso do Sul, Campo Grande, Brazil; Central Public Health Laboratory of Mato Grosso do Sul, Secretaria de Estado de Saúde de Mato Grosso do Sul, Campo Grande, Brazil
| | | | - James Venturini
- School of Medicine, Universidade Federal de Mato Grosso do Sul, Campo Grande, Brazil
| | - Tom M Chiller
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Nancy A Chow
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA.
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Almeida-Paes R, do Valle ACF, Freitas DFS, de Macedo PM, Zancopé-Oliveira RM, Gutierrez-Galhardo MC. The present and future research agenda of sporotrichosis on the silver anniversary of zoonotic sporotrichosis in Rio de Janeiro, Brazil. Mem Inst Oswaldo Cruz 2024; 119:e230208. [PMID: 38359307 PMCID: PMC10868377 DOI: 10.1590/0074-02760230208] [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: 11/10/2023] [Accepted: 01/24/2024] [Indexed: 02/17/2024] Open
Abstract
Twenty-five years have passed since the initial observation of endemic zoonotic sporotrichosis in Rio de Janeiro, Brazil. Since then, this disease has spread throughout South America. Accompanying the emergence of this mycosis, some progress has been made, including the expansion of a research network in this field and higher visibility of sporotrichosis within government authorities and funding agencies. However, there are still some challenges to curbing the expansion of this disease in the coming years. These include the development of rapid and accurate diagnostic tests, new antifungal drugs, particularly for the treatment of extracutaneous manifestations of sporotrichosis, and more comprehensive care for cats with sporotrichosis. Including these actions in the sporotrichosis research agenda is required so as to change the development of this disease in the years to come.
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Affiliation(s)
- Rodrigo Almeida-Paes
- Fundação Oswaldo Cruz-Fiocruz, Instituto Nacional de Infectologia Evandro Chagas, Laboratório de Micologia, Rio de Janeiro, RJ, Brasil
| | - Antonio Carlos Francesconi do Valle
- Fundação Oswaldo Cruz-Fiocruz, Instituto Nacional de Infectologia Evandro Chagas, Laboratório de Dermatologia Infecciosa, Rio de Janeiro, RJ, Brasil
| | - Dayvison Francis Saraiva Freitas
- Fundação Oswaldo Cruz-Fiocruz, Instituto Nacional de Infectologia Evandro Chagas, Laboratório de Dermatologia Infecciosa, Rio de Janeiro, RJ, Brasil
| | - Priscila Marques de Macedo
- Fundação Oswaldo Cruz-Fiocruz, Instituto Nacional de Infectologia Evandro Chagas, Laboratório de Dermatologia Infecciosa, Rio de Janeiro, RJ, Brasil
| | - Rosely Maria Zancopé-Oliveira
- Fundação Oswaldo Cruz-Fiocruz, Instituto Nacional de Infectologia Evandro Chagas, Laboratório de Micologia, Rio de Janeiro, RJ, Brasil
| | - Maria Clara Gutierrez-Galhardo
- Fundação Oswaldo Cruz-Fiocruz, Instituto Nacional de Infectologia Evandro Chagas, Laboratório de Dermatologia Infecciosa, Rio de Janeiro, RJ, Brasil
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Colombo SA, Bicalho GC, de Oliveira CSF, de Magalhães Soares DF, Salvato LA, Keller KM, Bastos CDVE, Morais MHF, Rodrigues AM, Cunha JLR, de Azevedo MI. Emergence of zoonotic sporotrichosis due to Sporothrix brasiliensis in Minas Gerais, Brazil: A molecular approach to the current animal disease. Mycoses 2023; 66:911-922. [PMID: 37452233 DOI: 10.1111/myc.13631] [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: 03/10/2023] [Revised: 06/24/2023] [Accepted: 06/28/2023] [Indexed: 07/18/2023]
Abstract
Sporotrichosis is a neglected fungal zoonosis with significant impacts on human and animal health. Accurate diagnosis, treatment, and understanding of the transmission dynamics of Sporothrix species are essential for mitigating the spread of sporotrichosis. This study aimed to identify the Sporothrix species involved in the ongoing outbreaks of animal sporotrichosis in the metropolitan region of Belo Horizonte, Minas Gerais, Brazil, and analyse the phylogenetic relationships between pathogenic species to investigate the outbreak origin. Additionally, to better understand the evolution of the disease, we conducted a retrospective survey of positive feline and canine cases from November 2017 to July 2021 with proven cultures for Sporothrix. A significant increase in animal cases over the last 4 years was observed, with cats being the most affected host. Sporothrix brasiliensis was the predominant agent in 100% of the clinical isolates (n = 180) molecularly identified. Phylogenetic and haplotype analysis points towards the cases isolated from Minas Gerais sharing the haplotype originating from a long-lasting outbreak of cat-transmitted sporotrichosis in Rio de Janeiro, however, with a secondary contribution from genotypes circulating in other outbreaks in Brazil. Thus, we present clear evidence of the circulation of different S. brasiliensis genotypes associated with animal sporotrichosis in the metropolitan region of Belo Horizonte. Genetic monitoring can contribute to understanding the causal agent for zoonotic sporotrichosis in epidemiological processes and help to implement disease prevention and control measures.
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Affiliation(s)
- Salene Angelini Colombo
- Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Gustavo Canesso Bicalho
- Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | | | - Lauranne Alves Salvato
- Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Kelly Moura Keller
- Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Camila de Valgas E Bastos
- Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Anderson Messias Rodrigues
- Departamento de Microbiologia, Imunologia e Parasitologia, Disciplina de Biologia Celular, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - João Luis Reis Cunha
- Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Maria Isabel de Azevedo
- Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Corrêa-Junior D, de Andrade IB, Alves V, Avellar-Moura I, Rodrigues-Alves T, de Souza Rabello VB, de S Araújo GR, Borba-Santos LP, Zancopé-Oliveira RM, Almeida-Paes R, Frases S. Metabolic Plasticity and Virulence-Associated Factors of Sporothrix brasiliensis Strains Related to Familiar Outbreaks of Cat-to-Human Transmitted Sporotrichosis. J Fungi (Basel) 2023; 9:724. [PMID: 37504713 PMCID: PMC10381138 DOI: 10.3390/jof9070724] [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: 06/14/2023] [Revised: 06/30/2023] [Accepted: 06/30/2023] [Indexed: 07/29/2023] Open
Abstract
Sporothrix brasiliensis is the main agent of zoonotic sporotrichosis transmitted by domestic cats in South America. In humans, sporotrichosis commonly presents with cutaneous or lymphocutaneous lesions, and in cats, with multiple ulcerated skin lesions associated with enlarged lymph nodes and respiratory signs. Fungal virulence factors may affect the clinical presentation of the mycoses. Sporothrix spp. present some virulence factors. This study aims to compare 24 S. brasiliensis strains from 12 familiar outbreaks of cat-to-human transmitted sporotrichosis. Fungal growth in different substrates, thermotolerance, resistance to oxidative stress, and production of enzymes were evaluated. An invertebrate model of experimental infection was used to compare the virulence of the strains. The strains grew well on glucose and N-acetyl-D-glucosamine but poorly on lactate. Their thermotolerance was moderate to high. All strains were susceptible to hydrogen peroxide, and the majority produced hemolysins but not phospholipase and esterase. There was no significant difference in the putative virulence-associated factors studied among the different hosts. Moreover, strains isolated from a human and a cat from four familiar outbreaks presented a very similar profile of expression of these factors, reinforcing the zoonotic transmission of S. brasiliensis in Brazil and demonstrating the plasticity of this species in the production of virulence factors.
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Affiliation(s)
- Dario Corrêa-Junior
- Laboratório de Biofísica de Fungos, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-902, Brazil
| | - Iara Bastos de Andrade
- Laboratório de Biofísica de Fungos, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-902, Brazil
| | - Vinicius Alves
- Laboratório de Biofísica de Fungos, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-902, Brazil
| | - Igor Avellar-Moura
- Laboratório de Biofísica de Fungos, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-902, Brazil
| | - Tânia Rodrigues-Alves
- Laboratório de Biofísica de Fungos, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-902, Brazil
| | - Vanessa Brito de Souza Rabello
- Laboratório de Biologia Celular de Fungos, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 24020-141, Brazil
| | - Glauber R de S Araújo
- Laboratório de Biofísica de Fungos, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-902, Brazil
| | - Luana Pereira Borba-Santos
- Laboratório de Biologia Celular de Fungos, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 24020-141, Brazil
| | - Rosely Maria Zancopé-Oliveira
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro 21041-210, Brazil
| | - Rodrigo Almeida-Paes
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro 21041-210, Brazil
- Rede Micologia RJ, FAPERJ, Rio de Janeiro 20020-000, Brazil
| | - Susana Frases
- Laboratório de Biofísica de Fungos, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-902, Brazil
- Rede Micologia RJ, FAPERJ, Rio de Janeiro 20020-000, Brazil
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Cognialli RCR, Cáceres DH, Bastos FDAGD, Cavassin FB, Lustosa BPR, Vicente VA, Breda GL, Santos-Weiss I, Queiroz-Telles F. Rising Incidence of Sporothrix brasiliensis Infections, Curitiba, Brazil, 2011-2022. Emerg Infect Dis 2023; 29:1330-1339. [PMID: 37347527 PMCID: PMC10310366 DOI: 10.3201/eid2907.230155] [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] [Indexed: 06/23/2023] Open
Abstract
Zoonotic outbreaks of sporotrichosis are increasing in Brazil. We examined and described the emergence of cat-transmitted sporotrichosis (CTS) caused by the fungal pathogen Sporothrix brasiliensis. We calculated incidence and mapped geographic distribution of cases in Curitiba, Brazil, by reviewing medical records from 216 sporotrichosis cases diagnosed during 2011-May 2022. Proven sporotrichosis was established in 84 (39%) patients and probable sporotrichosis in 132 (61%). Incidence increased from 0.3 cases/100,000 outpatient visit-years in 2011 to 21.4 cases/100,000 outpatient visit-years in 2021; of the 216 cases, 58% (n = 126) were diagnosed during 2019-2021. The main clinical form of sporotrichosis was lymphocutaneous (63%), followed by localized cutaneous (24%), ocular (10%), multisite infections (3%), and cutaneous disseminated (<0.5%). Since the first report of CTS in Curitiba in 2011, sporotrichosis has increased substantially, indicating continuous disease transmission. Clinician and public awareness of CTS and efforts to prevent transmission are needed.
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Izoton CFG, de Brito Sousa AX, Valete CM, Schubach ADO, Procópio-Azevedo AC, Zancopé-Oliveira RM, de Macedo PM, Gutierrez-Galhardo MC, Castro-Alves J, Almeida-Paes R, Martins ACDC, Freitas DFS. Sporotrichosis in the nasal mucosa: A single-center retrospective study of 37 cases from 1998 to 2020. PLoS Negl Trop Dis 2023; 17:e0011212. [PMID: 36972287 PMCID: PMC10079221 DOI: 10.1371/journal.pntd.0011212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 04/06/2023] [Accepted: 03/02/2023] [Indexed: 03/29/2023] Open
Abstract
Background
Sporotrichosis is a subcutaneous or implantation mycosis caused by some species of the genus Sporothrix. Rio de Janeiro state, Brazil, experiences hyperendemic levels of zoonotic sporotrichosis, with increasing cases of disseminated disease, especially in people living with HIV (PLHIV). Involvement of the nasal mucosa is rare and occurs isolated or in disseminated cases, with a delayed resolution.
Methodology/Principal findings
This study aimed to describe the epidemiological, clinical, and therapeutic profiles of 37 cases of sporotrichosis with involvement of the nasal mucosa treated at the ear, nose, and throat (ENT) outpatient clinic of the Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, from 1998 to 2020. Data were reviewed from the medical records and stored in a database. The Mann–Whitney test was used to compare the means of quantitative variables, and Pearson chi-square and Fisher’s exact tests were used to verify the association between qualitative variables (p<0.05). Most patients were males, students or retirees, with a median age of 38 years, residents in the municipality of Rio de Janeiro, and infected through zoonotic transmission. Disseminated sporotrichosis forms in patients with comorbidities (mostly PLHIV) were more common than the isolated involvement of the mucosa. The main characteristics of lesions in the nasal mucosa were the presence/elimination of crusts, involvement of various structures, mixed appearance, and severe intensity. Due to therapeutic difficulty, itraconazole was combined with amphotericin B and/or terbinafine in most cases. Of the 37 patients, 24 (64.9%) healed, with a median of 61 weeks of treatment, 9 lost follow-up, 2 were still treating and 2 died.
