RESUMEN
Dermatophytes show a wide geographic distribution and are the main causative agents of skin fungal infections in many regions of the world. Recently, their resistance to antifungal drugs has led to an obstacle to effective treatment. To address the lack of dermatophytosis data in Iraq, this study was designed to investigate the distribution and prevalence of dermatophytes in the human population and single point mutations in squalene epoxidase gene (SQLE) of terbinafine resistant isolates. The identification of 102 dermatophytes isolated from clinical human dermatophytosis was performed through morphological and microscopic characteristics followed by molecular analysis based on ITS and TEF-1α sequencing. Phylogeny was achieved through RAxML analysis. CLSI M38-A2 protocol was used to assess antifungal susceptibility of the isolates to four major antifungal drugs. Additionally, the presence of point mutations in SQLE gene, which are responsible for terbinafine resistance was investigated. Tinea corporis was the most prevalent clinical manifestation accounting for 37.24% of examined cases of dermatophytosis. Based on ITS, T. indotineae (50.98%), T. mentagrophytes (19.61%), and M. canis (29.41%) was identified as an etiologic species. T. indotineae and T. mentagrophytes strains were identified as T. interdigitale based on TEF-1α. Terbinafine showed the highest efficacy among the tested antifungal drugs. T. indotineae and T. mentagrophytes showed the highest resistance to antifungal drugs with MICs of 2-4 and 4 µg/mL, while M. canis was the most susceptible species. Three of T. indotineae isolates showed mutations in SQLE gene Phe397Leu substitution. A non-previously described point mutation, Phe311Leu was identified in T. indotineae and mutations Lys276Asn, Phe397Leu and Leu419Phe were diagnosed in T. mentagrophytes XVII. The results of mutation analysis showed that Phe397Leu was a destabilizing mutation; protein stability has decreased with variations in pH, and point mutations affected the interatomic interaction, resulting in bond disruption. These results could help to control the progression of disease effectively and make decisions regarding the selection of appropriate drugs for dermatophyte infections.
Asunto(s)
Antifúngicos , Arthrodermataceae , Farmacorresistencia Fúngica , Pruebas de Sensibilidad Microbiana , Mutación Puntual , Escualeno-Monooxigenasa , Tiña , Humanos , Antifúngicos/farmacología , Irak/epidemiología , Tiña/microbiología , Tiña/epidemiología , Tiña/tratamiento farmacológico , Farmacorresistencia Fúngica/genética , Masculino , Arthrodermataceae/genética , Arthrodermataceae/efectos de los fármacos , Arthrodermataceae/patogenicidad , Arthrodermataceae/aislamiento & purificación , Femenino , Escualeno-Monooxigenasa/genética , Adulto , Filogenia , Terbinafina/farmacología , Terbinafina/uso terapéutico , Persona de Mediana Edad , Adolescente , Adulto Joven , Niño , Proteínas Fúngicas/genética , AncianoRESUMEN
We present a 76-year-old Japanese male with tinea faciei, tinea corporis, and tinea unguium with dermatophytoma. We performed fungal culture and confirmed the causative fungus to be Trichophyton rubrum. We treated the patient using oral fosravuconazole l-lysine ethanolate (F-RVCZ). More than one year has passed since the end of treatment, but there has been no recurrence. This case suggests that F-RVCZ is effective for tinea other than tinea unguium.
Asunto(s)
Onicomicosis/tratamiento farmacológico , Onicomicosis/microbiología , Tiña/tratamiento farmacológico , Tiña/microbiología , Triazoles/administración & dosificación , Administración Oral , Anciano , Arthrodermataceae/aislamiento & purificación , Arthrodermataceae/patogenicidad , Humanos , Masculino , Onicomicosis/complicaciones , Onicomicosis/patología , Tiña/complicaciones , Tiña/patología , Resultado del TratamientoRESUMEN
Superficial mycoses of skin, nails and hair are among the common fungal infections. They are caused by dermatophytes, non-dermatophyte moulds, yeasts and yeast-like fungi. Such fungal infections are widespread all over the world and are predominant in tropical as well as subtropical regions. Environmental factors, such as warm, humid and pitiable hygienic conditions, are conducive for their growth and proliferation. Although it does not cause mortality, it is known to be associated with excessive morbidity which may be psychological or physical. This affects the quality of life of the infected individuals which leads to a negative impact on their occupational, emotional and social status. Such infections are increasing on a global scale and, therefore, are of serious concern worldwide. This review article covers the global and Indian scenario of superficial mycoses taking into account the historical background, aetiological agents, prevalence, cultural and environmental factors, risk factors, pathogenesis and hygienic practices for the prevention of superficial mycoses.
