Molecular identification and antifungal susceptibility profiles of clinical strains of Fonsecaea spp. isolated from patients with chromoblastomycosis in Rio de Janeiro, Brazil

dc.creatorCoelho, Rowena Alves
dc.creatorBrito-Santos, Fábio
dc.creatorFigueiredo-Carvalho, Maria Helena Galdino
dc.creatorSilva, Juliana Vitoria Dos Santos
dc.creatorGutierrez-Galhardo, Maria Clara
dc.creatorValle, Antonio Carlos Francesconi do
dc.creatorZancopé-Oliveira, Rosely Maria
dc.creatorTrilles, Luciana
dc.creatorMeyer, Wieland
dc.creatorFreitas, Dayvison Francis Saraiva
dc.creatorAlmeida-Paes, Rodrigo
dc.date2019-07-11T12:54:37Z
dc.date2019-07-11T12:54:37Z
dc.date2018
dc.date.accessioned2023-09-26T22:09:16Z
dc.date.available2023-09-26T22:09:16Z
dc.identifierCOELHO, Rowena Alves et al. Molecular identification and antifungal susceptibility profiles of clinical strains of Fonsecaea spp. isolated from patients with chromoblastomycosis in Rio de Janeiro, Brazil. Plos Neglected Tropical Diseases, p. 1-15, July 2018.
dc.identifier1935-2727
dc.identifierhttps://www.arca.fiocruz.br/handle/icict/33978
dc.identifier10.1371/journal.pntd.0006675
dc.identifier1935-2735
dc.identifier.urihttps://repositorioslatinoamericanos.uchile.cl/handle/2250/8875484
dc.descriptionBackground: 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.
dc.formatapplication/pdf
dc.languageeng
dc.publisherPublic Library of Science
dc.rightsopen access
dc.subjectFonsecaea spp.
dc.subjectChromoblastomycosis
dc.titleMolecular identification and antifungal susceptibility profiles of clinical strains of Fonsecaea spp. isolated from patients with chromoblastomycosis in Rio de Janeiro, Brazil
dc.typeArticle


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