Conclusions
Immunosuppression was determinant to the outcome, with worse prognosis and lower probability of cure. Notably in this group, the systematization of the ENT examination for early identification of lesions is recommended to optimize the treatment and outcome of the disease.
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Affiliation(s)
| | - Antonio Xavier de Brito Sousa
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
- Instituto de Educação Médica, Rio de Janeiro, Brazil
| | - Cláudia Maria Valete
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
- Faculdade de Medicina da Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | | | | | | | - Julio Castro-Alves
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Rodrigo Almeida-Paes
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
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Ribeiro DSC, Machado LJ, Pereira JG, Baptista ARDS, da Rocha EMDS. Laser therapy in the treatment of feline sporotrichosis: A case series. BRAZILIAN JOURNAL OF VETERINARY MEDICINE 2023; 45:e005822. [PMID: 37146090 PMCID: PMC10153455 DOI: 10.29374/2527-2179.bjvm005822] [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: 12/23/2022] [Accepted: 04/03/2023] [Indexed: 05/07/2023] Open
Abstract
Sporotrichosis is the most prevalent subcutaneous mycosis in Latin America and is an important zoonosis in expansion throughout all the brazilian territory. Domestic cats are highly susceptible to the disease and play an important role in the spread of the agent to both other animals and humans. Sporothrix brasiliensis, the predominant species in the country, has greater virulence and some isolates also showed resistance to azoles, the class of antifungals of choice for treatment. Because it is a long-duration treatment, of high cost, and oral use, sick animals are often abandoned, which contributes to the spread and permanence of the infection as an important public health problem. Therefore, new therapeutic alternatives or adjuncts to treatment with antifungals may contribute to combating this zoonotic agent. In this work we describe the result of the treatment with laser therapy of eight Sporothrix spp infected cats. Our findings show the efficacy of the laser treatment even in different clinical forms. This technique has the potential to decrease the time length and costs of conventional treatment as well as the improvement of the treatment results.
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Affiliation(s)
- Daniella Souther Carvalho Ribeiro
- Veterinarian, MSc. Programa de Pós-graduação em Microbiologia e Parasitologia Aplicadas (PPGMPA),Departamento de Microbiologia e Parasitologia,Instituto Biomédico, Universidade Federal Fluminense (UFF)- Niterói, RJ, Brazil.
| | | | | | | | - Elisabeth Martins da Silva da Rocha
- Veterinarian, DSc., Departamento de Microbiologia e Parasitologia (MIP), Instituto Biomédico. Universidade Federal Fluminense (UFF). Niterói, RJ, Brazil.
- Correspondence
Elisabeth Martins da Silva da Rocha
Departamento de Microbiologia e Parasitologia, Instituto Biomédico, Universidade Federal Fluminense - UFF, Campus Valonguinho
Alameda Barros Terra, s/nº, Bloco E, Quinto Pavimento
CEP 24020-150 - Niterói (RJ), Brasil
E-mail:
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Spatial Distribution of Canine Sporotrichosis in Rio de Janeiro, Brazil (1998–2018) and Its Correlation with Socioeconomic Conditions. J Fungi (Basel) 2022; 8:jof8111207. [DOI: 10.3390/jof8111207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/08/2022] [Accepted: 11/10/2022] [Indexed: 11/17/2022] Open
Abstract
Canine sporotrichosis is a poorly described global disease and a spatial approach has not yet been used to assess the disease in dogs. Therefore, this study aimed to describe the occurrence of canine sporotrichosis in the state of Rio de Janeiro, Brazil, from 1998 to 2018 and its correlation with socioeconomic characteristics using exploratory spatial data analysis. A total of 295 cases of canine sporotrichosis were identified and 249 were georeferenced. There was a higher concentration of cases in the municipality of Rio de Janeiro, as well as along the border of the city and the adjacent municipalities in the great metropolitan area. The cases occurred in areas where most of the dwellings are houses. Moreover, no focus of disease density was found in the southern part of Rio de Janeiro city over the period studied, possibly due to better socioeconomic conditions. Areas with a high concentration of canine sporotrichosis cases coincided with regions that possessed a low proportion of households without paving, suggesting that the disease is not necessarily linked to extreme poverty. The mapping of areas with a greater density of cases is fundamental to formulate targeted and strategic plans in order to implement effective public health prevention and control measures.
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Teixeira MM, Almeida-Paes R, Bernardes-Engemann AR, Nicola AM, de Macedo PM, Valle ACF, Gutierrez-Galhardo MC, Freitas DFS, Barker BM, Matute DR, Stajich JE, Zancopé-Oliveira RM. Single nucleotide polymorphisms and chromosomal copy number variation may impact the Sporothrix brasiliensis antifungal susceptibility and sporotrichosis clinical outcomes. Fungal Genet Biol 2022; 163:103743. [PMID: 36152775 DOI: 10.1016/j.fgb.2022.103743] [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: 11/26/2021] [Revised: 09/16/2022] [Accepted: 09/16/2022] [Indexed: 02/05/2023]
Abstract
Feline-transmitted sporotrichosis has garnered attention due to the recent high incidence and the lack of efficient control in the epicenter of the epidemic, Rio de Janeiro, Brazil. Sporothrix brasiliensis is the major pathogen involved in feline-to-human sporotrichosis in Brazil and displays more virulent genotypes than the closely related species S. schenckii. Over the last two decades, several reports of antifungal-resistant strains have emerged. Sequencing and comparison analysis of the outbreak strains allowed us to observe that the azole non-wild-type S. brasiliensis strain CFP 1054 had significant chromosomal variations compared to wild-type strains. One of these variants includes a region of 231 Kb containing 75 duplicated genes, which were overrepresented for lipid and isoprenoid metabolism. We also identified an additional strain (CFP 1055) that was resistant to itraconazole and amphotericin B, which had a single nucleotide polymorphism in the tac1 gene. The patients infected with these two strains showed protracted clinical course and sequelae. Even though our sample size is modest, these results suggest the possibility of identifying specific point mutations and large chromosomal duplications potentially associated with antifungal resistance and clinical outcomes of sporotrichosis.
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Affiliation(s)
- Marcus M Teixeira
- Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ, USA; Faculty of Medicine, University of Brasília-DF, Brazil
| | - Rodrigo Almeida-Paes
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Andréa R Bernardes-Engemann
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | | | - Priscila M de Macedo
- Laboratório de Pesquisa Clínica em Dermatologia Infecciosa, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Antonio Carlos F Valle
- Laboratório de Pesquisa Clínica em Dermatologia Infecciosa, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, 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, RJ, Brazil
| | - Dayvison F S Freitas
- Laboratório de Pesquisa Clínica em Dermatologia Infecciosa, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Bridget M Barker
- Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ, USA
| | - Daniel R Matute
- Biology Department, University of North Carolina, Chapel Hill, NC, USA
| | - Jason E Stajich
- Department of Microbiology & Plant Pathology and Institute for Integrative Genome Biology, University of California, Riverside, Riverside, CA, USA
| | - Rosely M Zancopé-Oliveira
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil.
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10
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Bernardes-Engemann AR, Tomki GF, Rabello VBDS, Almeida-Silva F, Freitas DFS, Gutierrez-Galhardo MC, Almeida-Paes R, Zancopé-Oliveira RM. Sporotrichosis Caused by Non-Wild Type Sporothrix brasiliensis Strains. Front Cell Infect Microbiol 2022; 12:893501. [PMID: 35694546 PMCID: PMC9184675 DOI: 10.3389/fcimb.2022.893501] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 04/28/2022] [Indexed: 01/19/2023] Open
Abstract
The zoonotic transmission of sporotrichosis due to Sporothrix brasiliensis occurs largely in Rio de Janeiro state, Brazil since the 1990´s. Most patients infected with S. brasiliensis respond well to itraconazole or terbinafine. However, a few patients have a slow response or do not respond to the treatment and develop a chronic infection. The aim of this study was to analyze strains of S. brasiliensis against five different drugs to determine minimal inhibitory concentration distributions, to identify non-wild type strains to any drug evaluated and the clinical aspects of infections caused by them. This study evaluated 100 Sporothrix spp. strains obtained from 1999 to 2018 from the Evandro Chagas National Institute of Infectious Diseases, Fiocruz, which were identified through a polymerase chain reaction using specific primers for species identification. Two-fold serial dilutions of stock solutions of amphotericin B, itraconazole, posaconazole, ketoconazole and terbinafine prepared in dimethyl sulfoxide were performed to obtain working concentrations of antifungal drugs ranging from 0.015 to 8.0 mg/L. The broth microdilution reference method was performed according the M38-A2 CLSI guideline. All strains were identified as S. brasiliensis and thirteen were classified as non-wild type, two of them against different drugs. Non-wild type strains were identified throughout the entire study period. Patients infected by non-wild type strains presented prolonged treatment times, needed increased antifungal doses than those described in the literature and one of them presented a permanent sequel. In addition, three of them, with immunosuppression, died from sporotrichosis. Despite the broad use of antifungal drugs in hyperendemic areas of sporotrichosis, an emergence of non-wild type strains did not occur. The results of in vitro antifungal susceptibility tests should guide sporotrichosis therapy, especially in immunosuppressed patients.
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Affiliation(s)
- Andréa Reis Bernardes-Engemann
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Gabriela Ferreira Tomki
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Vanessa Brito de Souza Rabello
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Fernando Almeida-Silva
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Dayvison Francis Saraiva Freitas
- Laboratório de Pesquisa Clínica em Dermatologia Infecciosa - Instituto Nacional de Infectologia Evandro Chagas – Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Maria Clara Gutierrez-Galhardo
- Laboratório de Pesquisa Clínica em Dermatologia Infecciosa - 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
| | - Rosely Maria Zancopé-Oliveira
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
- *Correspondence: Rosely Maria Zancopé-Oliveira,
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11
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Falcão EMM, Romão AR, Magalhães MDAFM, de Lima Filho JB, do Valle ACF, Bastos FI, Gutierrez-Galhardo MC, Freitas DFS. A Spatial Analysis of the Spread of Hyperendemic Sporotrichosis in the State of Rio de Janeiro, Brazil. J Fungi (Basel) 2022; 8:jof8050434. [PMID: 35628690 PMCID: PMC9145434 DOI: 10.3390/jof8050434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 04/16/2022] [Accepted: 04/21/2022] [Indexed: 02/01/2023] Open
Abstract
Sporotrichosis is a subacute/chronic subcutaneous mycosis. Since the late 1990s, there has been a hyperendemic zoonotic transmission in the state of Rio de Janeiro, involving Sporothrix brasiliensis, the most virulent causative species, and a “belt” was described along the limits between the capital and its outskirts (“Baixada Fluminense”). This study analyzes the distribution of sporotrichosis using secondary data from the Notifiable Diseases Information System (Sinan) of the Rio de Janeiro State Health Department (SES/RJ) from 2011 to 2015 and from the INI Electronic Patient Record System (Sipec) from 2008 to 2015. Cases diagnosed since the onset of the hyperendemic exceed all previously reported case series of the disease and there is a progressive expansion in the state of Rio de Janeiro. The study suggests the spread of the mycosis to all regions of the state and the expansion of the previously described “belt”, despite public health measures and changes in its profile over the years, with great social impact.
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Affiliation(s)
- Eduardo Mastrangelo Marinho Falcão
- Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro 21040-90, RJ, Brazil;
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro 21040-90, RJ, Brazil; (J.B.d.L.F.); (A.C.F.d.V.); (M.C.G.-G.)
