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Clinical Microbiology Reviews Jun 2024SUMMARYIn 2023, the World Health Organization designated eumycetoma causative agents as high-priority pathogens on its list of fungal priority pathogens. Despite this... (Review)
Review
SUMMARYIn 2023, the World Health Organization designated eumycetoma causative agents as high-priority pathogens on its list of fungal priority pathogens. Despite this recognition, a comprehensive understanding of these causative agents is lacking, and potential variations in clinical manifestations or therapeutic responses remain unclear. In this review, 12,379 eumycetoma cases were reviewed. In total, 69 different fungal species were identified as causative agents. However, some were only identified once, and there was no supporting evidence that they were indeed present in the grain. was by far the most commonly reported fungal causative agent. In most studies, identification of the fungus at the species level was based on culture or histology, which was prone to misidentifications. The newly used molecular identification tools identified new causative agents. Clinically, no differences were reported in the appearance of the lesion, but variations in mycetoma grain formation and antifungal susceptibility were observed. Although attempts were made to explore the differences in clinical outcomes based on antifungal susceptibility, the lack of large clinical trials and the inclusion of surgery as standard treatment posed challenges in drawing definitive conclusions. Limited case series suggested that eumycetoma cases caused by species were less responsive to treatment than those caused by . However, further research is imperative for a comprehensive understanding.
Topics: Mycetoma; Humans; Antifungal Agents; Madurella; Treatment Outcome
PubMed: 38690871
DOI: 10.1128/cmr.00034-23 -
Molecules (Basel, Switzerland) Apr 2024In the search for new bioactive agents against the infectious pathogen responsible for the neglected tropical disease (NTD) mycetoma, we tested a collection of 27...
In the search for new bioactive agents against the infectious pathogen responsible for the neglected tropical disease (NTD) mycetoma, we tested a collection of 27 essential oils (EOs) in vitro against , the primary pathogen responsible for the fungal form of mycetoma, termed eumycetoma. Among this series, the EO of (Santalaceae), i.e., East Indian sandalwood oil, stood out prominently with the most potent inhibition in vitro. We, therefore, directed our research toward 15 EOs of species of different geographical origins, along with two samples of EOs from other plant species often commercialized as "sandalwood oils". Most of these EOs displayed similar strong activity against in vitro. All tested oils were thoroughly analyzed by GC-QTOF MS and most of their constituents were identified. Separation of the sandalwood oil into the fractions of sesquiterpene hydrocarbons and alcohols showed that its activity is associated with the sesquiterpene alcohols. The major constituents, the sesquiterpene alcohols ()-α- and ()-β-santalol were isolated from the oil by column chromatography on AgNO-coated silica. They were tested as isolated compounds against the fungus, and ()-α-santalol was about two times more active than the β-isomer.
Topics: Madurella; Plant Oils; Oils, Volatile; Mycetoma; Santalum; Sesquiterpenes; Antifungal Agents; Microbial Sensitivity Tests
PubMed: 38675665
DOI: 10.3390/molecules29081846 -
Anais Brasileiros de Dermatologia 2024
Review
Topics: Humans; Isotretinoin; Dermatologic Agents; Tinea Versicolor; Administration, Oral; Chronic Disease; Male; Treatment Outcome; Adult
PubMed: 38670865
DOI: 10.1016/j.abd.2023.08.014 -
Emerging Infectious Diseases May 2024We describe a feline sporotrichosis cluster and zoonotic transmission between one of the affected cats and a technician at a veterinary clinic in Kansas, USA. Increased...
We describe a feline sporotrichosis cluster and zoonotic transmission between one of the affected cats and a technician at a veterinary clinic in Kansas, USA. Increased awareness of sporotrichosis and the potential for zoonotic transmission could help veterinary professionals manage feline cases and take precautions to prevent human acquisition.
Topics: Animals; Cats; Female; Humans; Animal Technicians; Cat Diseases; Kansas; Sporothrix; Sporotrichosis; Zoonoses
PubMed: 38666748
DOI: 10.3201/eid3005.231563 -
BMJ Case Reports Apr 2024Mycetoma is a chronic granulomatous infectious disease with a triad of subcutaneous swelling, discharging sinuses and the presence of granules. The infection may occur...