Asunto(s)
Arthrodermataceae/patogenicidad , Dermatomicosis/epidemiología , Salud Global , Arthrodermataceae/aislamiento & purificación , Pueblo Asiatico , Dermatomicosis/microbiología , Dermatomicosis/patología , Cabello/microbiología , Humanos , India/epidemiología , Uñas/microbiología , Prevalencia , Calidad de Vida , Factores de Riesgo , Piel/microbiologíaRESUMEN
Onychomycoses are difficult-to-treat fungal infections with a high recurrence rate that relates to the anatomic and pathophysiological conditions in the nail organ and the required extended duration of treatment. Clinical-epidemiological studies demonstrated that non-dermatophyte molds and yeasts are the primary causative agents in 20%-30% of onychomycoses. Mixed infections with dermatophytes are observed as well. Therefore, the causative agents should be determined by fungal culture and the antifungal treatment regimen should reliably cover non-dermatophytes, if appropriate. Systemic-topical combination therapy involving a broad-spectrum, locally applied antifungal may increase the mycological and clinical cure rates compared to monotherapy with systemic drugs.
Asunto(s)
Hongos , Onicomicosis , Antifúngicos/uso terapéutico , Arthrodermataceae/efectos de los fármacos , Arthrodermataceae/patogenicidad , Coinfección/tratamiento farmacológico , Coinfección/microbiología , Combinación de Medicamentos , Hongos/efectos de los fármacos , Hongos/patogenicidad , Humanos , Uñas/microbiología , Onicomicosis/tratamiento farmacológico , Onicomicosis/epidemiología , Onicomicosis/microbiología , Prevalencia , Levaduras/efectos de los fármacos , Levaduras/patogenicidadRESUMEN
Trichophyton mentagrophytes secretes Metallocarboxypeptidase A and B of the M14 family as endoproteases and exoprotease. T. mentagrophytes produce Metalloprotease 3 and 4 which degrades the protein into the short peptides and amino acids. To understand the host fungal relationship and identification of such genes expressed during infection is utmost important. T. mentagrophytes encodes some proteins which are associated with the glyoxylate cycle. The glyoxylate cycle enzymes have been involving in virulence of dermatophytes and their up-regulation during dermatophytes growth on keratin. On comparing the expression level of virulence protease and non-protease genes, we observed, among exoprotease protease genes, Metallocarboxypeptidase B was strongly up regulated (134.6 fold high) followed by Metallocarboxypeptidase A (115.6 fold high) and Di-peptidyl-peptidases V (10.1 fold high), in dermatophytic patients as compared to ATCC strain. Furthermore, among endoprotease, Metalloprotease 4 was strongly up regulated (131.6 fold high) followed by Metalloprotease 3 (16.7 fold high), in clinical strains as compared to T. mentagrophytes ATCC strain. While among non-protease genes, Citrate Synthase was highly expressed (118 fold high), followed by Isocitrate Lyase (101.6 fold high) and Malate Synthase (52.9 fold high). All the studied virulence genes were considered the best suitable ones by geNorm, Best keeper, Norm Finder and Ref finder.