- Correspondence:
| | - Anselmo Rocha Romão
- Instituto de Comunicação e Informação Científica e Tecnologia em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro 21040-90, RJ, Brazil; (A.R.R.); (M.d.A.F.M.M.); (F.I.B.)
| | | | - José Berilo de Lima Filho
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro 21040-90, RJ, Brazil; (J.B.d.L.F.); (A.C.F.d.V.); (M.C.G.-G.)
| | - Antonio Carlos Francesconi do Valle
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro 21040-90, RJ, Brazil; (J.B.d.L.F.); (A.C.F.d.V.); (M.C.G.-G.)
| | - Francisco Inácio Bastos
- Instituto de Comunicação e Informação Científica e Tecnologia em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro 21040-90, RJ, Brazil; (A.R.R.); (M.d.A.F.M.M.); (F.I.B.)
| | - Maria Clara Gutierrez-Galhardo
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro 21040-90, RJ, Brazil; (J.B.d.L.F.); (A.C.F.d.V.); (M.C.G.-G.)
| | - Dayvison Francis Saraiva Freitas
- Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro 21040-90, RJ, Brazil;
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro 21040-90, RJ, Brazil; (J.B.d.L.F.); (A.C.F.d.V.); (M.C.G.-G.)
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12
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Schechtman RC, Falcão EMM, Carard M, García MSC, Mercado DS, Hay RJ. Sporotrichosis: hyperendemic by zoonotic transmission, with atypical presentations, hypersensitivity reactions and greater severity. An Bras Dermatol 2022; 97:1-13. [PMID: 34893422 PMCID: PMC8799859 DOI: 10.1016/j.abd.2021.07.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 06/23/2021] [Accepted: 07/13/2021] [Indexed: 11/01/2022] Open
Abstract
In recent decades, an alarming increase in the number of sporotrichosis cases has been reported in southern and southeastern Brazil, especially in the state of Rio de Janeiro, has been considered a long-term hyperendemic condition associated with feline transmission. According to phenotypic classifications, the Sporothrix species recovered from cats were classified as S. brasiliensis in 96.5% of the studied cases. This finding has also been demonstrated in humans, which confirms the zoonotic transmission associated with this predominant species in Brazil. The zoonotic transmission of the fungus and its important virulence in the context of the hyperendemic situation in Rio de Janeiro have changed the approach to the disease, which in its classic form was restricted to certain professional groups and very specific regions in the Brazilian territory, into a public health challenge of scientific interest. Its atypical manifestations and hypersensitivity reactions are increasingly frequent, constituting a new sporotrichosis aspect, which deserves attention from the medical community, as well as from other health professionals.
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Affiliation(s)
- Regina Casz Schechtman
- Instituto de Dermatologia Professor Rubem David Azulay, Pontifícia Universidade Católica do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
| | | | - Marciela Carard
- Instituto de Dermatologia Professor Rubem David Azulay, Pontifícia Universidade Católica do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Maria Salomé Cajas García
- Instituto de Dermatologia Professor Rubem David Azulay, Pontifícia Universidade Católica do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Diana Stohmann Mercado
- Instituto de Dermatologia Professor Rubem David Azulay, Pontifícia Universidade Católica do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Roderick James Hay
- International Foundation of Dermatology, University of London, London, UK
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13
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Rabello VBS, Almeida MA, Bernardes-Engemann AR, Almeida-Paes R, de Macedo PM, Zancopé-Oliveira RM. The Historical Burden of Sporotrichosis in Brazil: a Systematic Review of Cases Reported from 1907 to 2020. Braz J Microbiol 2021; 53:231-244. [PMID: 34825345 DOI: 10.1007/s42770-021-00658-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 10/21/2021] [Indexed: 01/26/2023] Open
Abstract
Sporotrichosis is a cosmopolitan subcutaneous mycosis caused by Sporothrix species. Recently, this mycosis has gained notoriety due to the appearance of new endemic areas, recognition of new pathogenic species, changes in epidemiology, occurrence of outbreaks, and increasing numbers of cases. The purpose of this study is to analyze the peculiarities of sporotrichosis cases in Brazil since its first report in the country until 2020. In this work, ecological, epidemiological, clinical, and laboratorial characteristics were compiled. A systematic review of human sporotrichosis diagnosed in Brazil and published up to December 2020 was performed on PubMed/MEDLINE, SciELO, Web of Science, and LILACS databases. Furthermore, animal sporotrichosis and environmental isolation of Sporothrix spp. in Brazil were also evaluated. The study included 230 papers, resulting in 10,400 human patients. Their ages ranged from 5 months to 92 years old and 55.98% were female. The lymphocutaneous form was predominant (56.14%), but systemic involvement was also notably reported (14.34%), especially in the lungs. Besides, hypersensitivity manifestations (4.55%) were described. Most patients had the diagnosis confirmed by isolation of Sporothrix spp., mainly from skin samples. Sporothrix brasiliensis was the major agent identified. HIV infection, cardiovascular diseases, and diabetes were the most common comorbidities. Cure rate was 85.83%. Concerning animal sporotrichosis, 8538 cases were reported, mostly in cats (90.77%). Moreover, 13 Sporothrix spp. environmental strains were reported. This review highlights the burden of the emergent zoonotic sporotrichosis in Brazil, reinforcing the importance of "One Health" based actions to help controlling this disease.
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Affiliation(s)
- Vanessa Brito Souza Rabello
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Marcos Abreu Almeida
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Andrea Reis Bernardes-Engemann
- 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
| | - Priscila Marques de Macedo
- Laboratório de Pesquisa Clínica Em Dermatologia Infecciosa, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Rosely Maria Zancopé-Oliveira
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.
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14
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Sporotrichosis: A Clinicopathologic Study of 89 Consecutive Cases, Literature Review, and New Insights About Their Differential Diagnosis. Am J Dermatopathol 2021; 42:751-755. [PMID: 32149828 DOI: 10.1097/dad.0000000000001617] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Sporotrichosis is the most common and least severe of deep mycoses. This disease has varied clinic presentation as well as several differential diagnosis. METHODS A cross-sectional and retrospective, individually based, observational study, based on records from the dermatopathology service of a university hospital in Brazil. A total of 175 patients were identified with clinical suspicion of sporotrichosis, from 2009 to 2017. Statistical analysis using prevalence ratios was conducted to characterize the clinicopathologic and epidemiological aspects. RESULTS The disease was suspected in 175 patients given the clinical presentation. Of these, 86 cases (49.14%) were sporotrichosis, 39 (22.29%) chronic granulomatous inflammatory processes of unidentified etiology, and 5 squamous cell carcinomas (2.86%). The majority of cases (52 or 60.46%) occurred in the upper limbs. A total of 40 samples presented a suppurative chronic granulomatous inflammatory process (46.51%). Only 5 samples (12.50%) showed positive staining (periodic-Schiff acid or GROCOTT). CONCLUSIONS The sporotrichosis cases underwent both cumulative and linear growth, especially in the group above 60 years. Squamous cell carcinomas appeared several times as a misdiagnosis of sporotrichosis by dermatologists, so it should be considered as an important differential diagnose due to the current context of skin cancers.
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15
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van Rhijn N, Bromley M. The Consequences of Our Changing Environment on Life Threatening and Debilitating Fungal Diseases in Humans. J Fungi (Basel) 2021; 7:367. [PMID: 34067211 PMCID: PMC8151111 DOI: 10.3390/jof7050367] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 04/30/2021] [Accepted: 05/04/2021] [Indexed: 12/16/2022] Open
Abstract
Human activities have significantly impacted the environment and are changing our climate in ways that will have major consequences for ourselves, and endanger animal, plant and microbial life on Earth. Rising global temperatures and pollution have been highlighted as potential drivers for increases in infectious diseases. Although infrequently highlighted, fungi are amongst the leading causes of infectious disease mortality, resulting in more than 1.5 million deaths every year. In this review we evaluate the evidence linking anthropomorphic impacts with changing epidemiology of fungal disease. We highlight how the geographic footprint of endemic mycosis has expanded, how populations susceptible to fungal infection and fungal allergy may increase and how climate change may select for pathogenic traits and indirectly contribute to the emergence of drug resistance.
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Affiliation(s)
| | - Michael Bromley
- Manchester Fungal Infection Group, University of Manchester, Manchester M13 9PL, UK;
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16
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Eudes Filho J, dos Santos IB, Reis CMS, Patané JSL, Paredes V, Bernardes JPRA, Poggiani SDSC, Castro TDCB, Gomez OM, Pereira SA, Schubach EYP, Gomes KP, Mavengere H, Alves LGDB, Lucas J, Paes HC, Albuquerque P, Cruz LM, McEwen JG, Stajich JE, Almeida-Paes R, Zancopé-Oliveira RM, Matute DR, Barker BM, Felipe MSS, Teixeira MDM, Nicola AM. A novel Sporothrix brasiliensis genomic variant in Midwestern Brazil: evidence for an older and wider sporotrichosis epidemic. Emerg Microbes Infect 2020; 9:2515-2525. [PMID: 33155518 PMCID: PMC7717857 DOI: 10.1080/22221751.2020.1847001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 10/25/2020] [Indexed: 12/30/2022]
Abstract
Sporotrichosis is a subcutaneous infection caused by fungi from the genus Sporothrix. It is transmitted by inoculation of infective particles found in plant-contaminated material or diseased animals, characterizing the classic sapronotic and emerging zoonotic transmission, respectively. Since 1998, southeastern Brazil has experienced a zoonotic sporotrichosis epidemic caused by S. brasiliensis, centred in the state of Rio de Janeiro. Our observation of feline sporotrichosis cases in Brasília (Midwestern Brazil), around 900 km away from Rio de Janeiro, led us to question whether the epidemic caused by S. brasiliensis has spread from the epicentre in Rio de Janeiro, emerged independently in the two locations, or if the disease has been present and unrecognized in Midwestern Brazil. A retrospective analysis of 91 human and 4 animal cases from Brasília, ranging from 1993 to 2018, suggests the occurrence of both sapronotic and zoonotic transmission. Molecular typing of the calmodulin locus identified S. schenckii as the agent in two animals and all seven human patients from which we were able to recover clinical isolates. In two other animals, the disease was caused by S. brasiliensis. Whole-genome sequence typing of seven Sporothrix spp. strains from Brasília and Rio de Janeiro suggests that S. brasiliensis isolates from Brasília are genetically distinct from those obtained at the epicentre of the outbreak in Rio de Janeiro, both in phylogenomic and population genomic analyses. The two S. brasiliensis populations seem to have separated between 2.2 and 3.1 million years ago, indicating independent outbreaks or that the zoonotic S. brasiliensis outbreak might have started earlier and be more widespread in South America than previously recognized.