Mycetoma is a chronic granulomatous infectious disease with a triad of subcutaneous swelling, discharging sinuses and the presence of granules. The infection may occur following minor trauma or penetrating thorn injury. We report a case of a man in his 40s with a history of thorn prick 9 years ago, followed by the formation of painless discharging sinuses on the right foot for the past 2 years. Clinical, local epidemiological, histopathological examination and Gram stain confirmed the diagnosis of actinomycetoma. Prior to initiating the Welsh regimen, a pretreatment assessment of the patient's auditory function was conducted through pure tone audiometry, indicating the existence of pre-existing high-frequency bilateral sensorineural hearing loss. The patient was treated with linezolid as an alternative to amikacin, at a dosage of 600 mg two times per day, leading to complete resolution within 3 weeks. This underscores linezolid's efficacy as a safe and cost-effective alternative for actinomycetoma, without causing ototoxic side effects.
Topics: Humans; Linezolid; Male; Hearing Loss, Sensorineural; Mycetoma; Adult; Anti-Bacterial Agents; Treatment Outcome
PubMed: 38663898
DOI: 10.1136/bcr-2023-258686 -
Blue onychomatricoma: Blue discoloration of an onychomatricoma secondary to pigmented onychomycosis.Journal of Cutaneous Pathology Jul 2024
Topics: Humans; Onychomycosis; Skin Neoplasms; Male; Nail Diseases; Female; Middle Aged
PubMed: 38661225
DOI: 10.1111/cup.14628 -
ACS Biomaterials Science & Engineering May 2024Persistent foot odor and itchiness are common symptoms of tinea pedis, significantly disrupting the daily life of those affected. The cuticular barrier at the site of...
Persistent foot odor and itchiness are common symptoms of tinea pedis, significantly disrupting the daily life of those affected. The cuticular barrier at the site of the tinea pedis is thickened, which impedes the effective penetration of antifungal agents. Additionally, fungi can migrate from the skin surface to deeper tissues, posing challenges in the current clinical treatment for tinea pedis. To effectively treat tinea pedis, we developed a platform of bilayer gelatin methacrylate (GelMA) microneedles (MNs) loaded with salicylic acid (SA) and FK13-a1 (SA/FK13-a1@GelMA MNs). SA/FK13-a1@GelMA MNs exhibit pH- and matrix metalloproteinase (MMP)-responsive properties for efficient drug delivery. The MNs are designed to deliver salicylic acid (SA) deep into the stratum corneum, softening the cuticle and creating microchannels. This process enables the antibacterial peptide FK13-a1 to penetrate through the stratum corneum barrier, facilitating intradermal diffusion and exerting antifungal and anti-inflammatory effects. In severe cases of tinea pedis, heightened local pH levels and MMP activity further accelerate drug release. Our research demonstrates that SA/FK13-a1@GelMA MNs are highly effective against , , and . They also reduced stratum corneum thickness, fungal burden, and inflammation in a guinea pig model of tinea pedis induced by . Furthermore, it was discovered that SA/FK13-a1@GelMA MNs exhibit excellent biocompatibility. These findings suggest that SA/FK13-a1@GelMA MNs have significant potential for the clinical treatment of tinea pedis as well as other fungal skin disorders.
Topics: Tinea Pedis; Animals; Hydrogen-Ion Concentration; Needles; Antifungal Agents; Matrix Metalloproteinases; Humans; Drug Delivery Systems; Guinea Pigs; Gelatin; Methacrylates
PubMed: 38659287
DOI: 10.1021/acsbiomaterials.4c00305 -
Anais Brasileiros de Dermatologia 2024
Topics: Humans; Dermoscopy; Eczema; Tinea Pedis; Psoriasis; Hand Dermatoses; Female; Male; Adult; Middle Aged
PubMed: 38658237
DOI: 10.1016/j.abd.2023.05.008 -
BMJ Open Apr 2024Diabetic foot ulcers are feared complications of diabetes mellitus (DM), requiring extensive treatment and hospital admissions, ultimately leading to amputation and...
