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Clinical Microbiology and Infection :... Mar 2022
Topics: Antifungal Agents; Humans; Itraconazole; Madurella; Mycetoma; Neglected Diseases
PubMed: 33915283
DOI: 10.1016/j.cmi.2021.04.018 -
Antimicrobial Agents and Chemotherapy Feb 2021We present an susceptibility assay for hyphae using resazurin for endpoint reading. Using this assay, reproducible MICs were obtained for amphotericin B, itraconazole,...
We present an susceptibility assay for hyphae using resazurin for endpoint reading. Using this assay, reproducible MICs were obtained for amphotericin B, itraconazole, voriconazole, posaconazole, terbinafine, and micafungin. Results were comparable with those of a 2,3-bis-(2-methoxy-4-nitro-5-sulfophenyl)-2-tetrazolium-5-carboxanilide salt (XTT)-based susceptibility assay. The lowest MICs were obtained for itraconazole and posaconazole (MIC, 0.016 µg/ml) followed by voriconazole (MIC, 0.063 µg/ml). Amphotericin B, micafungin, and terbinafine appeared much less effective.
Topics: Antifungal Agents; Itraconazole; Madurella; Microbial Sensitivity Tests; Oxazines; Voriconazole; Xanthenes
PubMed: 33318015
DOI: 10.1128/AAC.01338-20 -
Clinics in Dermatology 2012Eumycetoma is caused by different fungi. Madurella mycetomatis, Madurella grisae, and Scedosporium apiospermum are the most common causative agents. This disease is more...
Eumycetoma is caused by different fungi. Madurella mycetomatis, Madurella grisae, and Scedosporium apiospermum are the most common causative agents. This disease is more frequent on the lower extremities but can also be present in other areas. The diagnosis is made by direct microscopic examination and histologic study, which should show hyphae and vesicles characteristic of the fungi. Etiologic identification of the species of the fungus is sometimes difficult by culture and biopsy specimen; in these cases, molecular techniques can help to identify the infecting organism. Treatment has been with amphotericin B, which is now seldom used due to its side effects and limited success. The best therapeutic choice is surgical removal of the lesion, followed by medical treatment. This includes antifungals such as the azoles, ketoconazole and itraconazole; in resistant cases, posaconazole and voriconazole are currently recommended. In particular, the combination of terbinafine and itraconazole can elicit a good result in some cases.
Topics: Antifungal Agents; Drug Resistance, Multiple, Fungal; Humans; Mycetoma
PubMed: 22682186
DOI: 10.1016/j.clindermatol.2011.09.009 -
Antimicrobial Agents and Chemotherapy Jun 2010Eumycetoma caused by Madurella mycetomatis is treated surgically and with high doses of ketoconazole. Therapeutic responses are poor, and recurrent infections are...
Eumycetoma caused by Madurella mycetomatis is treated surgically and with high doses of ketoconazole. Therapeutic responses are poor, and recurrent infections are common. In search of therapeutic alternatives in the treatment of mycetoma, we determined the in vitro susceptibilities of M. mycetomatis isolates against caspofungin, anidulafungin, and micafungin. As a comparator fungus, Aspergillus fumigatus was used. Minimal effective concentrations (MECs) and MICs were assessed and compared to those of ketoconazole. M. mycetomatis isolates were not susceptible to the echinocandins.
Topics: Anidulafungin; Antifungal Agents; Aspergillus fumigatus; Caspofungin; Drug Resistance, Fungal; Echinocandins; Humans; In Vitro Techniques; Lipopeptides; Madurella; Micafungin; Microbial Sensitivity Tests; Mycetoma
PubMed: 20350944
DOI: 10.1128/AAC.01546-09 -
Journal of Clinical Microbiology Mar 2002Madurella mycetomatis is the main causative agent of human eumycetoma, a severe debilitating disease endemic in Sudan. It has been suggested that eumycetoma has a...
Madurella mycetomatis is the main causative agent of human eumycetoma, a severe debilitating disease endemic in Sudan. It has been suggested that eumycetoma has a soil-borne or thorn prick-mediated origin. For this reason, efforts were undertaken to culture M. mycetomatis from soil samples (n = 43) and thorn collections (n = 35) derived from areas in which it is endemic. However, ribosomal sequencing data revealed that the black fungi obtained all belonged to other fungal species. In addition, we performed PCR-mediated detection followed by restriction fragment length polymorphism (RFLP) analysis for the identification of M. mycetomatis DNA from the environmental samples as well as biopsies from patients with mycetoma. In the case of the Sudanese soil samples, 17 out of 74 (23%) samples were positive for M. mycetomatis DNA. Among the thorn collections, 1 out of 22 (5%) was positive in the PCR. All PCR RFLP patterns clearly indicated the presence of M. mycetomatis. In contrast, 15 Dutch and English control soil samples were all negative. Clinically and environmentally obtained fungal PCR products share the same PCR RFLP patterns, suggesting identity, at least at the species level. These observations support the hypothesis that eumycetoma is primarily environmentally acquired and suggest that M. mycetomatis needs special conditions for growth, as direct isolation from the environment seems to be impossible.
Topics: DNA, Fungal; Humans; Madurella; Mycetoma; Plants; Polymerase Chain Reaction; Soil Microbiology
PubMed: 11880433
DOI: 10.1128/JCM.40.3.1031-1036.2002 -
Genome Announcements May 2016We present the first genome sequence for a strain of the main mycetoma causative agent, Madurella mycetomatis This 36.7-Mb genome sequence will offer new insights into...
