Pathogenic potential of an environmental Aspergillus fumigatus strain recovered from soil of Pygoscelis papua (Gentoo penguins) colony in Antarctica.

Aspergillus fumigatus is a common opportunistic pathogen in different animals, including birds such as penguins. For the first time, a fungal strain identified as A. fumigatus was isolated from soil in the nests of gentoo penguins, Pygoscelis papua, on Livingston Island, South Shetland Islands (maritime Antarctica). This isolate (A. fumigatus UFMGCB 11829) displayed a series of potentially pathogenic characteristics in vitro. We evaluated its detailed molecular taxonomy and submitted the A. fumigatus UFMGCB 11829 Antarctic strain to in vivo pathogenic modelling. The isolate was confirmed to represent A. fumigatus morphological and phylogenetic analysis showed that it was closely related to A. fumigatus sequences reported from animals, immunosuppressed humans, storage grains, plants and soils. The strain displayed the best mycelial growth and conidia production at 37 ºC; however, it was also able to grow and produce conidia at 15º, demonstrating its capability to survive and colonize penguin nest at least in the summer season in maritime Antarctica. In pathogenicity tests, healthy mice did not showed symptoms of infection; however, 50% lethality was observed in immunosuppressed mice that were inoculated with 106 and 107 spores. Lethality increased to 100% when inoculated with 108 spores. Our data highlight the potential pathogenicity of opportunistic A. fumigatus that may be present in the Antarctic, and the risks of both their further transfer within Antarctica and outwards to other continents, risks which may be exacerbated due global climatic changes.

Does maritime Antarctic permafrost harbor environmental fungi with pathogenic potential?

We assessed the potentially pathogenic fungi present in Antarctic permafrost and the overlying active layer on King George, Robert, Livingston and Deception Islands in the South Shetland Islands archipelago, maritime Antarctica. Permafrost and active layer sub-samples were incubated at 37 °C to select fungi able to grow inside the human body. A total of 67 fungal isolates were obtained, 27 from the permafrost and 40 from the active layer. These represented 18 taxa of the genera Alternaria, Aspergillus, Curvularia, Penicillium, Rhodotorula and Talaromyces. The majority of fungi detected occurred exclusively either in the permafrost or the active layer at each site. Only Aspergillus thermomutatus, Penicillium cf. chrysogenum and Rhodotorula cf. mucilaginosa were present in both permafrost and active layer samples from the same site. The yeast R. cf. mucilaginosa was recovered from both in at least two sites. The genus Penicillium was the most abundant and widely distributed genus in both permafrost and active layer samples across the sites sampled. All fungal isolates were screened using enzymatic, pH and antifungal assays to identify their virulence potential. Aspergillus hiratsukae, A. thermomutatus and R. cf. mucilaginosa, known human opportunistic fungi, were identified, displayed phospholipase, esterase, proteinase and hemolytic activities. All three also displayed the ability to grow at 40°, 45° and/or 50 °C and resistance to fluconazole and itraconazole; additionally, R. cf. mucilaginosa showed resistance to amphotericin B and viability after 100 d at -80 °C. A. thermomutatus UFMGCB 17415 killed the entire larvae of Tenebrio molitor in six days and R. cf. mucilaginosa UFMGCB 17448 and 17473 in three and four days, respectively. The melting of maritime Antarctic permafrost as a result of climate change may threaten the release of wild strains of pathogenic fungi geographically isolated for long time, which may in turn be transported within and beyond Antarctica by different biological and non-biological vectors.

Molecular diagnosis of Acanthamoeba keratitis: evaluation in rat model and application in suspected human cases.

Acanthamoeba keratitis (AK) is a progressive corneal infection that demands rapid and sensitive techniques for diagnosis to avoid risk of visual impairment. We evaluated two DNA extraction techniques and a semi-nested-PCR (snPCR) targeting the 18S rRNA gene to detect Acanthamoeba cysts and trophozoites. The most effective protocol was evaluated in samples of corneal scrapings and biopsies from an AK rat model and applied to diagnosis of human cases of AK. DNA extraction performed with a commercial kit based on DNA binding to magnetic beads was more efficient than a method based on alkaline lysis, allowing the detection of one trophozoite and one cyst of Acanthamoeba in samples prepared from cultures. This technique and sn-PCR were applied in corneal scrapings of rats experimentally infected with Acanthamoeba (n = 6), resulting in 100% of positivity, against 16.7% (n = 6) of positive identification in culture method using non-nutrient agar (NNA) with Escherichia coli. Corneal biopsies from rats were also tested (n = 6) and resulted in positivity in all samples in both molecular and culture methods. Eight out of ten presumptive human cases of Acanthamoeba keratitis were also confirmed by sn-PCR of scrapping samples, while the culture method was positive in only four cases. We discuss that animal model of AK can be an efficient tool to validate diagnostic methods and conclude that DNA extraction with the kit and snPCR protocol described here is an effective alternative for diagnosis of AK.