INTRODUCTION
Diabetic foot ulcers are feared complications of diabetes mellitus (DM), requiring extensive treatment and hospital admissions, ultimately leading to amputation and increased mortality. Different factors contribute to the development of foot ulcers and related complications. Onychomycosis, being more prevalent in patients with diabetes, could be an important risk factor for developing ulcers and related infections. However, the association between onychomycosis and diabetic complications has not been well studied in primary care.
RESEARCH DESIGN AND METHODS
To determine the impact of onychomycosis on ulcer development and related complications in patients with diabetes in primary care, a longitudinal cohort study was carried out using routine care data from the Extramural Leiden University Medical Center Academic Network. Survival analyses were performed through Cox proportional hazards models with time-dependent covariates.
RESULTS
Data from 48 212 patients with a mean age of 58 at diagnosis of DM, predominantly type 2 (87.8%), were analysed over a median follow-up of 10.3 years. 5.7% of patients developed an ulcer. Onychomycosis significantly increased the risk of ulcer development (HR 1.37, 95% CI 1.13 to 1.66), not affected by antimycotic treatment, nor after adjusting for confounders (HR 1.23, 95% CI 1.01 to 1.49). The same was found for surgical interventions (HR 1.54, 95% CI 1.35 to 1.75) and skin infections (HR 1.48, CI 95% 1.28 to 1.72), again not affected by treatment and significant after adjusting for confounders (HR 1.32, 95% CI 1.16 to 1.51 and HR 1.27, 95% CI 1.10 to 1.48, respectively).
CONCLUSIONS
Onychomycosis significantly increased the risk of ulcer development in patients with DM in primary care, independently of other risk factors. In addition, onychomycosis increased the risk of surgeries and infectious complications. These results underscore the importance of giving sufficient attention to onychomycosis in primary care and corresponding guidelines. Early identification of onychomycosis during screening and routine care provides a good opportunity for timely recognition of increased ulcer risk.
Topics: Humans; Onychomycosis; Female; Male; Middle Aged; Longitudinal Studies; Netherlands; Diabetic Foot; Aged; Risk Factors; General Practice; Diabetes Mellitus, Type 2; Proportional Hazards Models; Adult; Primary Health Care
PubMed: 38658014
DOI: 10.1136/bmjopen-2023-076441 -
Current Microbiology Apr 2024Aspergillus fumigatus and Fusarium solani infections have become severe health threat; both pathogens are considered a priority due to the increasing emergence of...
Aspergillus fumigatus and Fusarium solani infections have become severe health threat; both pathogens are considered a priority due to the increasing emergence of antifungal-resistant strains and high mortality rates. Therefore, the discovery of new therapeutic strategies has become crucial. In this study, we evaluated the antifungal and antivirulence effects of vanillin and tannic acid against Aspergillus fumigatus and Fusarium solani. The minimum inhibitory concentrations of the compounds were determined by the microdilution method in RPMI broth in 96-well microplates according to CLSI. Conidial germination, protease production, biofilm formation, and in vivo therapeutic efficacy assays were performed. The results demonstrated that vanillin and tannic acid had antifungal activity against Aspergillus fumigatus, while tannic acid only exhibited antifungal activity against Fusarium solani. We found that vanillin and tannic acid inhibited conidial germination and secreted protease production and biofilm formation of the fungal pathogens using sub-inhibitory concentrations. Besides, vanillin and tannic acid altered the fungal membrane permeability, and both compounds showed therapeutic effect against aspergillosis and fusariosis in an infection model in Galleria mellonella larvae. Our results highlight the antivirulence effect of vanillin and tannic acid against priority pathogenic fungi as a possible therapeutic alternative for human fungal infections.
Topics: Benzaldehydes; Fusarium; Tannins; Antifungal Agents; Microbial Sensitivity Tests; Biofilms; Aspergillus fumigatus; Animals; Aspergillosis; Virulence; Larva; Fusariosis; Spores, Fungal; Moths; Polyphenols
PubMed: 38656548
DOI: 10.1007/s00284-024-03678-w