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Affiliation(s)
- João Eudes Filho
- Graduate Program in Genomic Sciences and Biotechnology, Catholic University of Brasília, Brasília, Brazil
| | | | | | | | | | | | | | | | - Oscar Mauricio Gomez
- Cellular & Molecular Biology Unit, Corporación para Investigaciones Biológicas, Medellín, Colombia
| | - Sandro Antonio Pereira
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | | | - Heidi Mavengere
- Department of Biology, University of North Carolina, Chapel Hill, USA
| | | | - Joaquim Lucas
- Graduate Program in Genomic Sciences and Biotechnology, Catholic University of Brasília, Brasília, Brazil
| | | | | | - Laurício Monteiro Cruz
- Office of Environmental Surveillance of Zoonoses, Federal District Health Secretariat, Brasília, Brazil
| | - Juan G. McEwen
- Cellular & Molecular Biology Unit, Corporación para Investigaciones Biológicas, Medellín, Colombia
| | - Jason E. Stajich
- Department of Microbiology & Plant Pathology and Institute for Integrative Genome Biology, University of California, Riverside, USA
| | - Rodrigo Almeida-Paes
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | - Daniel R. Matute
- Department of Biology, University of North Carolina, Chapel Hill, USA
| | - Bridget M. Barker
- Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, USA
| | - Maria Sueli Soares Felipe
- Graduate Program in Genomic Sciences and Biotechnology, Catholic University of Brasília, Brasília, Brazil
- Institute of Biological Sciences, University of Brasília, Brasília, Brazil
| | - Marcus de Melo Teixeira
- Graduate Program in Genomic Sciences and Biotechnology, Catholic University of Brasília, Brasília, Brazil
- Faculty of Medicine, University of Brasília, Brazil
| | - André Moraes Nicola
- Graduate Program in Genomic Sciences and Biotechnology, Catholic University of Brasília, Brasília, Brazil
- Faculty of Medicine, University of Brasília, Brazil
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17
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de Carvalho JA, Hagen F, Fisher MC, de Camargo ZP, Rodrigues AM. Genome-wide mapping using new AFLP markers to explore intraspecific variation among pathogenic Sporothrix species. PLoS Negl Trop Dis 2020; 14:e0008330. [PMID: 32609739 PMCID: PMC7329091 DOI: 10.1371/journal.pntd.0008330] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Accepted: 04/27/2020] [Indexed: 11/19/2022] Open
Abstract
Sporotrichosis is a chronic subcutaneous mycosis caused by Sporothrix species, of which the main aetiological agents are S. brasiliensis, S. schenckii, and S. globosa. Infection occurs after a traumatic inoculation of Sporothrix propagules in mammals' skin and can follow either a classic route through traumatic inoculation by plant debris (e.g., S. schenckii and S. globosa) or an alternative route through zoonotic transmission from animals (e.g., S. brasiliensis). Epizootics followed by a zoonotic route occur in Brazil, with Rio de Janeiro as the epicenter of a recent cat-transmitted epidemic. DNA-based markers are needed to explore the epidemiology of these Sporothrix expansions using molecular methods. This paper reports the use of amplified-fragment-length polymorphisms (AFLP) to assess the degree of intraspecific variability among Sporothrix species. We used whole-genome sequences from Sporothrix species to generate 2,304 virtual AFLP fingerprints. In silico screening highlighted 6 primer pair combinations to be tested in vitro. The protocol was used to genotype 27 medically relevant Sporothrix. Based on the overall scored AFLP markers (97-137 fragments), the values of polymorphism information content (PIC = 0.2552-0.3113), marker index (MI = 0.002-0.0039), effective multiplex ratio (E = 17.8519-35.2222), resolving power (Rp = 33.6296-63.1852), discriminating power (D = 0.9291-0.9662), expected heterozygosity (H = 0.3003-0.3857), and mean heterozygosity (Havp = 0.0001) demonstrated the utility of these primer combinations for discriminating Sporothrix. AFLP markers revealed cryptic diversity in species previously thought to be the most prevalent clonal type, such as S. brasiliensis, responsible for cat-transmitted sporotrichosis, and S. globosa responsible for large sapronosis outbreaks in Asia. Three combinations (#3 EcoRI-FAM-GA/MseI-TT, #5 EcoRI-FAM-GA/MseI-AG, and #6 EcoRI-FAM-TA/MseI-AA) provide the best diversity indices and lowest error rates. These methods make it easier to track routes of disease transmission during epizooties and zoonosis, and our DNA fingerprint assay can be further transferred between laboratories to give insights into the ecology and evolution of pathogenic Sporothrix species and to inform management and mitigation strategies to tackle the advance of sporotrichosis.
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Affiliation(s)
- Jamile Ambrósio de Carvalho
- Departament of Medicine, Discipline of infectious Diseases, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
- Laboratory of Emerging Fungal Pathogens, Department of Microbiology, Immunology, and Parasitology, Discipline of Cellular Biology, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Ferry Hagen
- Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
- Department of Medical Microbiology, UMC Utrecht, Utrecht, The Netherlands
- Laboratory of Medical Mycology, Jining No. 1 People's Hospital, Jining, Shandong, Peoples Republic of China
| | - Matthew C. Fisher
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, United Kingdom
| | - Zoilo Pires de Camargo
- Departament of Medicine, Discipline of infectious Diseases, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
- Laboratory of Emerging Fungal Pathogens, Department of Microbiology, Immunology, and Parasitology, Discipline of Cellular Biology, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Anderson Messias Rodrigues
- Laboratory of Emerging Fungal Pathogens, Department of Microbiology, Immunology, and Parasitology, Discipline of Cellular Biology, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
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18
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Albuquerque PC, Fonseca e Fonseca BDP, Zicker F, Zancopé-Oliveira RM, Almeida-Paes R. Bibliometric assessment and implications for practice of sporotrichosis research (1945-2018). F1000Res 2020; 9:654. [DOI: 10.12688/f1000research.24250.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/17/2020] [Indexed: 01/19/2023] Open
Abstract
Background: Sporotrichosis has recently emerged as an important mycosis worldwide, with diverse transmission and epidemiologic profiles. For instance, in Brazil most cases are related to zoonotic transmission from naturally infected cats, and the majority of cases in China are due to external injury with environmental materials. Publications on sporotrichosis and on its etiologic agent may guide the direction of the research in this field. It can also define priorities for future studies. Methods: In this study, we evaluated the trends of global research in Sporothrix and sporotrichosis, based on publications records retrieved from Scopus and Web of Science databases for the period of 1945 to 2018. The overall productivity in the field, its geographical and temporal distribution, research themes, co-authorship networks, funding sources, and the implications of research findings for health practice were assessed using bibliometric approaches. Results: A total of 4,007 unique publications involving 99 countries were retrieved, most of them published after 2000. Authors based on institutions from the United States of America and Brazil accounted for 57.4% of the publications. Brazil was the leading country in terms of research collaboration and networking, with co-authorship with 45 countries. The thematic mapping revealed a temporal shift from clinical to applied research. Despite the large number of countries publishing in this field, most of funded studies came from Brazil, Mexico, China, South Africa, or the United States of America. The analysis of content identified few specific public health recommendations for prevention, case-management, or research. Moreover, most papers do not have a clearly defined intended audience. Conclusion: As the research in this field is emerging in several countries, with the generation of a large amount of data, it is necessary that scientists strengthen efforts to translate the research results into practice to curb this neglected infection.
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19
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Albuquerque PC, Fonseca E Fonseca BDP, Zicker F, Zancopé-Oliveira RM, Almeida-Paes R. Bibliometric assessment and key messages of sporotrichosis research (1945-2018). F1000Res 2020; 9:654. [PMID: 33968371 PMCID: PMC8080985 DOI: 10.12688/f1000research.24250.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/30/2021] [Indexed: 01/19/2023] Open
Abstract
Background: Sporotrichosis has recently emerged as an important mycosis worldwide, with diverse transmission and epidemiologic profiles. For instance, in Brazil most cases are related to zoonotic transmission from naturally infected cats, and the majority of cases in China are due to external injury with environmental materials. Publications on sporotrichosis and on its etiologic agent may guide the direction of the research in this field. It can also define priorities for future studies. Methods: In this study, we evaluated the trends of global research in
Sporothrix and sporotrichosis, based on publications records retrieved from Scopus and Web of Science databases for the period of 1945 to 2018. The overall productivity in the field, its geographical and temporal distribution, research themes, co-authorship networks, funding sources, and if audience and research findings are addressed in the abstracts. Results: A total of 4,007 unique publications involving 99 countries were retrieved, most of them published after 2000. Authors based on institutions from the United States of America and Brazil accounted for 57.4% of the publications. Brazil was the leading country in terms of research collaboration and networking, with co-authorship with 45 countries. The thematic mapping revealed a temporal shift from clinical to applied research. Despite the large number of countries publishing in this field, most of funded studies came from Brazil, Mexico, China, South Africa, or the United States of America. The analysis of content identified few specific public health recommendations for prevention, case-management, or research. Moreover, most papers do not have a clearly defined intended audience. Conclusion: As the research in this field is emerging in several countries, with the generation of a large amount of data, it is necessary that scientists strengthen efforts to translate the research results into practice to curb this neglected infection.
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Affiliation(s)
- Priscila Costa Albuquerque
- Center for Technological Development in Health (CDTS), Oswaldo Cruz Foundation, Rio de Janeiro, RJ, 21040361, Brazil
| | | | - Fabio Zicker
- Center for Technological Development in Health (CDTS), Oswaldo Cruz Foundation, Rio de Janeiro, RJ, 21040361, Brazil
| | - Rosely Maria Zancopé-Oliveira
- Mycology Laboratory, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation, Rio de Janeiro, RJ, 21040900, Brazil
| | - Rodrigo Almeida-Paes
- Mycology Laboratory, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation, Rio de Janeiro, RJ, 21040900, Brazil
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20
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Rodrigues AM, Della Terra PP, Gremião ID, Pereira SA, Orofino-Costa R, de Camargo ZP. The threat of emerging and re-emerging pathogenic Sporothrix species. Mycopathologia 2020; 185:813-842. [PMID: 32052359 DOI: 10.1007/s11046-020-00425-0] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 01/09/2020] [Indexed: 01/19/2023]
Abstract
Sporotrichosis is a neglected subcutaneous mycosis of humans and animals acquired by traumatic inoculation of soil and plant material (classical route) contaminated with infectious propagules of the pathogen or being bitten/scratched by infected cats (alternative route). Within a genus composed of 53 species displaying an essentially environmental core, there are only a few members which have considerable impacts on human or animal health. Infections are typically caused by S. brasiliensis, S. schenckii or S. globosa. Rare mammal pathogens include members of the S. pallida and S. stenocereus complexes. To illustrate the tremendous impact of emerging zoonotic sporotrichosis on public health, we discuss the main features of the expanding epidemics driven by S. brasiliensis in cats and humans. The cat entry in the transmission chain of sporotrichosis, causing epizooties (cat-cat) or zoonosis (cat-human), has contributed to the definition of new paradigms in Sporothrix transmission, reaching epidemic levels, making the disease a serious public health problem. Indeed, S. brasiliensis infection in humans and animals is likely to become even more important in the future, with projections of its expansion in biogeographic domains and host range, as well as greater virulence in mammals. Therefore, lessons from a long-standing outbreak in the state of Rio de Janeiro about the source and distribution of the etiological agents among outbreak areas can be used to create better control and prevention plans and increase awareness of sporotrichosis as a serious emerging zoonotic disease.
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Affiliation(s)
- Anderson Messias Rodrigues
- Laboratory of Emerging Fungal Pathogens, Cell Biology Division, Department of Microbiology, Immunology and Parasitology, Paulista School of Medicine, Federal University of São Paulo, São Paulo, 04023-062, Brazil.
| | - Paula Portella Della Terra
- Laboratory of Emerging Fungal Pathogens, Cell Biology Division, Department of Microbiology, Immunology and Parasitology, Paulista School of Medicine, Federal University of São Paulo, São Paulo, 04023-062, Brazil
| | - Isabella Dib Gremião
- Laboratory of Clinical Research on Dermatozoonoses in Domestic Animals, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Sandro Antonio Pereira
- Laboratory of Clinical Research on Dermatozoonoses in Domestic Animals, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Rosane Orofino-Costa
- Dermatology Department, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro (FCM-UERJ), Rio de Janeiro, RJ, Brazil
| | - Zoilo Pires de Camargo
- Laboratory of Emerging Fungal Pathogens, Cell Biology Division, Department of Microbiology, Immunology and Parasitology, Paulista School of Medicine, Federal University of São Paulo, São Paulo, 04023-062, Brazil
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21
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Falcão EMM, de Lima Filho JB, Campos DP, Valle ACFD, Bastos FI, Gutierrez-Galhardo MC, Freitas DFS. [Hospitalizations and deaths related to sporotrichosis in Brazil (1992-2015)]. CAD SAUDE PUBLICA 2020; 35:e00109218. [PMID: 31066776 DOI: 10.1590/0102-311x00109218] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 03/13/2019] [Indexed: 11/22/2022] Open
Abstract
Sporotrichosis is a subcutaneous mycosis with global distribution, and patients generally receive outpatient treatment. Since 1998 there has been an increase in cases in the state of Rio de Janeiro, Brazil, mainly via zoonotic transmission involving cats. Patients coinfected with the human immunodeficiency virus (HIV) often require hospitalization and evolve to death. This study analyzes and describes data from 1992 to 2015 obtained from the database of the Brazilian Unified National Health System (SUS). There were 782 hospitalizations and 65 deaths in Brazil. Six percent of the hospitalizations and 40% of the deaths involved coinfection with HIV. There were 250 hospitalizations and 36 deaths in Rio de Janeiro, with a progressive increase over the course of the period. The states of São Paulo and Goiás also showed high numbers. Men, non-whites, and individuals with low schooling evolved more frequently to death. In conclusion, sporotrichosis is associated with hospitalizations and deaths throughout Brazil, especially in the state of Rio de Janeiro.
