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de Menezes MLP, Cruz KS, Ogusku MM, da Silva BKNI, Alves MJ, Grisolia ME, Gonçalves MJF, de Souza JVB, Jackisch-Matsuura AB. Histoplasmosis in HIV/AIDS patients in Amazonas, Northern Brazil. Braz J Microbiol 2024:10.1007/s42770-024-01277-2. [PMID: 38368282 DOI: 10.1007/s42770-024-01277-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 02/07/2024] [Indexed: 02/19/2024] Open
Abstract
Histoplasmosis is commonly observed in AIDS patients as a neglected opportunistic disease that has an important relationship with environmental factors. The present study described the clinical characteristics of HIV/AIDS patients diagnosed with disseminated histoplasmosis in a tertiary healthcare facility in Manaus, Amazonas, Brazil, and evaluated the patients' homes and urban environmental samples as a source of exposure to Histoplasma capsulatum. A review of medical records from 2017 to 2019 of patients with HIV/AIDS associated with histoplasmosis was carried out, as well as the collection of environmental samples in the homes of these patients. These samples were subjected to DNA extraction and then subjected to qPCR. A total of 62 patients diagnosed with HIV/AIDS and histoplasmosis were identified, which corresponds to 4.5% (n = 62/1372) of the HIV/AIDS cases detected in the period. Of these, 68% (n = 42/62) were male, with a mean age of 36 years and low education. In 47% (n = 29/62) of the cases, the diagnosis of HIV/AIDS and histoplasmosis occurred simultaneously. Mortality was 45% (n = 28/62), and 68% (n = 42/62) of these patients did not regularly use highly active antiretroviral therapy. The main symptoms found were respiratory, gastrointestinal, and weight loss, and in 81% (n = 50/62), the place of residence was in an urban area. A total of 57 environmental samples were analyzed, and the presence of Histoplasma capsulatum was not detected in any of the analyzed samples. There was a high mortality rate in the studied group of patients with AIDS and histoplasmosis. Most patients reported residing in urban areas of Manaus, with no history of travel to other areas previously known as being high risk for histoplasmosis.
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Affiliation(s)
- Marcia Larissa Pereira de Menezes
- Laboratório de Diversidade Microbiana da Amazônia Com Importância Para a Saúde, Instituto Leônidas e Maria Deane - FIOCRUZ, Manaus, Amazonas, Brazil
- Programa de Pós-Graduação Em Condições de Vida E Situações de Saúde Na Amazônia (PPGVIDA) - ILMD/FIOCRUZ, Manaus, Amazonas, Brazil
| | - Katia Santana Cruz
- Laboratório de Micologia Médica, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil
| | - Mauricio Morishi Ogusku
- Laboratório de Micobacteriologia, Instituto Nacional de Pesquisas da Amazônia (INPA), Manaus, Amazonas, Brazil
| | | | - Marla Jalene Alves
- Laboratório de Diversidade Microbiana da Amazônia Com Importância Para a Saúde, Instituto Leônidas e Maria Deane - FIOCRUZ, Manaus, Amazonas, Brazil
| | - Maria Eduarda Grisolia
- Laboratório de Diversidade Microbiana da Amazônia Com Importância Para a Saúde, Instituto Leônidas e Maria Deane - FIOCRUZ, Manaus, Amazonas, Brazil
| | | | | | - Ani Beatriz Jackisch-Matsuura
- Laboratório de Diversidade Microbiana da Amazônia Com Importância Para a Saúde, Instituto Leônidas e Maria Deane - FIOCRUZ, Manaus, Amazonas, Brazil.
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da Silva BKNI, Alves Cortez AC, Oliveira LA, de Almeida JDR, de Souza ÉS, Cruz KS, Jackisch Matsuura AB, Ogusku MM, Solórzano Chavarría KJ, Baía-da-Silva D, Bassat Q, Guimarães Lacerda MV, Frickmann H, de Souza JVB. Design and optimization of an improved qPCR assay for the detection of Histoplasma capsulatum. Eur J Microbiol Immunol (Bp) 2023; 13:37-44. [PMID: 37738109 PMCID: PMC10578137 DOI: 10.1556/1886.2023.00026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 09/01/2023] [Indexed: 09/24/2023] Open
Abstract
Background This study aimed at improving a real-time polymerase-chain-reaction (qPCR) assay for the detection of Histoplasma capsulatum, a fungal pathogen that can cause severe respiratory infections in humans, in clinical and soil samples. Methods Primer and probes were in-silico designed, in-silico and in-vitro evaluated including clinical biopsy materials and finally subjected to a real-world application with collected soil samples. Results Applying the qPCR assay with liver and lung biopsies from 71 patients each, including 59 patients infected with human immunodeficiency virus (HIV), as well as with Sabouraud (SAB) agar culture as the diagnostic reference standard, diagnostic accuracy of the qPCR assay of 100% (5/5) sensitivity and 96% (63/66) specificity for liver samples and 100% (4/4) sensitivity and 94% (63/67) specificity for the lung samples was recorded. When applying the assay with soil samples from caves near of Presidente Figueiredo city, Amazonas, Brazil, one sample from the Maroaga cave was confirmed as positive. Conclusions The improved qPCR assessed in this study was successful in detecting H. capsulatum with high efficiency and accuracy in in-vitro evaluation, including the identification of the target pathogen in both clinical and environmental samples.
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Affiliation(s)
| | | | | | | | | | - Katia Santana Cruz
- Medical Mycology Laboratory, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado-FMT-HVD, Manaus, Brazil
| | - Ani Beatriz Jackisch Matsuura
- Microbial Diversity Laboratory of the Amazon with Health Importance, Leônidas and Maria Deane Institute-Fiocruz-AM, Manaus, Amazonas, Brazil
| | - Mauricio Morishi Ogusku
- Mycobacteriology Laboratory, Instituto Nacional de Pesquisas da Amazonia–INPA, Manaus, Brazil
| | - Karolina Jeaneth Solórzano Chavarría
- Graduate Program in Tropical Medicine, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado-FMT-HVD, Manaus, Brazil
- Carlos Borborema Clinical Research Unit, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado-FMT-HVD, Manaus, Brazil
| | - Djane Baía-da-Silva
- Graduate Program in Pharmaceutical Sciences, Universidade Federal do Amazonas-UFAM, Manaus, Brazil
- Graduate Program in Tropical Medicine, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado-FMT-HVD, Manaus, Brazil
- Carlos Borborema Clinical Research Unit, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado-FMT-HVD, Manaus, Brazil
- Instituto Leônidas Maria Deane- ILMD, Fiocruz-AM, Manaus, Brazil
- Pharmacy Faculty, Universidade Nilton Lins, Manaus, Brazil
| | - Quique Bassat
- ISGlobal, Hospital Clínic – Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
- ICREA, Pg. Lluís Companys 23, 080100Barcelona, Spain
- Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Marcus Vinícius Guimarães Lacerda
- Graduate Program in Tropical Medicine, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado-FMT-HVD, Manaus, Brazil
- Carlos Borborema Clinical Research Unit, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado-FMT-HVD, Manaus, Brazil
- Instituto Leônidas Maria Deane- ILMD, Fiocruz-AM, Manaus, Brazil
- University of Texas Medical Branch, Galveston, USA
| | - Hagen Frickmann
- Institute for Medical Microbiology, Virology and Hygiene, University Medicine Rostock, Rostock, Germany
- Department of Microbiology and Hospital Hygiene, Bundeswehr Hospital, Hamburg, Germany
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