CÁC CHỦNG VI NẤM NGOÀI DA PHÂN LẬP ĐƯỢC VÀ ĐỘ NHẠY CẢM VỚI CÁC THUỐC KHÁNG NẤM HIỆN NAY TRÊN BỆNH NHÂN ĐẾN KHÁM TẠI BỆNH VIỆN DA LIỄU THÀNH PHỐ HỒ CHÍ MINH NĂM 2021

Đặt vấn đề: Nhiễm vi nấm ngoài da (dermatophytosis) là một trong những bệnh phổ biến và khó điều trị. Vấn đề chẩn đoán tác nhân gây bệnh chưa được quan tâm triệt để, cộng với tình trạng kháng thuốc ngày càng tăng. Do đó cần thiết phải có nghiên cứu khảo sát các chủng vi nấm ngoài da hiện đang lưu hành trên các bệnh nhân đến khám tại bệnh viện Da Liễu, từ đó có cơ sở chẩn đoán và điều trị hiệu quả. Mục tiêu: Phân lập, định danh và tìm hiểu tỷ lệ của các chủng vi nấm ngoài da. Khảo sát độ nhạy cảm với các thuốc khám nấm hiện nay trên các bệnh nhân đến khám tại bệnh viện Da Liễu Thành phố Hồ Chí Minh. Phương pháp nghiên cứu: cắt ngang mô tả, đối tượng từ 339 mẫu bệnh phẩm da, tóc, móng nghi ngờ do vi nấm ngoài da đến khám ngoại trú tại Khoa Khám bệnh Bệnh viện Da Liễu Thành phố Hồ Chí Minh từ tháng 1 đến tháng 5 năm 2021 có chỉ định soi tươi tìm vi nấm của bác sĩ lâm sàng. Các bệnh phẩm được cấy vào môi trường Dermatophyte test medium (DTM) và Sabouraud dextrose Agar (SDA) để phân biệt và định danh. Các chủng vi nấm ngoài da được thực hiện kháng nấm bằng phương pháp đĩa khuếch tán để đánh giá hiệu lực gồm các chất kháng nấm: fluconazole, griseofulvin, itraconazole, ketoconazole. Kết quả: Tỷ lệ bệnh nhân được chẩn đoán nhiễm nấm ngoài da là 47,2%. Trên 107 mẫu bệnh phẩm nuôi cấy phân lập được vi nấm ngoài da, Trichophyton rubrum chiếm tỉ lệ cao nhất là 63,55%, kế đến là Trichophyton mentagrophytes với tỉ lệ 28,04%, Microsporum gypseum chiếm tỉ lệ 4,67%, và cuối cùng là Microsporum canis có tỉ lệ thấp nhất là 3,74%. Tất cả vi nấm ngoài da đều nhạy với thuốc kháng nấm itraconazole (100%); trong khi đó, mức độ nhạy cảm với griseofulvin là 98%. Đối với thuốc kháng nấm ketoconazole, mức độ nhạy với thuốc đạt 52,9%, và có 30,4% mẫu vi nấm ngoài da kháng với ketoconazole. Kết luận: Tỉ lệ nhiễm nấm da do vi nấm ngoài da của bệnh nhân còn cao; trong đó, loài Trichophyton rubrum là loài thường gặp nhất. Kết quả kháng nấm đồ cho thấy tình trạng đề kháng ngày càng tăng của vi nấm, có thể giảm hiệu quả điều trị.

Survey of Keratinophilic Fungi from Feathers of Birds in Tuscany

Although keratinophilic fungi on avian feathers have been widely described, data from European literature are quite lacking regarding Mediterranean countries. The aim of the present study was therefore to evaluate the occurrence of fungal species on feathers of different avian species in Italy. A total of 378 feather samples from both aquatic (n = 254) and terrestrial birds (n = 124), for a total of 30 bird species, were cultured for keratinophilic fungi. Fungal isolates were recognized by their macro- and micro-scopical morphology, and results were corroborated by PCR and sequencing. Keratinophilic fungi belonging to 11 different species (Scopulariopsis brevicaulis, Chrysosporium keratinophilum, Trichophyton terrestre, Microsporum gypseum, Sepedonium sp., Chrysosporium pannorum, Myriodontium sp., Chrysosporium tropicum, Chrysosporium pruinosum, Chrysosporium luteum and Aphanoascus fulvescens) were isolated from 71 animals (18.8%). The frequency of isolation of keratinophilic species from terrestrial birds was significantly higher in waterfowl. Migratory birds in Italy have been proven to carry pathogenic fungi such as dermatophytes, (A. platyrhyncos, A. crecca, E. rubecula), besides saprophytic species.