Asunto(s)
Arthrodermataceae/genética , Genes Fúngicos , Péptido Hidrolasas/genética , Tiña/microbiología , Antígenos Fúngicos/genética , Arthrodermataceae/aislamiento & purificación , Arthrodermataceae/metabolismo , Arthrodermataceae/patogenicidad , ADN de Hongos/genética , Perfilación de la Expresión Génica/métodos , Regulación Fúngica de la Expresión Génica , Humanos , India , Análisis por Micromatrices , Péptido Hidrolasas/metabolismo , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Tiña/genética , Factores de Virulencia/genética , Factores de Virulencia/metabolismoRESUMEN
Nannizzia (N.) incurvata (formerly Microsporum incurvatum) represents a geophilic dermatophyte which has been previously classified as belonging to the species complex of N. gypsea (formerly Microsporum gypseum). A 42-year-old Vietnamese female from Saxony, Germany, suffered from tinea corporis of the right buttock after she returned from a 2-week-visit to her homeland Vietnam. From skin scrapings of lesions, N. incurvata grew on Sabouraud's dextrose agar. Treatment by ciclopirox olamine cream twice daily for 4 weeks was successful. A 6-year-old Cambodian boy living near river Mekong with contact history to chicken, dogs and cattle suffered from tinea faciei and capitis. Symptoms of the favus-like tinea capitis and tinea faciei were erythema and scaly patches with areas of alopecia. N. incurvata grew on Sabouraud's dextrose agar. The boy was treated with oral terbinafine 125 mg daily, topical miconazole cream and ketoconazole shampoo. The symptoms healed within 4 weeks of treatment. Cultivation of the samples revealed growth of N. incurvata. For confirmation of species identification, the isolates were subject to sequencing of ITS (internal transcribed spacer) region of the rDNA, and addition of the "translation elongation factor 1 α" (TEF 1 α) gene. Sequencing of the ITS region showed 100% accordance with the sequence of N. incurvata deposited at the NCBI database under the accession number MF415405. N. incurvata is a rare, or might be underdiagnosed geophilic dermatophyte described in Sri Lanka and Vietnam until now. This is the first isolation of N. incurvata in Cambodia, and the first description of favus in a child due to this dermatophyte.
Asunto(s)
Arthrodermataceae/patogenicidad , Tiña Favosa/microbiología , Tiña/microbiología , Adulto , Arthrodermataceae/genética , Cambodia , Niño , ADN Ribosómico/genética , Femenino , Humanos , Masculino , Análisis de Secuencia de ADN , VietnamRESUMEN
Tinea capitis (TC) mainly occurs in children, and related studies in adults are rare. We aimed to investigate the current epidemiological, clinical and mycological characteristics of TC and to compare adult and paediatric patients in northern Taiwan. We conducted a retrospective study at Chang Gung Memorial Hospital, Linkou Branch, from 2014 to 2019. The dataset included age, sex, records of underlying diseases, animal contact history, frequent hair salon visits, clinical patterns, treatment and outcome via chart or phone call reviews. The average ages of 72 children and 104 adults recruited were 6.0 and 74.0 years, respectively. A female predominance was noted in both groups, and the ratio of females was significantly higher in adults (94.2% vs 59.7%, P < .0001). Microsporum canis (76.4%) and Trichophyton mentagrophytes (11.1%) in children, and M. canis (49.0%) and T. violaceum (31.7%) in adults were the most common pathogens. Adults were more likely to be infected with T. violaceum (OR = 10.14, 95% CI = 2.04-50.26) than children. In contrast, adults were less likely to be infected with M. canis than children (OR = 0.31, 95% CI = 0.11-0.90). Furthermore, adults visited hair salons more, had less animal contact and were more immunosuppressed than children. TC is not unusual in the adult population. Dermatologists are advised to realise risk factors such as immunosuppression and regular hair salon visit in adult TC.
Asunto(s)
Tiña del Cuero Cabelludo , Anciano , Arthrodermataceae/aislamiento & purificación , Arthrodermataceae/patogenicidad , Niño , Preescolar , Femenino , Humanos , Terapia de Inmunosupresión , Masculino , Microsporum/aislamiento & purificación , Microsporum/patogenicidad , Persona de Mediana Edad , Estudios Retrospectivos , Taiwán/epidemiología , Tiña del Cuero Cabelludo/epidemiología , Tiña del Cuero Cabelludo/patología , Trichophyton/aislamiento & purificación , Trichophyton/patogenicidadRESUMEN
PURPOSE: In this paper, we reported three distinct cases of tinea, including tenia ungulum, tenia pedis, and tenia cruris caused by the infection of Nannizzia nana in the immunocompetent patients who were also the residents of Guatemala. Dermatophytes were identified phenotypically and genotypically. Thereafter, DNA was extracted from the fungal isolates and a fragment of the ITS1-5.8S-ITS2 region was amplified and sequenced. The direct visual examination revealed the presence of fungal hyphae and arthroconidia. These characteristic morphological features resembled with the general features of the species, Nannizzia nana. Furthermore, nucleotide sequences that were amplified from the fungal isolates, confirmed the species identification. Thereafter, all the patients were treated with Terbinafine (250mg) through oral route for two weeks, except the patient with onychomycosis, who received the same treatment but for an extended period of three months. All the patients showed complete recovery from dermatophytosis. This study contributes to a better understanding of the epidemiology of human infections that are caused by dermatophytes, often misdiagnosed. Dermatophytes are currently less known but are now being more frequently identified due to the improvements in the diagnostic techniques.
