Molecular identification and antifungal susceptibility profiles of clinical strains of Fonsecaea spp. isolated from patients with chromoblastomycosis in Rio de Janeiro, Brazil.
BACKGROUND:Chromoblastomycosis (CBM) is a difficult-to-treat chronic subcutaneous mycosis. In Brazil, the main agent of this disease is Fonsecaea pedrosoi, which is phenotypically very similar to other Fonsecaea species, differing only genetically. The correct species identification is relevant sinc...
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ftdoajarticles:oai:doaj.org/article:150ea99077994f9a89356b85b852bdb4 2023-05-15T15:15:35+02:00 Molecular identification and antifungal susceptibility profiles of clinical strains of Fonsecaea spp. isolated from patients with chromoblastomycosis in Rio de Janeiro, Brazil. Rowena Alves Coelho Fábio Brito-Santos Maria Helena Galdino Figueiredo-Carvalho Juliana Vitoria Dos Santos Silva Maria Clara Gutierrez-Galhardo Antonio Carlos Francesconi do Valle Rosely Maria Zancopé-Oliveira Luciana Trilles Wieland Meyer Dayvison Francis Saraiva Freitas Rodrigo Almeida-Paes 2018-07-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0006675 https://doaj.org/article/150ea99077994f9a89356b85b852bdb4 EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC6080783?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0006675 https://doaj.org/article/150ea99077994f9a89356b85b852bdb4 PLoS Neglected Tropical Diseases, Vol 12, Iss 7, p e0006675 (2018) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2018 ftdoajarticles https://doi.org/10.1371/journal.pntd.0006675 2022-12-31T00:18:36Z BACKGROUND:Chromoblastomycosis (CBM) is a difficult-to-treat chronic subcutaneous mycosis. In Brazil, the main agent of this disease is Fonsecaea pedrosoi, which is phenotypically very similar to other Fonsecaea species, differing only genetically. The correct species identification is relevant since different species may differ in their epidemiologic aspects, clinical presentation, and treatment response. METHODOLOGY/PRINCIPAL FINDINGS:Partial sequencing of the internal transcribed spacer (ITS) was used to identify twenty clinical isolates of Fonsecaea spp. Their in vitro antifungal susceptibility was determined using the broth microdilution method, according to the M38-A2 protocol. Amphotericin B (AMB), flucytosine (5FC), terbinafine (TRB), fluconazole (FLC), itraconazole (ITC), ketoconazole (KTC), posaconazole (POS), voriconazole (VRC), ravuconazole (RVC), caspofungin (CAS), and micafungin (MFG) were tested. The association between ITC/TRB, AMB/5FC, and ITC/CAS was studied by the checkerboard method to check synergism. The available patients' data were correlated with the obtained laboratory results. Fonsecaea monophora (n = 10), F. pedrosoi (n = 5), and F. nubica (n = 5) were identified as CBM' agents in the study. TRB and VRC were the drugs with the best in vitro activity with minimal inhibitory concentrations (MIC) lower than 0.25 mg/L. On the other hand, FLC, 5FC, AMB, and MFG showed high MICs. The AMB/5FC combination was synergistic for three F. monophora strains while the others were indifferent. Patients had moderate or severe CBM, and ITC therapy was not sufficient for complete cure in most of the cases, requiring adjuvant surgical approaches. CONCLUSIONS/SIGNIFICANCE:F. monophora, the second most frequent Fonsecaea species in South America, predominated in patients raised and born in Rio de Janeiro, Brazil, without cerebral involvement in these cases. TRB, VRC, and the AMB/5FC combination should be further investigated as a treatment option for CBM. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 12 7 e0006675 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Rowena Alves Coelho Fábio Brito-Santos Maria Helena Galdino Figueiredo-Carvalho Juliana Vitoria Dos Santos Silva Maria Clara Gutierrez-Galhardo Antonio Carlos Francesconi do Valle Rosely Maria Zancopé-Oliveira Luciana Trilles Wieland Meyer Dayvison Francis Saraiva Freitas Rodrigo Almeida-Paes Molecular identification and antifungal susceptibility profiles of clinical strains of Fonsecaea spp. isolated from patients with chromoblastomycosis in Rio de Janeiro, Brazil. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