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Affiliation(s)
| | | | | | | | - Francisco Inácio Bastos
- Instituto de Comunicação e Informação Científica e Tecnologia em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | | | - Dayvison Francis Saraiva Freitas
- Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.,Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
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22
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Lemos Tavares P, Carvalho Ribeiro A, Kercher Berte F, da Silva Hellwig AH, Machado Pagani D, Tavares de Souza CC, Brittes Rott M, Scroferneker ML. The interaction between Sporothrix schenckii sensu stricto and Sporothrix brasiliensis with Acanthamoeba castellanii. Mycoses 2019; 63:302-307. [PMID: 31820499 DOI: 10.1111/myc.13043] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 12/04/2019] [Accepted: 12/05/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND Sporotrichosis is a group of zoonotic subcutaneous mycoses, found worldwide and caused by fungi belonging to the genus Sporothrix. Protozoans of the genus Acanthamoeba are widely distributed, and some species may be pathogenic and/or opportunistic. These organisms coexist in the same environment and may interact. OBJECTIVES This study determined the profile of interactions of S schenckii sensu stricto and S brasiliensis with A castellanii, using an in vitro co-culture model to evaluate the intrinsic characteristics of the two Sporothrix species and A castellanii. METHODS We compared the rate of phagocytosis of S schenckii sensu stricto and S brasiliensis by A castellanii; the viability of S schenckii sensu stricto and S brasiliensis after contact with A castellanii; the viability of the amoeba after contact with a fungal species; and the influence of S schenckii sensu stricto and S brasiliensis on the encystment process of A castellanii. RESULTS The analyses indicated that A castellanii phagocytised both S schenckii and S brasiliensis, with significantly more S schenckii than S brasiliensis in the first two hours of contact. Our results showed a significant increase in conidia and hyphae count after 72 hours of co-culture of A castellanii with S brasiliensis, and the amoebae lysed after they ingested the fungi, indicating that the fungi probably used the amoebae as a source of nutrition. CONCLUSIONS Our results were obtained in vitro and these organisms may not behave similarly in vivo; in vivo studies of co-infections are necessary in order to gain a thorough understanding of this relationship.
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Affiliation(s)
- Priscila Lemos Tavares
- Postgraduate Program in Medicine, Medical Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
| | - Amanda Carvalho Ribeiro
- Department of Microbiology, Immunology and Parasitology, ICBS, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
| | - Francisco Kercher Berte
- Department of Microbiology, Immunology and Parasitology, ICBS, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
| | | | - Danielle Machado Pagani
- Postgraduate Program in Agricultural and Environmental Microbiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
| | - Carine Cristina Tavares de Souza
- Postgraduate Program in Agricultural and Environmental Microbiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
| | - Marilise Brittes Rott
- Department of Microbiology, Immunology and Parasitology, ICBS, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil.,Postgraduate Program in Agricultural and Environmental Microbiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
| | - Maria Lúcia Scroferneker
- Postgraduate Program in Medicine, Medical Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil.,Department of Microbiology, Immunology and Parasitology, ICBS, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
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23
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Emerging Fungal Infections: New Patients, New Patterns, and New Pathogens. J Fungi (Basel) 2019; 5:jof5030067. [PMID: 31330862 PMCID: PMC6787706 DOI: 10.3390/jof5030067] [Citation(s) in RCA: 167] [Impact Index Per Article: 33.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 07/18/2019] [Accepted: 07/19/2019] [Indexed: 01/13/2023] Open
Abstract
The landscape of clinical mycology is constantly changing. New therapies for malignant and autoimmune diseases have led to new risk factors for unusual mycoses. Invasive candidiasis is increasingly caused by non-albicans Candida spp., including C. auris, a multidrug-resistant yeast with the potential for nosocomial transmission that has rapidly spread globally. The use of mould-active antifungal prophylaxis in patients with cancer or transplantation has decreased the incidence of invasive fungal disease, but shifted the balance of mould disease in these patients to those from non-fumigatus Aspergillus species, Mucorales, and Scedosporium/Lomentospora spp. The agricultural application of triazole pesticides has driven an emergence of azole-resistant A. fumigatus in environmental and clinical isolates. The widespread use of topical antifungals with corticosteroids in India has resulted in Trichophyton mentagrophytes causing recalcitrant dermatophytosis. New dimorphic fungal pathogens have emerged, including Emergomyces, which cause disseminated mycoses globally, primarily in HIV infected patients, and Blastomyceshelicus and B. percursus, causes of atypical blastomycosis in western parts of North America and in Africa, respectively. In North America, regions of geographic risk for coccidioidomycosis, histoplasmosis, and blastomycosis have expanded, possibly related to climate change. In Brazil, zoonotic sporotrichosis caused by Sporothrix brasiliensis has emerged as an important disease of felines and people.
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Conceição-Silva F, Morgado FN. Immunopathogenesis of Human Sporotrichosis: What We Already Know. J Fungi (Basel) 2018; 4:jof4030089. [PMID: 30065160 PMCID: PMC6162489 DOI: 10.3390/jof4030089] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 07/26/2018] [Accepted: 07/27/2018] [Indexed: 12/19/2022] Open
Abstract
Sporotrichosis is a subacute/chronic mycosis caused by dimorphic fungus of the genus Sporothrix. This mycosis may affect both human and domestic animals and in the last few years, the geographic dispersion and increase of sporotrichosis worldwide has been observed. The occurrence of cases related to scratching/bites of domestic felines have increased, characterizing the disease as predominantly a zoonosis. In humans, sporotrichosis mainly involves the cutaneous tegument of infected patients, but other tissues may also present the infection. The main forms of clinical presentation are lymphocutanous sporotrichosis (LC) and fixed sporotrichosis (F). Although less common, mucosal, cutaneous disseminated, and extracutaneous forms have also been described. Multiple factors from the fungus and host can play a role in driving the clinical evolution of sporotrichosis to benign or severe disease. In this review, we discuss the immunopathological aspects involved in human sporotrichosis. Putting together the two branches of knowledge—host immune response and fungal evading mechanisms—we may perceive new possibilities in understanding the fungus–host interaction in order to be in a position to go further in the control of sporotrichosis.
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Affiliation(s)
- Fatima Conceição-Silva
- Laboratory of Immunoparasitology, Oswaldo Cruz Institute, IOC/Fiocruz, Avenida Brasil 4365 Pavilhão 26 sala 408-Manguinhos, Rio de Janeiro 21040-360, Brazil.
| | - Fernanda Nazaré Morgado
- Laboratory of Leishmaniasis Research, Oswaldo Cruz Institute, IOC/Fiocruz, Avenida Brasil 4365 Pavilhão 26 sala 509-Manguinhos, Rio de Janeiro 21040-360, Brazil.
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25
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Macêdo-Sales PA, Souto SRLS, Destefani CA, Lucena RP, Machado RLD, Pinto MR, Rodrigues AM, Lopes-Bezerra LM, Rocha EMS, Baptista ARS. Domestic feline contribution in the transmission of Sporothrix in Rio de Janeiro State, Brazil: a comparison between infected and non-infected populations. BMC Vet Res 2018; 14:19. [PMID: 29347940 PMCID: PMC5774141 DOI: 10.1186/s12917-018-1340-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 01/08/2018] [Indexed: 11/23/2022] Open
Abstract
Background Sporotrichosis is a neglected zoonosis caused by pathogenic fungi belonging to the Sporothrix schenckii complex. In Rio de Janeiro state, this disease reached an epidemic status with over 4700 domestic felines and around 4000 humans affected since the mid-90s. The present study evaluated clinical and epidemiological aspects and also the frequency of colonization and infection by these fungi in healthy cats and among those with suspicious cutaneous lesions, inhabiting four Rio de Janeiro state distinct areas. Results Three hundred and seventy-one cats were included in two groups: 175 healthy cats [CRG] and 196 cats showing lesions suggesting sporotrichosis [SSG]. Mycological diagnosis allowed SSG animals to be divided in positive [104 cats; +SG] and negative [92 cats; -SG] groups. Nails, oral mucosa and lesions swabs were submitted to culture and potential colonies were subculture for micromorphologycal analysis, dimorphism and molecular tests. In the CRG, only one cat was colonized in the oral cavity [0.57%]; in the -SG group, four animals showed colonization of the nail and/or oral cavity [4.3%]; while the highest frequency of colonization [39.4%] was observed in the +SG. All molecularly typed isolates were identified as S. brasiliensis. Conclusion The results obtained here indicate that healthy cats have a minor role in sporotrichosis transmission within the state of Rio de Janeiro. Conversely, a higher participation of diseased feline in sporotrichosis transmission was evidenced, especially by the colonization of their oral cavity. Sporothrix brasiliensis equally affects and colonizes animals from distinct Rio de Janeiro state areas. Thus, we hypothesize that sporotrichosis is a uniform endemic throughout the state, whose transmission depends mainly on the contact with cats with sporotrichosis. Since Rio de Janeiro displays a world unique epidemic model of the disease, not fully understood, data on the infected and non-infected animals can be of major importance for future strategies of sporotrichosis prevention and control. Finally, considering the importance of the current concept of “one health”, the experience here observed can be helpful for distinct epizootias and/or zoonosis.
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Affiliation(s)
- Pãmella A Macêdo-Sales
- Applied Microbiology e Parasitology Postgraduation Program, Fluminense Federal University (UFF), Niterói, RJ, Brazil
| | - Simone R L S Souto
- Veterinary Medicine Postgraduation Program, Fluminense Federal University (UFF), Niterói, RJ, Brazil
| | - Carolina A Destefani
- Medical and Molecular Mycology Laboratory, Microbiology and Parasitology Department, Biomedical Institute, Fluminense Federal University (UFF), Rua Prof. Hernani Melo, 101 São Domingos, Niterói, RJ, CEP: 24210-130, Brazil
| | - Ricardo P Lucena
- Medical and Molecular Mycology Laboratory, Microbiology and Parasitology Department, Biomedical Institute, Fluminense Federal University (UFF), Rua Prof. Hernani Melo, 101 São Domingos, Niterói, RJ, CEP: 24210-130, Brazil
| | - Ricardo Luiz D Machado
- Medical and Molecular Mycology Laboratory, Microbiology and Parasitology Department, Biomedical Institute, Fluminense Federal University (UFF), Rua Prof. Hernani Melo, 101 São Domingos, Niterói, RJ, CEP: 24210-130, Brazil
| | - Marcia R Pinto
- Medical and Molecular Mycology Laboratory, Microbiology and Parasitology Department, Biomedical Institute, Fluminense Federal University (UFF), Rua Prof. Hernani Melo, 101 São Domingos, Niterói, RJ, CEP: 24210-130, Brazil
| | - Anderson M Rodrigues
- Microbiology, Immunology and Parasitology Department, São Paulo Federal University (UNIFESP), São Paulo, SP, Brazil
| | - Leila M Lopes-Bezerra
- Cellular Mycology and Fungal Proteomics Laboratory, Rio de Janeiro State University (UERJ), Rio de Janeiro, RJ, Brazil
| | - Elisabeth M S Rocha
- Medical and Molecular Mycology Laboratory, Microbiology and Parasitology Department, Biomedical Institute, Fluminense Federal University (UFF), Rua Prof. Hernani Melo, 101 São Domingos, Niterói, RJ, CEP: 24210-130, Brazil
| | - Andréa Regina S Baptista
- Medical and Molecular Mycology Laboratory, Microbiology and Parasitology Department, Biomedical Institute, Fluminense Federal University (UFF), Rua Prof. Hernani Melo, 101 São Domingos, Niterói, RJ, CEP: 24210-130, Brazil.