Asunto(s)
Arthrodermataceae/genética , Dermatomicosis/diagnóstico , Adulto , Antifúngicos/uso terapéutico , Arthrodermataceae/patogenicidad , ADN de Hongos/genética , Dermatomicosis/tratamiento farmacológico , Dermatomicosis/microbiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Técnicas de Diagnóstico Molecular , Terbinafina/uso terapéuticoRESUMEN
Dermatophytoses (ringworms) are among the most frequent skin infections and are a highly prevalent cause of human disease worldwide. Despite the incidence of these superficial mycoses in healthy people and the compelling evidence on chronic and deep infections in immunocompromised individuals, the mechanisms controlling dermatophyte invasion in the skin are scarcely known. In the last years, the association between certain primary immunodeficiencies and the susceptibility to severe dermatophytosis as well as the evidence provided by novel experimental models mimicking human disease have significantly contributed to deciphering the basic immunological mechanisms against dermatophytes. In this review, we outline the current knowledge on fungal virulence factors involved in the pathogenesis of dermatophytoses and recent evidence from human infections and experimental models that shed light on the cells and molecules involved in the antifungal cutaneous immune response. The latest highlights emphasize the contribution of C-type lectin receptors signaling and the cellular immune response mediated by IL-17 and IFN-γ in the anti-dermatophytic defense and skin inflammation control.
Asunto(s)
Inmunidad Adaptativa , Arthrodermataceae/patogenicidad , Inmunidad Innata , Piel/microbiología , Tiña/microbiología , Animales , Arthrodermataceae/inmunología , Interacciones Huésped-Patógeno , Humanos , Inmunidad Celular , Transducción de Señal , Piel/inmunología , Tiña/inmunología , VirulenciaRESUMEN
Onychomycosis is a common and intractable superficial mycosis that occurs worldwide. Treatment with both oral and topical drugs is recommended, but the objective evaluation procedure to determine the efficacy of and the appropriate delivery system for the drugs remains controversial. This may be attributed to the lack of a reliable animal model that not only mirrors the pathophysiology of human onychomycosis but is also feasible. Therefore, we attempted to establish an animal model of onychomycosis using immunosuppressed guinea pigs and elucidate the pathophysiology of human onychomycosis. In the present study, we applied Trichophyton mentagrophytes TIMM2789 to the hind limb nails of corticosteroid-treated guinea pigs. The nails were examined macroscopically and histopathologically at 0, 14, and 42 days after a 2-week exposure period to the fungus. A large portion of the experimentally infected nails showed discoloration, which is an important clinical sign, and most infections were confirmed histopathologically in the deep layer of the nail plate at all time points. The infection rates at 0, 14, and 42 days after exposure were 39%, 61%, and 78%, respectively. Thus, we established an animal model of onychomycosis with good reproducibility and that might be appropriate for extrapolation to the pathophysiology of the human disease.
Asunto(s)
Arthrodermataceae/patogenicidad , Modelos Animales de Enfermedad , Cobayas , Terapia de Inmunosupresión/métodos , Onicomicosis , Animales , Humanos , Inyecciones Intramusculares , Masculino , Uñas/microbiología , Uñas/patología , Onicomicosis/inmunología , Onicomicosis/microbiología , Onicomicosis/patología , Triamcinolona Acetonida/administración & dosificaciónRESUMEN
BACKGROUND: In China, the prevalence of superficial fungal infections of the foot is high and recurrence is common. However, a prospective, large-scale and multicentre study on the aetiology of superficial fungal infections of the foot is still lacking. OBJECTIVES: To study the epidemiology of aetiological agents of superficial fungal infections of the foot in urban outpatients in mainland China, as well as to understand the aetiology features of the pathogenic agent. METHODS: The study was designed as a multicentre, prospective epidemiological survey. A total of 1704 subjects were enrolled from seven geographical areas in mainland China. For each subject, one mycological sample and one bacterial sample were collected. KOH wet mount examination and culture were performed at local laboratories. The bacterial results were only reported in those with positive mycology. Further morphological identification and, if necessary, molecular biological identification were conducted in a central laboratory. RESULTS: Of 1704 enrolled subjects, 1327 (77.9%) subjects had positive fungal culture results. The incidence of dermatophytes, yeasts and moulds was 90.1%, 8.1% and 1.1%, respectively. The most frequently isolated aetiological agent (fungus) was Trichophyton rubrum. Moccasin form was the most commonly reported clinical diagnosis of superficial fungal infections. The most frequently isolated bacterial genus in patients was Staphylococcus. CONCLUSION: This study prospectively investigated the clinical and mycological features of human dermatophytosis in mainland China. T rubrum was the most frequently isolated fungus, and moccasin form was the most commonly reported clinical diagnosis of superficial fungal infections.