BACKGROUND:Chromoblastomycosis (CBM) is a difficult-to-treat chronic subcutaneous mycosis. In Brazil, the main agent of this disease is Fonsecaea pedrosoi, which is phenotypically very similar to other Fonsecaea species, differing only genetically. The correct species identification is relevant since different species may differ in their epidemiologic aspects, clinical presentation, and treatment response. METHODOLOGY/PRINCIPAL FINDINGS:Partial sequencing of the internal transcribed spacer (ITS) was used to identify twenty clinical isolates of Fonsecaea spp. Their in vitro antifungal susceptibility was determined using the broth microdilution method, according to the M38-A2 protocol. Amphotericin B (AMB), flucytosine (5FC), terbinafine (TRB), fluconazole (FLC), itraconazole (ITC), ketoconazole (KTC), posaconazole (POS), voriconazole (VRC), ravuconazole (RVC), caspofungin (CAS), and micafungin (MFG) were tested. The association between ITC/TRB, AMB/5FC, and ITC/CAS was studied by the checkerboard method to check synergism. The available patients' data were correlated with the obtained laboratory results. Fonsecaea monophora (n = 10), F. pedrosoi (n = 5), and F. nubica (n = 5) were identified as CBM' agents in the study. TRB and VRC were the drugs with the best in vitro activity with minimal inhibitory concentrations (MIC) lower than 0.25 mg/L. On the other hand, FLC, 5FC, AMB, and MFG showed high MICs. The AMB/5FC combination was synergistic for three F. monophora strains while the others were indifferent. Patients had moderate or severe CBM, and ITC therapy was not sufficient for complete cure in most of the cases, requiring adjuvant surgical approaches. CONCLUSIONS/SIGNIFICANCE:F. monophora, the second most frequent Fonsecaea species in South America, predominated in patients raised and born in Rio de Janeiro, Brazil, without cerebral involvement in these cases. TRB, VRC, and the AMB/5FC combination should be further investigated as a treatment option for CBM. |
format |
Article in Journal/Newspaper |
author |
Rowena Alves Coelho Fábio Brito-Santos Maria Helena Galdino Figueiredo-Carvalho Juliana Vitoria Dos Santos Silva Maria Clara Gutierrez-Galhardo Antonio Carlos Francesconi do Valle Rosely Maria Zancopé-Oliveira Luciana Trilles Wieland Meyer Dayvison Francis Saraiva Freitas Rodrigo Almeida-Paes |
author_facet |
Rowena Alves Coelho Fábio Brito-Santos Maria Helena Galdino Figueiredo-Carvalho Juliana Vitoria Dos Santos Silva Maria Clara Gutierrez-Galhardo Antonio Carlos Francesconi do Valle Rosely Maria Zancopé-Oliveira Luciana Trilles Wieland Meyer Dayvison Francis Saraiva Freitas Rodrigo Almeida-Paes |
author_sort |
Rowena Alves Coelho |
title |
Molecular identification and antifungal susceptibility profiles of clinical strains of Fonsecaea spp. isolated from patients with chromoblastomycosis in Rio de Janeiro, Brazil. |
title_short |
Molecular identification and antifungal susceptibility profiles of clinical strains of Fonsecaea spp. isolated from patients with chromoblastomycosis in Rio de Janeiro, Brazil. |
title_full |
Molecular identification and antifungal susceptibility profiles of clinical strains of Fonsecaea spp. isolated from patients with chromoblastomycosis in Rio de Janeiro, Brazil. |
title_fullStr |
Molecular identification and antifungal susceptibility profiles of clinical strains of Fonsecaea spp. isolated from patients with chromoblastomycosis in Rio de Janeiro, Brazil. |
title_full_unstemmed |
Molecular identification and antifungal susceptibility profiles of clinical strains of Fonsecaea spp. isolated from patients with chromoblastomycosis in Rio de Janeiro, Brazil. |
title_sort |
molecular identification and antifungal susceptibility profiles of clinical strains of fonsecaea spp. isolated from patients with chromoblastomycosis in rio de janeiro, brazil. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2018 |
url |
https://doi.org/10.1371/journal.pntd.0006675 https://doaj.org/article/150ea99077994f9a89356b85b852bdb4 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 12, Iss 7, p e0006675 (2018) |
op_relation |
http://europepmc.org/articles/PMC6080783?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0006675 https://doaj.org/article/150ea99077994f9a89356b85b852bdb4 |
op_doi |
https://doi.org/10.1371/journal.pntd.0006675 |
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PLOS Neglected Tropical Diseases |
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12 |
container_issue |
7 |
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e0006675 |
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