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26
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Multicenter, International Study of MIC/MEC Distributions for Definition of Epidemiological Cutoff Values for Sporothrix Species Identified by Molecular Methods. Antimicrob Agents Chemother 2017; 61:AAC.01057-17. [PMID: 28739796 DOI: 10.1128/aac.01057-17] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 07/20/2017] [Indexed: 01/19/2023] Open
Abstract
Clinical and Laboratory Standards Institute (CLSI) conditions for testing the susceptibilities of pathogenic Sporothrix species to antifungal agents are based on a collaborative study that evaluated five clinically relevant isolates of Sporothrixschenckii sensu lato and some antifungal agents. With the advent of molecular identification, there are two basic needs: to confirm the suitability of these testing conditions for all agents and Sporothrix species and to establish species-specific epidemiologic cutoff values (ECVs) or breakpoints (BPs) for the species. We collected available CLSI MICs/minimal effective concentrations (MECs) of amphotericin B, five triazoles, terbinafine, flucytosine, and caspofungin for 301 Sporothrix schenckii sensu stricto, 486 S. brasiliensis, 75 S. globosa, and 13 S. mexicana molecularly identified isolates. Data were obtained in 17 independent laboratories (Australia, Europe, India, South Africa, and South and North America) using conidial inoculum suspensions and 48 to 72 h of incubation at 35°C. Sufficient and suitable data (modal MICs within 2-fold concentrations) allowed the proposal of the following ECVs for S. schenckii and S. brasiliensis, respectively: amphotericin B, 4 and 4 μg/ml; itraconazole, 2 and 2 μg/ml; posaconazole, 2 and 2 μg/ml; and voriconazole, 64 and 32 μg/ml. Ketoconazole and terbinafine ECVs for S. brasiliensis were 2 and 0.12 μg/ml, respectively. Insufficient or unsuitable data precluded the calculation of ketoconazole and terbinafine (or any other antifungal agent) ECVs for S. schenckii, as well as ECVs for S. globosa and S. mexicana These ECVs could aid the clinician in identifying potentially resistant isolates (non-wild type) less likely to respond to therapy.
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27
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Orofino-Costa R, de Macedo PM, Rodrigues AM, Bernardes-Engemann AR. Sporotrichosis: an update on epidemiology, etiopathogenesis, laboratory and clinical therapeutics. An Bras Dermatol 2017; 92:606-620. [PMID: 29166494 PMCID: PMC5674690 DOI: 10.1590/abd1806-4841.2017279] [Citation(s) in RCA: 181] [Impact Index Per Article: 25.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 07/23/2017] [Indexed: 01/19/2023] Open
Abstract
In the late 90's there was a change in both the route of transmission and the people at risk for sporotrichosis. This zoonotic cat-man alternative transmission route elicited changes in strategies to control the epidemic. There was a progressive increase in the number of cases involving especially children and the elderly. In addition to becoming hyperendemic, uncommon clinical pictures like immunoreactive clinical presentations or severe systemic cases have emerged. New species were identified and classified through molecular tools using more virulent clinical isolates, like S. brasiliensis, compared to the environmental isolates. Likewise, different species of Sporothrix have been associated with different geographic regions. The serological and molecular techniques are used as an auxiliary tool for the diagnosis and/or for species identification, although the isolation and the identification of Sporothrix spp. in clinical specimen is still the gold standard. Currently sporotrichosis epidemics requires the knowledge of the epidemiological-molecular profile to control the disease and the specific treatment. Itraconazole, potassium iodide, terfinafine, and amphotericin B are the available drugs in Brazil to treat sporotrichosis. The drug of choice, its posology, and treatment duration vary according to the clinical presentation, the Sporothrix species, and host immune status. New treatment choices, including a vaccine, are being developed; nevertheless, more clinical trials are required to confirm its efficacy.
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Affiliation(s)
- Rosane Orofino-Costa
- Dermatology Department, Faculdade de Ciências
Médicas, Universidade do Estado do Rio de Janeiro (FCM-UERJ), Rio de Janeiro,
RJ, Brazil
- Medical Mycology Laboratory, Dermatology Department, Hospital
Universitário Pedro Ernesto, Rio de Janeiro, RJ, Brazil
| | - Priscila Marques de Macedo
- Infectious Dermatology Clinical Research Laboratory, Instituto
Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz
(INI/Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Anderson Messias Rodrigues
- Laboratory of Emerging Fungal Pathogen, Department of Microbiology,
Immunology and Parasitology, Universidade Federal de São Paulo (UNIFESP), SP,
Brazil
| | - Andréa Reis Bernardes-Engemann
- Dermatology Department, Faculdade de Ciências
Médicas, Universidade do Estado do Rio de Janeiro (FCM-UERJ), Rio de Janeiro,
RJ, Brazil
- Medical Mycology Laboratory, Dermatology Department, Hospital
Universitário Pedro Ernesto, Rio de Janeiro, RJ, Brazil
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Queiroz-Telles F, Fahal AH, Falci DR, Caceres DH, Chiller T, Pasqualotto AC. Neglected endemic mycoses. THE LANCET. INFECTIOUS DISEASES 2017; 17:e367-e377. [PMID: 28774696 DOI: 10.1016/s1473-3099(17)30306-7] [Citation(s) in RCA: 159] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 10/19/2016] [Accepted: 03/23/2017] [Indexed: 01/18/2023]
Abstract
Fungi often infect mammalian hosts via the respiratory route, but traumatic transcutaneous implantation is also an important source of infections. Environmental exposure to spores of pathogenic fungi can result in subclinical and unrecognised syndromes, allergic manifestations, and even overt disease. After traumatic cutaneous inoculation, several fungi can cause neglected mycoses such as sporotrichosis, chromoblastomycosis, mycetoma, entomophthoramycosis, and lacaziosis. Most of these diseases have a subacute to chronic course and they can become recalcitrant to therapy and lead to physical disabilities, including inability to work, physical deformities, and amputations. For many years, paracoccidioidomycosis was considered the most prevalent endemic systemic mycosis in the Americas, but this situation might be changing with recognition of the worldwide presence of Histoplasma capsulatum. Both paracoccidioidomycosis and histoplasmosis can mimic several infectious and non-infectious medical conditions and lead to death if not recognised early and treated. Cutaneous implantation and systemic mycoses are neglected diseases that affect millions of individuals worldwide, especially in low-income countries where their management is suboptimum because challenges in diagnosis and therapeutic options are substantial issues.
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Affiliation(s)
| | | | - Diego R Falci
- Infectious Diseases Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Centro Universitário La Salle, Canoas, Brazil
| | - Diego H Caceres
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Tom Chiller
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Alessandro C Pasqualotto
- Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil; Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
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29
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Orofino-Costa R, de Macedo PM, Bernardes-Engemann AR. Hyperendemia of Sporotrichosis in the Brazilian Southeast: Learning From Clinics and Therapeutics. CURRENT FUNGAL INFECTION REPORTS 2015. [DOI: 10.1007/s12281-015-0235-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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30
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Mahmoudi S, Zaini F. Sporotrichosis in Iran: A mini review of reported cases in patients suspected to cutaneous leishmaniasis. Curr Med Mycol 2015; 1:39-45. [PMID: 28680987 PMCID: PMC5490312 DOI: 10.18869/acadpub.cmm.1.2.39] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Revised: 05/25/2015] [Accepted: 06/02/2015] [Indexed: 11/17/2022] Open
Abstract
Sporotrichosis is a chronic subcutaneous fungal infection with global distribution. It is a rare fungal infection with nine reported cases in Iran, including eight humans and one animal, within the past 30 years. Among the human cases, seven were of the fixed cutaneous type of sporotrichosis and one had sporotrichoid lymphocutaneous. The reported patients were within the age range of 23-60 years, and six of them were female. The most frequent sites of infection were forearms and hands, as well as the face and legs. In addition, the majority of the cases had previously been suspected of leishmaniasis and received treatment. Sporotrichosis is not a well-known condition in Iran and is often misdiagnosed and erroneously treated for other cutaneous parasitic or bacterial infections with similar clinical manifestations. Therefore, sporotrichosis should be taken into account in the differential diagnosis of nodular-ulcerative skin lesions.
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Affiliation(s)
- S Mahmoudi
- MSc Student of Medical Mycology, Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - F Zaini
- Professor of Medical Mycology, Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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31
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Phylogeography and evolutionary patterns in Sporothrix spanning more than 14 000 human and animal case reports. Persoonia - Molecular Phylogeny and Evolution of Fungi 2015; 35:1-20. [PMID: 26823625 PMCID: PMC4713101 DOI: 10.3767/003158515x687416] [Citation(s) in RCA: 136] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 10/21/2014] [Indexed: 01/19/2023]
Abstract
Pathology to vertebrate hosts has emerged repeatedly in the order Ophiostomatales. Occasional infections have been observed in Sporothrix mexicana at a low level of virulence, while the main pathogenic species cluster in a derived clade around S. schenckii s.str. In this paper, phylogeny and epidemiology of the members of this clade were investigated for 99 clinical and 36 environmental strains using four genetic loci, viz. rDNA ITS and partial CAL, TEF1, and TEF3; data are compared with amplified fragment length polymorphism (AFLP) genotyping. The four main species of the pathogenic clade were recognised. The species proved to show high degrees of endemicity, which enabled interpretation of literature data where live material or genetic information is lacking. The clade of four species comprised nine subclusters, which often had limited geographic distribution and were separate from each other in all partitions, suggesting low degrees of interbreeding between populations. In contrast, S. globosa exhibited consistent global distribution of identical AFLP types, suggesting another type of dispersal. Sporothrix brasiliensis is known to be involved in an expanding zoonosis and transmitted by cats, whereas S. globosa infections originated from putrid plant material, causing a sapronosis. Sporothrix schenckii s.str., the most variable species within the clade, also had a plant origin, with ecological similarities to that of S. globosa. A hypothesis was put forward that highly specific conditions in the plant material are required to promote the growth of Sporothrix. Fermented, self-heated plant debris may stimulate the thermodependent yeast-like invasive form of the fungus, which facilitates repeated infection of mammals.
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Asexual propagation of a virulent clone complex in a human and feline outbreak of sporotrichosis. EUKARYOTIC CELL 2014; 14:158-69. [PMID: 25480940 DOI: 10.1128/ec.00153-14] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Sporotrichosis is one of the most frequent subcutaneous fungal infections in humans and animals caused by members of the plant-associated, dimorphic genus Sporothrix. Three of the four medically important Sporothrix species found in Brazil have been considered asexual as no sexual stage has ever been reported in Sporothrix schenckii, Sporothrix brasiliensis, or Sporothrix globosa. We have identified the mating type (MAT) loci in the S. schenckii (strain 1099-18/ATCC MYA-4821) and S. brasiliensis (strain 5110/ATCC MYA-4823) genomes by using comparative genomic approaches to determine the mating type ratio in these pathogen populations. Our analysis revealed the presence of a MAT1-1 locus in S. schenckii while a MAT1-2 locus was found in S. brasiliensis representing genomic synteny to other Sordariomycetes. Furthermore, the components of the mitogen-activated protein kinase (MAPK)-pheromone pathway, pheromone processing enzymes, and meiotic regulators have also been identified in the two pathogens, suggesting the potential for sexual reproduction. The ratio of MAT1-1 to MAT1-2 was not significantly different from 1:1 for all three Sporothrix species, but the population of S. brasiliensis in the outbreaks originated from a single mating type. We also explored the population genetic structure of these pathogens using sequence data of two loci to improve our knowledge of the pattern of geographic distribution, genetic variation, and virulence phenotypes. Population genetics data showed significant population differentiation and clonality with a low level of haplotype diversity in S. brasiliensis isolates from different regions of sporotrichosis outbreaks in Brazil. In contrast, S. schenckii isolates demonstrated a high degree of genetic variability without significant geographic differentiation, indicating the presence of recombination. This study demonstrated that two species causing the same disease have contrasting reproductive strategies and genetic variability patterns.
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Téllez MD, Batista-Duharte A, Portuondo D, Quinello C, Bonne-Hernández R, Carlos IZ. Sporothrix
schenckii complex biology: environment and fungal pathogenicity. Microbiology (Reading) 2014; 160:2352-2365. [DOI: 10.1099/mic.0.081794-0] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Sporothrix schenckii is a complex of various species of fungus found in soils, plants, decaying vegetables and other outdoor environments. It is the aetiological agent of sporotrichosis in humans and several animals. Humans and animals can acquire the disease through traumatic inoculation of the fungus into subcutaneous tissue. Despite the importance of sporotrichosis, it being currently regarded as an emergent disease in several countries, the factors driving its increasing medical importance are still largely unknown. There have only been a few studies addressing the influence of the environment on the virulence of these pathogens. However, recent studies have demonstrated that adverse conditions in its natural habitats can trigger the expression of different virulence factors that confer survival advantages both in animal hosts and in the environment. In this review, we provide updates on the important advances in the understanding of the biology of Spor. schenckii and the modification of its virulence linked to demonstrated or putative environmental factors.