Asunto(s)
Dermatomicosis , Pie/microbiología , Adulto , Arthrodermataceae/aislamiento & purificación , Arthrodermataceae/patogenicidad , China/epidemiología , Dermatomicosis/epidemiología , Dermatomicosis/etiología , Dermatomicosis/patología , Femenino , Pie/patología , Hongos/aislamiento & purificación , Hongos/patogenicidad , Humanos , Incidencia , Masculino , Micosis/epidemiología , Micosis/etiología , Micosis/patología , Pacientes Ambulatorios , Prevalencia , Estudios Prospectivos , Levaduras/aislamiento & purificación , Levaduras/patogenicidadRESUMEN
The APSES family, comprising of the transcriptional regulators Asm1p, Phd1p, Sok2p, Efg1p, and StuA, is found exclusively in fungi and has been reported to control several cellular processes in these organisms. However, its function in dermatophytes has not yet been completely understood. Here, we generated two null mutant strains by deleting the stuA gene in the dermatophyte Trichophyton rubrum, the most common clinical isolate obtained from human skin and nail mycoses. The functional characterization of the knocked-out strains revealed the involvement of stuA in germination, morphogenesis of conidia and hyphae, pigmentation, stress responses, and virulence. Although the mutant strains could grow under several nutritional conditions, growth on the keratin medium, human nails, and skin was impaired. The co-culture of stuA mutants with human keratinocytes revealed enhanced development. Moreover, a stuA mutant grown on the keratin substrate showed a marked decrease in the transcript numbers of the hydrophobin encoding gene (hypA), suggesting the involvement of stuA in the molecular mechanisms underlying mechanosensing during the fungi-host interaction. In addition, bioinformatics analyses revealed the potential involvement of StuA in different biological processes such as oxidation-reduction, phosphorylation, proteolysis, transcription/translation regulation, and carbohydrate metabolism. Cumulatively, the present study suggested that StuA is a crosstalk mediator of many pathways and is an integral component of the infection process, implying that it could be a potential target for antifungal therapy.
Asunto(s)
Arthrodermataceae/genética , Arthrodermataceae/patogenicidad , Proteínas Fúngicas/genética , Proteínas Fúngicas/metabolismo , Interacciones Huésped-Patógeno/genética , Arthrodermataceae/metabolismo , Línea Celular , Regulación Fúngica de la Expresión Génica , Interacciones Huésped-Patógeno/fisiología , Humanos , Queratinocitos/microbiología , Queratinas/metabolismo , Micosis/microbiología , Uñas/microbiología , Piel/microbiología , Estrés Fisiológico/fisiología , Virulencia/genéticaAsunto(s)
Arthrodermataceae/patogenicidad , Tiña del Cuero Cabelludo/microbiología , Antifúngicos/uso terapéutico , Preescolar , Griseofulvina/uso terapéutico , Humanos , Cetoconazol/uso terapéutico , Masculino , Cuero Cabelludo/patología , Tiña del Cuero Cabelludo/tratamiento farmacológico , Resultado del TratamientoRESUMEN
The major problems in determining the causative factors of the high prevalence of dermatophytoses include the lack of a well-standardized antifungal susceptibility testing method, the low consistency of in vitro and clinical minimal inhibitory concentration values, the high genomic diversity of the population, and the unclear mechanism of pathogenicity. These factors are of particular importance when the disease is recalcitrant and relapses. Herein, we identified and characterized Trichophyton mentagrophytes isolates obtained from therapy-resistant cases in humans and animals. We used genomic diversity analysis of 17 human and 27 animal clinical isolates with the MP-PCR technique, determined their phenotypic enzymatic activity and host range, and performed antifungal susceptibility testing to currently available antifungal drugs from various chemical groups. Genomic diversity values of 35.3% and 33.3% were obtained for clinical isolates from humans and animals, respectively, yet without any relationship to the host species or antifungal drug to which resistance in therapy was revealed. The highest activity of keratinase enzymes was recorded for fox, guinea pig, and human hairs. These hosts can be considered as the main species in the host range of these isolates. A phenyl morpholine derivative, i.e. amorolfine, exhibited superior activity against strains obtained from both humans and animals with the lowest MIC50. Interestingly, high compliance of terbinafine in vitro resistance with clinical problems in the treatment with this substance was shown as well. The high resistance of dermatophytes to drugs is the main cause of the recalcitrance of the infection, whereas the other features of the fungus are less important.