We present the first genome sequence for a strain of the main mycetoma causative agent, Madurella mycetomatis This 36.7-Mb genome sequence will offer new insights into the pathogenesis of mycetoma, and it will contribute to the development of better therapies for this neglected tropical disease.
PubMed: 27231361
DOI: 10.1128/genomeA.00418-16 -
BMJ Case Reports Aug 2018
Topics: Adult; Bone Diseases; Fibula; Humans; Leg Dermatoses; Madurella; Mycetoma; Tibia
PubMed: 30150342
DOI: 10.1136/bcr-2018-225567 -
Antimicrobial Agents and Chemotherapy Apr 2011Presently, therapy of eumycetoma in Sudan is still based on surgery combined with prolonged ketoconazole therapy. This usually results in a poor clinical outcome. To...
Presently, therapy of eumycetoma in Sudan is still based on surgery combined with prolonged ketoconazole therapy. This usually results in a poor clinical outcome. To determine if posaconazole and terbinafine could offer better therapeutic alternatives, the in vitro susceptibilities of 34 Madurella mycetomatis strains were determined. It appeared that posaconazole was highly active against M. mycetomatis but terbinafine was only moderately active. Since posaconazole has an excellent safety profile, it might provide an important alternative in mycetoma therapy.
Topics: Antifungal Agents; Itraconazole; Ketoconazole; Madurella; Microbial Sensitivity Tests; Naphthalenes; Terbinafine; Triazoles
PubMed: 21263050
DOI: 10.1128/AAC.01045-10 -
Journal of the European Academy of... Aug 2020At the dermatology service of the General Hospital of Mexico City, Mexico, two patients, father and son, with black-grain mycetoma were seen. The grains were isolated,...
BACKGROUND
At the dermatology service of the General Hospital of Mexico City, Mexico, two patients, father and son, with black-grain mycetoma were seen. The grains were isolated, and the cultured fungi were identified as Madurella mycetomatis based on morphology. Using the M. mycetomatis specific PCR, amplicons of a different size than that of the M. mycetomatis type strain were obtained.
OBJECTIVE
To determine the causative agent of the two black-grain mycetoma cases and develop non-culture-based diagnostic tools to identify them to the species level.
METHODS
The M. mycetomatis specific, the internal transcribed spacer (ITS) region, β-tubulin (BT) and ribosomal binding protein 2 (RBP2) PCRs were used to confirm the identity of the isolates. Genetic variation was established by amplification fragment length polymorphisms. To determine the antifungal susceptibility profile, the Sensititre™ YeastOne™ assay was used. To develop a species-specific PCR primers were designed on the sequenced PCR amplicon from the M. mycetomatis specific PCR.
RESULTS
By analyzing the ITS, BT and RBP2 regions the isolates were identified as Madurella pseudomycetomatis. The isolates from father and son were similar but not identical to M. pseudomycetomatis from Venezuela and one from an unknown origin. Madurella pseudomycetomatis isolates were inhibited by itraconazole, posaconazole and voriconazole but showed increased MIC values for amphotericin B and fluconazole. They were not inhibited by the echinocandins and five flucytosine. The two patients were treated with itraconazole resulting in cure for the father while the son was lost to follow-up. The species-specific PCR developed for M. pseudomyceotmatis was discriminative and specific.
CONCLUSION
Madurella pseudomycetomatis is genetically diverse with same susceptibility profile as M. mycetomatis and causes eumycetoma in Latin America. The M. pseudomycetomatis specific PCR can be used to identify this causative agent to the species level; however, this needs to be validated in an endemic setting.
Topics: DNA Primers; Humans; Madurella; Mexico; Mycetoma; Species Specificity
PubMed: 32233084
DOI: 10.1111/jdv.16402 -
Transactions of the Royal Society of... Apr 2021Currently there is a wide knowledge gap in our understanding of mycetoma epidemiological characteristics, including the infection route.
BACKGROUND
Currently there is a wide knowledge gap in our understanding of mycetoma epidemiological characteristics, including the infection route.
METHODS
A cross-sectional descriptive epidemiological study was carried out to determine the role of exposure to animals and insects such as ticks in the transmission of eumycetoma in two adjacent villages at eastern Sudan.
RESULTS
Significant differences were found between the two villages in the level of contact and exposure to animals and ticks, the percentages of people bitten by ticks, participation in cleaning animal pens and knowledge of the medical importance of ticks. In the village with a high mycetoma prevalence rate, there were high infestation rates of ticks in domestic animals. Hyalomma and Rhipicephalus species were the most prevalent species in houses with mycetoma patients and together they constituted 83% of the total collection. Pool screening of vectors for the detection of Madurella mycetomatis recombinant RNA genes showed one positive pool from Rhipicephalus evertsi following amplification of the universal fungal primer and one positive sample from Hyalomma rufipes following the use of a specific primer.
CONCLUSION
The findings indicate a possible role of ticks in the transmission of eumycetoma causative agents. However, further in-depth studies are needed to verify this.
Topics: Animals; Cross-Sectional Studies; Humans; Madurella; Mycetoma; Sudan; Ticks
PubMed: 33690861
DOI: 10.1093/trstmh/trab030