Antifungal activity of extracts from Piper aduncum leaves prepared by different solvents and extraction techniques against dermatophytes Trichophyton rubrum and Trichophyton interdigitale.

The effects of different solvents and extraction techniques upon the phytochemical profile and anti-Trichophyton activity of extracts from Piper aduncum leaves were evaluated. Extract done by maceration method with ethanol has higher content of sesquiterpenes and antifungal activity. This extract may be useful as an alternative treatment for dermatophytosis.

Identification and in vitro antifungal susceptibility testing of 200 clinical isolates of Candida spp. responsible for fingernail infections.

A total of 200 samples of Candida spp. that are responsible for fingernail infections were isolated in Belo Horizonte, MG, Brazil from April 2004 to May 2005. The samples were identified by routine microbiological techniques and had the following distribution: Candida parapsilosis (40.5%), C. albicans (31.5%), C. tropicalis (26%), and C. guilliermondii (2%). We performed in vitro susceptibility tests with ciclopiroxolamine, terbinafine, ketoconazole, itraconazole, and fluconazole using the CLSI (Clinical and Laboratory Standards Institute) and EUCAST (European Committee on Antibiotic Susceptibility Testing) methodologies. The percentages of agreement between the two methodologies varied from 48 to 100% (the percentage increased to more than 60% for the majority of the samples). Percentages of agreement between the methodologies lower than 60% were seen with ketoconazole (57%) and itraconazole (48%) for samples of C. albicans and with fluconazole (54%) for samples of C. tropicalis. In general, we observed higher agreement between the values of the MICs obtained with both methodologies for ciclopiroxolamine and terbinafine for all tested species. With azoles, lower percentages of agreement between the methodologies were observed for samples C. albicans and C. tropicalis.

Molecular typing and antifungal susceptibility of Trichophyton rubrum isolates from patients with onychomycosis pre- and post-treatment.

Forty sequential isolates of Trichophyton rubrum were obtained from patients suffering from onychomycosis at two time points, before and after antifungal oral therapy. Strain differentiation by specific amplification of the two tandemly repeated elements (TRS-1 and TRS-2) of the ribosomal DNA of T. rubrum was performed. In addition, susceptibility tests were executed by the microdilution method with nine antifungal drugs: ketoconazole, itraconazole, fluconazole, miconazole, clotrimazole, isoconazole, griseofulvin, cyclopiroxolamine and terbinafine. The combination of TRS-1 with TRS-2 PCR amplification patterns configured 11 T. rubrum genotypes and the three most prevalent (genotypes 1-I, 5-I and 2-I) accounted for 67.5% of the isolates. Seven isolates (35%) obtained before antifungal oral therapy exhibited genotype 1-I compared to the 11 (55%) obtained after the treatment. Twelve patients exhibited different strains before and after the antifungal therapy. With respect to in vitro susceptibility testing, terbinafine was the most potent agent, followed by itraconazole, clotrimazole, isoconazole, miconazole, cyclopiroxolamine, ketoconazole, griseofulvin and fluconazole. Furthermore, an increase in the minimum inhibitory concentrations (MIC) were observed for most of the azole agents when testing isolates obtained post-treatment from four patients. This increase in MIC occurred concomitantly with the major occurrence of genotype 1-I for isolates obtained after oral therapy. These data attempt to consider the relevance of in vivo drug resistance for onychomycosis caused by T. rubrum.

Antifungal susceptibility testing of Trichophyton rubrum by E-test.

Trichophyton rubrum isolates were used in susceptibility testing for azoles by E-test. Voriconazole was the most and fluconazole was the less-active drug. Our results are in agreement with susceptibility data observed by researchers that used others' methodologies. E-test seems to be a reliable methodology to susceptibility-testing for T. rubrum.

In vitro susceptibility of isolates of Sporothrix schenckii to amphotericin B, itraconazole, and terbinafine: comparison of yeast and mycelial forms.

Forty-three clinical isolates of Sporothrix schenckii derived from humans and animals were evaluated in vitro for their susceptibility to amphotericin B, itraconazole, and terbinafine. MICs were determined by the method of micro dilution in liquid media, using protocols M27-A2 for the yeast form and M38-A for the mycelial form, both standardized by the Clinical Laboratory Standards Institute. In general, higher MICs were found for the mycelial form (intervals of up to two dilutions). In the case of amphotericin B, a significant difference in activity was observed, with higher values (p<0.05) found for the mycelial form. MICs for itraconazole and terbinafine were similar for both yeast and mycelial forms but slightly higher for mycelia. Although data presented here indicate different levels of susceptibility when both growth forms were compared, indicating an intrinsic difference between them, it is still difficult to draw a consensus as to which form correlates better with clinical findings. More studies are necessary to determine the criteria for in vitro tests that will lead to efficient therapeutic choices.