Asunto(s)
Arthrodermataceae/patogenicidad , Tiña/microbiología , Animales , Antifúngicos/farmacología , Arthrodermataceae/efectos de los fármacos , Arthrodermataceae/genética , Variación Genética , Humanos , Pruebas de Sensibilidad Microbiana , Polonia , Reacción en Cadena de la PolimerasaRESUMEN
BACKGROUND: Tinea capitis (TC) is an infection of the scalp hair due to dermatophytes. Most commonly seen in prepubescent children, but data of adults tinea capitis (ATC) in China mainland are limited. OBJECTIVES: We aimed to evaluate epidemiological, clinical and mycological characteristics of ATC in China from 2000 to 2019. METHODS: We retrospectively analysed all ATC reported cases in China mainland, confirmed by mycological examination, by searching PubMed, Wanfang, Weipu and CNKI database. RESULTS: In sum, 40 papers involving 269 clinical cases were included. The average morbidity of ATC was calculated as 9.04% after standardisation. The sex ratio is 1:5.2 (31 male, 163 female); 76 people between 18 and 44 age level and 137 people between 45 and 89 age level were diagnosed as ATC. Culture or ITS sequencing identified Trichophyton violaceum in 70 cases (35.2%), Microsporum canis in 42 cases (21.1%), Trichophyton mentagrophyte in 32 cases (16.1%), Trichophyton rubrum in 23 cases (11.5%), Microsporum gypseum in 18 cases (9.0%), Trichophyton tonsurans in 6 cases (3.0%), Trichophyton schoenleini in 4 cases (2.0%), Epidermophyton floccosum in 2 cases (1.0%), Trichophyton verrucosum and Microsporum ferrugineum in one case (0.5%). ATC was easily to be diagnosed as furfur, seborrhoeic dermatitis (13%) or pustular and dermatocellulitis (11.15%).Six immunocompromised persons were recorded (2.2%). CONCLUSIONS: ATC mainly involves postmenopausal women. Trichophyton violaceum, M canis, T mentagrophyte remain the most common aetiological agent of ATC in China. Trichophyton rubrum own the much higher frequency in ATC than in children. For diversified clinical manifestations, recognising ATC profiles will help clinicians avoid misdiagnosis.
Asunto(s)
Arthrodermataceae , Dermatomicosis , Tiña del Cuero Cabelludo , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Arthrodermataceae/aislamiento & purificación , Arthrodermataceae/patogenicidad , China/epidemiología , Dermatomicosis/diagnóstico , Dermatomicosis/epidemiología , Femenino , Humanos , Masculino , Microsporum/aislamiento & purificación , Microsporum/patogenicidad , Persona de Mediana Edad , Morbilidad , Posmenopausia , Prevalencia , Estudios Retrospectivos , Factores de Riesgo , Tiña del Cuero Cabelludo/diagnóstico , Tiña del Cuero Cabelludo/epidemiología , Adulto JovenRESUMEN
The increasing number of dermatophytoses among animals observed recently in developed countries may be connected with relocation of many exotic species outside their natural living environment. Moreover, an impact on this situation may also be exerted by relapses related to limited compliance with antifungal treatment regimes. Many exotic animals, including camelids, imported to European countries are connected with cases of tuberculosis or zoophilic dermatophytoses in humans. In the present study, we identified and comprehensively analysed dermatophyte infections in alpacas from breeding farms in Poland. As part of this study, we determined the prevalence of dermatophyte infections in alpacas. The conventional and molecular mycological diagnostic procedures applied led to unambiguous identification of the aetiological factors of symptomatic dermatophytoses and asymptomatic animals, that is Trichophyton benhamiae and T. verrucosum. Furthermore, the susceptibility tests allowed choosing the best therapeutic option and revealed superior activity of allylamine drugs against all strains. Finally, in the case of strains isolated from symptomatic dermatophytoses, our study revealed a significantly higher virulence level expressed by high activity of chosen enzymes, especially related to keratinolytic and haemolytic activity. In conclusion, this report indicates that farmed alpacas can be a reservoir or vector for contagious zoophilic dermatophyte infection. For this reason, imported animals should be subjected to meticulous monitoring to detect not only symptomatic infections but also asymptomatic animals.