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Affiliation(s)
- M. D. Téllez
- Faculty of Pharmaceutical Sciences, Universidade Estadual Paulista Julio Mesquita Filho, UNESP Rua Expedicionarios do Brasil 1621-CEP : 14801-902, Araraquara, SP, Brazil
- Faculty of Chemical Engineering, Oriente University, Ave Las Americas, Santiago de Cuba, Cuba
| | - A. Batista-Duharte
- Immunotoxicology Laboratory, Toxicology and Biomedicine Center (TOXIMED), Medical Science University, Autopista Nacional Km. 1 1/2 CP 90400, Santiago de Cuba, Cuba
- Faculty of Pharmaceutical Sciences, Universidade Estadual Paulista Julio Mesquita Filho, UNESP Rua Expedicionarios do Brasil 1621-CEP : 14801-902, Araraquara, SP, Brazil
| | - D. Portuondo
- Faculty of Pharmaceutical Sciences, Universidade Estadual Paulista Julio Mesquita Filho, UNESP Rua Expedicionarios do Brasil 1621-CEP : 14801-902, Araraquara, SP, Brazil
| | - C. Quinello
- Faculty of Pharmaceutical Sciences, Universidade Estadual Paulista Julio Mesquita Filho, UNESP Rua Expedicionarios do Brasil 1621-CEP : 14801-902, Araraquara, SP, Brazil
| | | | - I. Z. Carlos
- Faculty of Pharmaceutical Sciences, Universidade Estadual Paulista Julio Mesquita Filho, UNESP Rua Expedicionarios do Brasil 1621-CEP : 14801-902, Araraquara, SP, Brazil
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Almeida-Paes R, de Oliveira MME, Freitas DFS, do Valle ACF, Zancopé-Oliveira RM, Gutierrez-Galhardo MC. Sporotrichosis in Rio de Janeiro, Brazil: Sporothrix brasiliensis is associated with atypical clinical presentations. PLoS Negl Trop Dis 2014; 8:e3094. [PMID: 25233227 PMCID: PMC4169245 DOI: 10.1371/journal.pntd.0003094] [Citation(s) in RCA: 119] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Accepted: 07/03/2014] [Indexed: 01/10/2023] Open
Abstract
Background There have been several recent changes in the taxonomy of Sporothrix schenckii as well as new observations regarding the clinical aspects of sporotrichosis. In this study, we determined the identification of the Sporothrix species associated with both classic and unusual clinical aspects of sporotrichosis observed in the endemic area of sporotrichosis in Rio de Janeiro, Brazil. Methodology/Principal Findings To verify whether S. brasiliensis is associated with clinical manifestations of sporotrichosis, a cross-sectional study was performed in which Sporothrix isolates from 50 patients with different clinical manifestations were analyzed and their isolates were studied by phenotypic and genotypic methods. Data from these patients revealed a distinct clinical picture and therapeutic response in infections caused by Sporothrix brasiliensis (n = 45) compared to patients with S. schenckii sensu stricto (n = 5). S. brasiliensis was associated with disseminated cutaneous infection without underlying disease, hypersensitivity reactions, and mucosal infection, whereas patients with S. schenckii presented with less severe and more often localized disease, similar to the majority of previously described sporotrichosis cases. Interestingly, S. brasiliensis-infected patients overall required shorter durations of itraconazole (median 16 weeks) compared to the individuals with S. schenckii (median 24 weeks). Conclusions/Significance These findings suggest that Sporothrix species are linked to different clinical manifestations of sporotrichosis and that S. brasiliensis is effectively treated with oral itraconazole. Sporothrix brasiliensis is a dimorphic fungus that is responsible for an ongoing epidemic of cat-transmitted sporotrichosis in Rio de Janeiro, Brazil. More than 4,100 human cases have been diagnosed in only one health institution since 1998. Most patients are children or housewives with frequent contact with domestic and/or stray cats. The patients usually live under poverty conditions in suburban regions of the metropolitan area with poor access to health care and unsanitary living conditions. For instance, most patients report that they need to have cats in their houses as a control against invasion by rodents. It is important to study the clinical aspects of S. brasiliensis infection in order to improve patient management, including optimizing therapeutic and prophylactic approaches. We have found that S. brasiliensis is responsible for some unusual clinical manifestations of sporotrichosis, such as disseminated infection in immunocompetent patients and hypersensitivity reactions. Also, treatment with itraconazole appears to be extremely effective in most cases of infection by S. brasiliensis. Our study will contribute for the management of the infection caused by S. brasiliensis, bringing benefits to the patients with sporotrichosis.
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Affiliation(s)
- Rodrigo Almeida-Paes
- Laboratório de Micologia, Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
- * E-mail:
| | | | - Dayvison Francis Saraiva Freitas
- Laboratório de Dermatologia Infecciosa, Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Antônio Carlos Francesconi do Valle
- Laboratório de Dermatologia Infecciosa, Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rosely Maria Zancopé-Oliveira
- Laboratório de Micologia, Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Maria Clara Gutierrez-Galhardo
- Laboratório de Dermatologia Infecciosa, Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
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Borges TS, Rossi CN, Fedullo JDL, Taborda CP, Larsson CE. Isolation of Sporothrix schenckii from the claws of domestic cats (indoor and outdoor) and in captivity in São Paulo (Brazil). Mycopathologia 2013; 176:129-37. [PMID: 23729233 DOI: 10.1007/s11046-013-9658-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2012] [Accepted: 04/13/2013] [Indexed: 11/29/2022]
Abstract
Sporotrichosis is a subcutaneous mycosis and is also a zoonosis (sapro- and anthropozoonosis). The objective of the present study was to determine the occurrence of sporotrichosis in domestic cats and in wild or exotic felines in captivity through the isolation of Sporothrix spp. from claw impressions in a culture medium. The samples included 132 felines, of which 120 (91.0 %) were domestic cats, 11 (8.3 %) were wild felines, and one (0.7 %) was an exotic felid. Twenty-one (17.5 %) were outdoor cats. Of the total, 89 (67.4 %) had contact with other animals of the same species. It was possible to isolate Sporothrix schenckii from the claws of one (0.7 %) of the felids probed; this animal exhibited generalised sporotrichosis and had infected a female veterinarian. The potential pathogenic agents Microsporum canis and Malassezia pachydermatis were isolated in 12.1 and 5.3 % of the animals, respectively. The following anemophilous fungi, which were considered to be contaminants, were also isolated: Penicillium sp. (28 or 21.2 %), Aspergillus sp. (13 or 9.8 %), Rhodotorula sp. (5 or 3.8 %), Candida sp. (5 or 3.8 %), Trichoderma sp. (1 or 0.7 %), and Acremonium sp. (1 or 0.7 %). Due to the low magnitude of occurrence (0.7 %) of Sporothrix in feline claws, the potential of the cats evaluated in this study to be sources of infection in the city of São Paulo is considerably low.
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Affiliation(s)
- Tatiana Saleme Borges
- Department of Internal Medicine, School of Veterinary Medicine and Animal Science, University of São Paulo, Av. Prof. Dr. Orlando Marques de Paiva, 87, Butantã, São Paulo (SP), 05508-270, Brazil.
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Abstract
Infectious and noninfectious skin diseases are observed in about 90% of HIV patients, and their incidence increases and is more severe as the immune system weakens. Cutaneous manifestations are considered good clinical predictors for the immunological condition of the patient with AIDS and the introduction of highly effective antiretroviral therapy totally changed the prognosis of the mycoses, among other diseases associated with AIDS, permitting longer survival and acceptable level of quality of life for these patients. This contribution describes the systemic mycoses that are more frequent in the seropositive population, that is, patients with HIV/AIDS, which are cryptococcosis, histoplasmosis, coccidioidomycosis, blastomycosis, paracoccidioidomycosis, sporotrichosis, penicilliosis, and aspergillosis. Their causative agents, mode of transmission, clinics, laboratorial diagnosis and therapy, in the aspects related to immunodepressed patients, are reviewed.
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Silva MBTD, Costa MMDM, Torres CCDS, Galhardo MCG, Valle ACFD, Magalhães MDAFM, Sabroza PC, Oliveira RMD. Esporotricose urbana: epidemia negligenciada no Rio de Janeiro, Brasil. CAD SAUDE PUBLICA 2012; 28:1867-80. [DOI: 10.1590/s0102-311x2012001000006] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Accepted: 07/13/2012] [Indexed: 11/22/2022] Open
Abstract
Na literatura científica, a esporotricose esteve associada por anos a profissionais que lidam com a terra, local onde o fungo causador habita. Recentemente, numa área urbana tem sido registrada a ocorrência relacionada à transmissão zoonótica. Este trabalho objetivou contribuir para o conhecimento sobre a esporotricose em área urbana, por intermédio da analise exploratória de sua distribuição socioespacial no Rio de Janeiro, Brasil, entre 1997 e 2007, identificando os espaços de transmissão mais intensos. Utilizando-se base de dados do Serviço de Vigilância em Saúde, Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, foram realizadas análises de frequência da doença e sua distribuição espacial. No período estudado, foram registrados 1.848 casos de esporotricose, com predomínio em mulheres adultas fora do mercado de trabalho. A fonte de contaminação predominante foi ferimento causado pelo gato doméstico, o que contribuiu para a disseminação da esporotricose em área urbana. O georreferenciamento de 1.681 casos evidenciou um cinturão de transmissão ao longo da divisa entre a capital e os municípios da região metropolitana.
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Salomão K, Pereira PRS, Campos LC, Borba CM, Cabello PH, Marcucci MC, de Castro SL. Brazilian propolis: correlation between chemical composition and antimicrobial activity. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2012; 5:317-24. [PMID: 18830454 PMCID: PMC2529390 DOI: 10.1093/ecam/nem058] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2006] [Accepted: 04/12/2007] [Indexed: 11/13/2022]
Abstract
The chemical composition of ethanol extracts from samples of Brazilian propolis (EEPs) determined by HPLC and their activity against Trypanosoma cruzi, Staphylococcus aureus, Streptococcus pneumoniae, Klebisiella pneumoniae, Candida albicans, Sporothrix schenckii and Paracoccidioides brasiliensis were determined. Based on the predominant botanical origin in the region of samples' collection, the 10 extracts were separated into three groups: A (B. dracunculifolia + Auraucaria spp), B (B. dracunculifolia) and C (Araucaria spp). Analysis by the multiple regression of all the extracts together showed a positive correlation, higher concentrations leading to higher biological effect, of S. aureus with p-coumaric acid (PCUM) and 3-(4-hydroxy-3-(oxo-butenyl)-phenylacrylic acid (DHCA1) and of trypomastigotes of T. cruzi with 3,5-diprenyl-4-hydroxycinnamic acid derivative 4 (DHCA4) and 2,2-dimethyl-6-carboxyethenyl-2H-1-benzopyran (DCBEN). When the same approach was employed for each group, due to the small number of observations, the statistical test gave unreliable results. However, an overall analysis revealed for group A an association of S. aureus with caffeic acid (CAF) and dicaffeoylquinic acid 3 (CAFQ3), of S. pneumoniae with CAFQ3 and monocaffeoylquinic acid 2 (CAFQ2) and of T. cruzi also with CAFQ3. For group B, a higher activity against S. pneumoniae was associated DCBEN and for T. cruzi with CAF. For group C no association was observed between the anitmicrobial effect and any component of the extracts. The present study reinforces the relevance of PCUM and derivatives, especially prenylated ones and also of caffeolyquinic acids, on the biological activity of Brazilian propolis.