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Antifúngicos/farmacología , Arthrodermataceae/fisiología , Camélidos del Nuevo Mundo , Tiña/veterinaria , Animales , Arthrodermataceae/efectos de los fármacos , Arthrodermataceae/patogenicidad , Fenotipo , Polonia , Prevalencia , Tiña/microbiología , Tiña/prevención & control , VirulenciaRESUMEN
The physical, psychological and financial burden of skin disease in low- to middle-income countries, where access to skincare is limited, is poorly understood. A group that we know very little about in this regard are refugees. There are limited data on the range of skin diseases and skincare needs of this group. To better understand the skincare needs of the displaced Rohingya population residing in the Kutupalong refugee camp, Bangladesh, we collected data on demographics, living conditions and range of dermatoses. In the 380 patients assessed, fungal skin infections, predominantly dermatophytes, were by far the most common skin disease seen (n = 215), followed by dermatitis (n = 81). Skin disease can be the presenting feature in many systemic conditions and may cause significant secondary complications itself. Developing a better understanding of the skincare needs of the refugee population is essential for future healthcare planning for this vulnerable group.
Asunto(s)
Evaluación de Necesidades/economía , Campos de Refugiados/estadística & datos numéricos , Refugiados/psicología , Enfermedades de la Piel/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Arthrodermataceae/patogenicidad , Bangladesh/epidemiología , Niño , Preescolar , Dermatitis/epidemiología , Dermatitis/patología , Dermatomicosis/epidemiología , Dermatomicosis/microbiología , Dermatomicosis/patología , Femenino , Necesidades y Demandas de Servicios de Salud , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Mianmar/etnología , Evaluación de Necesidades/estadística & datos numéricos , Refugiados/estadística & datos numéricos , Enfermedades de la Piel/patología , Adulto JovenRESUMEN
BACKGROUND: Gentamicin is a broad-spectrum aminoglycoside antibiotic produced by Micromonospora purpurea bacteria, effective against Gram-negative bacterial infections. Major fractions of the gentamicin complex (C1, C1a, C2, C2a) possess weak antifungal activity and one of the minor components (A, A1-A4, B, B1, X), gentamicin B1 was found to be a strong antifungal agent. METHODS: This work uses in vitro and in vivo dilution methods to compare the antifusarial, antiaspergillic and anticryptococcal effects of gentamicin derivatives and structurally-related congeners. RESULTS: The in vitro antifusarial activity of gentamicin B1 (minimum inhibitory concentration (MIC) 0.4 µg/mL) and structurally-related compounds (MIC 0.8-12.5 µg/mL) suggests that the purpuroseamine ring substituents are responsible for the specific antimycotic effect. The functional groups of the garoseamine and 2-deoxystreptamine rings of gentamicin derivatives are identical in gentamicin compounds and are unlikely to exert a significant antifungal effect. Among soil dermatophytes, Microsporum gypseum was more susceptible to gentamicin B1 (MIC 3.1 µg/mL) than Trichophyton gypseum (MIC 25 µg/mL). The in vitro antifungal effect of gentamicin B1 against plant pathogenic fungi was comparable to primary antifungal agents. CONCLUSION: Gentamicin is already in medical use. In vitro and preclinical in vivo synergisms of gentamicin B1 with amphotericin B suggest immediate clinical trials starting with subtoxic doses.