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Affiliation(s)
- Kelly Salomão
- Departamento de Ultra-estrutura e Biologia Celular, Departamento de Bacteriologia, Departamento de Micologia, Departamento de Genética, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro and Pós-graduação em Farmácia, Núcleo de Pós-graduação, Pesquisa e Extensão, Universidade Bandeirante de São Paulo, São Paulo, Brazil
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Almeida-Paes R, Bailão AM, Pizzini CV, Reis RS, de Almeida Soares CM, Peralta JM, Gutierrez-Galhardo MC, Zancopé-Oliveira RM. Cell-free antigens ofSporothrix brasiliensis: antigenic diversity and application in an immunoblot assay. Mycoses 2012; 55:467-75. [DOI: 10.1111/j.1439-0507.2012.02175.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Infectious Diseases. THE CAT 2012. [PMCID: PMC7161403 DOI: 10.1016/b978-1-4377-0660-4.00033-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Mattei AS, Madrid IM, Santin R, Silva FV, Carapeto LP, Meireles MC. Sporothrix schenckii in a hospital and home environment in the city of Pelotas/RS - Brazil. AN ACAD BRAS CIENC 2011; 83:1359-62. [DOI: 10.1590/s0001-37652011000400022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2009] [Accepted: 05/19/2011] [Indexed: 01/19/2023] Open
Abstract
This study describes the isolation of S. schenckii in hospital and home environments in Brazil. Samples were collected from surfaces of a veterinary service place and at home. S. schenckii was detected in 1.5% of the samples from the hospital environment. However, this fungus was isolated from all sampled areas in home environments. The isolation of S. schenckii deonstrates that these surfaces could act as infection sources to anials and huans. Therefore, employees and pet owners could be exposed to this agent, and the contamination, through surfaces, could occur through the traumatic inoculation of the fungus or by direct contact with pre-existing lesions.
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Yamada K, Zaitz C, Framil VMDS, Muramatu LH. Cutaneous sporotrichosis treatment with potassium iodide: a 24 year experience in São Paulo State, Brazil. Rev Inst Med Trop Sao Paulo 2011; 53:89-93. [PMID: 21537756 DOI: 10.1590/s0036-46652011000200006] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2009] [Accepted: 02/16/2011] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Sporotrichosis is a subacute or chronic disease caused by a dimorphic fungus, Sporothrix schenckii. The first and most traditional treatment is potassium iodide in satured solution (SSKI) used by DE BEURMANN in 1907. For its effectiveness, it is still used for cutaneous sporotrichosis. OBJECTIVE To evaluate the treatment of cutaneous sporotrichosis with SSKI in relation to clinical cure, side effects, length of treatment and reactivation. METHODS We conducted a retrospective analysis of medical records over a 24-year period (1981-2005). Patients of all ages who were treated in the hospital´s division of dermatology were included in the study providing that they had a positive culture of S. schenckii. Satured solution of potassium iodide (3 to 6g per day) was the treatment prescribed. For children, half of the dose was prescribed. RESULTS The lymphocutaneous disease was prevalent, the cure rate was 94.7%, side effects were described in 5.5% of the cases, mean length of treatment was 3.5 months and possible reactivation was observed in 11.1%. CONCLUSION SSKI is an effective drug, with many side effects, but with low frequency. Resolution was for maximum six months of treatment. SSKI has been found to be a very effective drug in this retrospective study of culture-proven cases of cutaneous and lymphocutaneous sporotrichosis. It should be used as first drug of choice especially in resource-limited settings.
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Affiliation(s)
- Karin Yamada
- Faculdade de Ciências Médicas, Santa Casa de São Paulo, São Paulo, SP, Brasil
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Mello CXD, Schubach ADO, Madeira MDF. Can yeast-like form of Sporothrix schenckii confuse the direct parasitological diagnosis of American cutaneous leishmaniasis? Rev Soc Bras Med Trop 2011; 44:127. [PMID: 21340427 DOI: 10.1590/s0037-86822011000100031] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Cintia Xavier de Mello
- Leishmaniasis Surveillance Laboratory, Evandro Chagas Clinical Research Institute, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil.
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Queiroz-Telles F, Nucci M, Colombo AL, Tobón A, Restrepo A. Mycoses of implantation in Latin America: an overview of epidemiology, clinical manifestations, diagnosis and treatment. Med Mycol 2011; 49:225-36. [DOI: 10.3109/13693786.2010.539631] [Citation(s) in RCA: 95] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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López-Romero E, Reyes-Montes MDR, Pérez-Torres A, Ruiz-Baca E, Villagómez-Castro JC, Mora-Montes HM, Flores-Carreón A, Toriello C. Sporothrix schenckii complex and sporotrichosis, an emerging health problem. Future Microbiol 2011; 6:85-102. [DOI: 10.2217/fmb.10.157] [Citation(s) in RCA: 130] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Sporothrix schenckii, now named the S. schenckii species complex, has largely been known as the etiological agent of sporotrichosis, which is an acute or chronic subcutaneous mycosis of humans and other mammals. Gene sequencing has revealed the following species in the S. schenckii complex: Sporothrix albicans, Sporothrix brasiliensis, Sporothrix globosa, Sporothrix luriei, Sporothrix mexicana and S. schenckii. The increasing number of reports of Sporothrix infection in immunocompromised patients, mainly the HIV-infected population, suggests sporotrichosis as an emerging global health problem concomitant with the AIDS pandemic. Molecular studies have demonstrated a high level of intraspecific variability. Components of the S. schenckii cell wall that act as adhesins and immunogenic inducers, such as a 70-kDa glycoprotein, are apparently specific to this fungus. The main glycan peptidorhamnomannan cell wall component is the only O-linked glycan structure known in S. schenckii. It contains an α-mannobiose core followed by one α-glucuronic acid unit, which may be mono- or di-rhamnosylated. The oligomeric structure of glucosamine-6-P synthase has led to a significant advance in the development of antifungals targeted to the enzyme’s catalytic domain in S. schenckii.
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Quintella LP, Passos SRL, do Vale ACF, Galhardo MCG, Barros MBDL, Cuzzi T, Reis RDS, de Carvalho MHGF, Zappa MB, Schubach ADO. Histopathology of cutaneous sporotrichosis in Rio de Janeiro: a series of 119 consecutive cases. J Cutan Pathol 2010; 38:25-32. [PMID: 20883452 DOI: 10.1111/j.1600-0560.2010.01626.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Sporotrichosis is the most common subcutaneous mycosis in Rio de Janeiro. Histopathological examination reveals diffuse granulomatous and suppurative dermatitis, and the fungus is rarely identifiable in tissue. We describe the histopathological features of cutaneous sporotrichosis, and investigate the association between them and the lack of visualization of the fungus. METHODS A total of 119 samples of confirmed sporotrichosis cases were studied. The characteristics of the inflammatory infiltrate, the presence of epidermal changes, necrosis and fibrosis, and the parasite burden were analyzed. The association between histopathological changes and the lack of visualization of the fungus was evaluated using prevalence ratios. RESULTS Granulomas were observed in all samples, suppurative granulomas in 100 (84%) and diffuse dermatitis in 114 (95.8%). Liquefaction and caseous necrosis were present in 78 (65.5%) and 52 (43.7%) samples, respectively. The fungus was not seen in 77 (64.7%) samples. Epithelioid, tuberculoid or foreign-body-type granulomas, caseous, fibrinoid or absent necrosis, predominance of lymphocytes among nonphagocytic cells and fibrosis were associated with the lack of visualization of the fungus. CONCLUSION The histopathological characteristics of sporotrichosis were variable when the causative fungus was not seen. In a proper context, the diagnosis of sporotrichosis remains a potential consideration even in the absence of demonstrable yeast.
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Affiliation(s)
- Leonardo Pereira Quintella
- Serviço de Anatomia Patológica, Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.
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Landell MF, Stopiglia CDO, Billodre RG, Heidrich D, Sorrentino JM, Vainstein MH, Scroferneker ML, Valente P. Evaluation of the Origin of a Sample of Sporothrix Schenckii that Caused Contamination of a Researcher in Southern Brazil. Mycopathologia 2010; 171:203-7. [DOI: 10.1007/s11046-010-9361-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2009] [Accepted: 08/31/2010] [Indexed: 01/19/2023]
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Fernandes GF, Lopes-Bezerra LM, Bernardes-Engemann AR, Schubach TMP, Dias MAG, Pereira SA, de Camargo ZP. Serodiagnosis of sporotrichosis infection in cats by enzyme-linked immunosorbent assay using a specific antigen, SsCBF, and crude exoantigens. Vet Microbiol 2010; 147:445-9. [PMID: 20708355 PMCID: PMC7125942 DOI: 10.1016/j.vetmic.2010.07.007] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2009] [Revised: 07/01/2010] [Accepted: 07/07/2010] [Indexed: 11/29/2022]
Abstract
The main objective of this study is to standardize an ELISA for the diagnosis of feline sporotrichosis. Sporothrix schenckii is the etiological agent of human and animal sporotrichosis. Cats may act as reservoirs for S. schenckii and can transmit the infection to humans by a bite or scratch. There are few methods for the serological diagnosis of fungal diseases in animals. In this paper, an ELISA test for the diagnosis of cat sporotrichosis is proposed, which detects S. schenckii-specific antibodies in feline sera. Two different kinds of antigens were used: “SsCBF”, a specific molecule from S. schenckii that consists of a Con A-binding fraction derived from a peptido-rhamnomannan component of the cell wall, and a S. schenckii crude exoantigen preparation. The ELISA was developed, optimized, and evaluated using sera from 30 cats with proven sporotrichosis (by culture isolation); 22 sera from healthy feral cats from a zoonosis center were used as negative controls. SsCBF showed 90% sensitivity and 96% specificity in ELISA; while crude exoantigens demonstrated 96% sensitivity and 98% specificity. The ELISA assay described here would be a valuable screening tool for the detection of specific S. schenckii antibodies in cats with sporotrichosis. The assay is inexpensive, quick to perform, easy to interpret, and permits the diagnosis of feline sporotrichosis.
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Pereira SA, Passos SRL, Silva JN, Gremião IDF, Figueiredo FB, Teixeira JL, Monteiro PCF, Schubach TMP. Response to azolic antifungal agents for treating feline sporotrichosis. Vet Rec 2010; 166:290-4. [PMID: 20208075 DOI: 10.1136/vr.166.10.290] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The effectiveness and safety of treatment with ketoconazole and itraconazole were compared in 773 sporotrichosis-infected cats over a four-year period (2002 to 2005). Five hundred and ninety-eight cats received oral ketoconazole and 175 received oral itraconazole. Treatment was successful in 238 (30.8 per cent) cats, of which 171 (28.6 per cent) of 598 received 13.5 to 27.0 mg/kg/day ketoconazole and 67 (38.3 per cent) of 175 received 8.3 to 27.7 mg/kg/day itraconazole. Adverse effects were reported in 306 (39.6 per cent) of the cats, 105 (13.6 per cent) died and 430 (55.6 per cent) dropped out of treatment or were still under treatment at the time of data analysis.
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Affiliation(s)
- S A Pereira
- Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, Avenida Brasil, 4365, Manguinhos, Rio de Janeiro, RJ 21040-900, Brazil.
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Rubio G, Sánchez G, Porras L, Alvarado Z. [Sporotrichosis: prevalence, clinical and epidemiological features in a reference center in Colombia]. Rev Iberoam Micol 2010; 27:75-9. [PMID: 20346295 DOI: 10.1016/j.riam.2010.01.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2009] [Revised: 12/10/2009] [Accepted: 01/07/2010] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Sporotrichosis is a subacute and chronic infection caused by Sporothrix schenckii, which affects humans and other mammals. Clinical and epidemiological information in Colombia is scarce. OBJECTIVE To describe clinical and socio-demographic findings and diagnostic tests in patients with sporotrichosis from 1996 to 2005 in a national reference center in Colombia, and to determine the institutional prevalence from 2002 to 2005. MATERIAL AND METHODS This was a prevalence study, including patients with clinical diagnosis of sporotrichosis and at least one of the following criteria: positive culture with S. schenckii, pathologic diagnosis suggestive of sporotrichosis, or response to treatment with potassium iodide. RESULTS Sixty cases were included, 67% were male, and 25% of them were farmers. The most affected anatomical areas were the forearms and hands (32.5% and 22.8% respectively). Most cases came from the Cundinamarca and Boyacá areas. The cases presented as fixed cutaneous sporotrichosis and lymphangitic sporotrichosis. Differential diagnoses with: leishmaniasis and chromoblastomycosis were performed in most of the cases. All patients were treated with potassium iodide. The prevalence for our center from 2002 to 2005 was 8 cases per 100,000 patients. CONCLUSIONS The characteristics of our patients are similar to those described in other populations, with some differences. The culture continues to be the gold standard for diagnosis purposes. Potassium iodide is the treatment of choice in our center.
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Affiliation(s)
- Gustavo Rubio
- Oficina de Docencia e Investigación, Centro Dermatológico Federico Lleras Acosta E.S.E, Bogotá D.C. Colombia
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