POLA INFEKSI JAMUR KUKU (ONIKOMIKOSIS) JARI TANGAN DAN KAKI PADA PEKERJA TEMPAT PENITIPAN HEWAN PADA MEDIA POTATO DEXTROSE AGAR (PDA)

Onikomikosis merupakan infeksi pada lempeng kuku yang dapat disebabkan oleh jamur dermatofita (Tinea unguium), non dermatofita atau yeast. Onikomikosis adalah kelainan kuku yang disebabkan oleh jamur dermatofita dan non-dermatofita. Infeksi onikomikosis menyebabkan kerusakan pada kuku yang menyebabkan lempeng kuku menebal, rapuh dan mudah hancur. Penelitian ini bertujuan untuk mengetahui identifikasi jamur kuku tangan dan kaki pada pekerja penitipan hewan. Jenis penelitian yang digunakan adalah penelitian deskriptif. Pengambilan sampel penelitian dilakukan di empat tempat penitipan hewan yang berbeda sebanyak 20 sampel di Surabaya dan tempat pemeriksaan dilakukan di Laboratorium Analis Kesehatan STIKES Ngudia Husada madura. Metode pemeriksaan yang dilakukan melalui metode pengamatan langsung dan metode kultur jamur. Hasil identifikasi menunjukkan bahwa dari 20 sampel sebanyak 11 sampel (55%) positif Tinea unguium (jamur kuku). Pada pengamatan metode kultur jamur hasil positif sebanyak 6 sampel (30%) dengan kode P1, P4, P8, P11, P15 dan P20 terinfeksi oleh jamur Aspergillus sp , Penicillium 10% dengan kode P5 dan P14, Rhizopus sp 5% kode P18, Microsporum gypseum sebanyak 5% kode P13, dan Trichophyton mentagrophytes 5% kode P19. Hasil screening pada penelitian ini menunjukkan para pekerja belum memiliki hygiene diri yang baik khususnya dalam memelihara kebersihan kuku kaki dan tangan sehingga menyebabkan faktor resiko terjadinya infeksi jamur kuku.

In vitro antidermatophytic activity of bioactive compounds from selected medicinal plants

Fungal infections are among the most difficult diseases to manage in humans. Eukaryotic fungal pathogens share many similarities with their host cells, which impairs the development of antifungal compounds. Therefore, it is desirable to harness the pharmaceutical potential of medicinal plants for antifungal drug discovery. In this study, the antifungal activity of sixteen plant extracts was investigated against selected dermatophytic fungi. Of the sixteen plants, the cladode (leaf) of Asparagus racemosus, and seed extract of Cassia occidentalis showed antifungal activity against Microsporum gypseum, Microsporum nanum, Trichophyton mentagrophytes and Trichophyton terrestre. The plant antifungal compounds were located by direct bioassay against Cladosporium herbarum. IR and NMR spectrometry analyses of these compounds identified the presence of saponin (in A. racemosus) and hydroxy anthraquinone (in C. occidentalis) in these antifungal compounds. The antidermatophytic activity of plant anthraquinone and saponins with reports of little or no hemolytic activity, makes these compounds ideal for alternative antifungal therapy and warrants further in-depth investigation in vivo.

Olorofim effectively eradicates dermatophytes in vitro and in vivo

Superficial fungal infections are prevalent worldwide, with dermatophytes, as the most common cause. Various antifungal agents including azoles and allylamines are commonly used to treat dermatophytosis. However, their overuse has yielded drug-resistant strains, calling for the development of novel anti-mycotic compounds. Olorofim, is a newly developed antifungal compound, which targets pyrimidine biosynthesis in molds. The purpose of this study was to determine the in vitro and in vivo antifungal effects of olorofim against common dermatophytes. The in vitro activity of olorofim against dermatophytes was assessed by microtiter broth dilution method. Bioinformatic analysis of olorofim binding to dihydroorotate dehydrogenase (DHODH) of dermatophytes was also performed, using Aspergillus fumigatus DHODH as a template. The in vivo efficacy of the drug was investigated, using a guinea pig model, experimentally infected with Microsporum gypseum. Microtiter assays confirmed the high in vitro sensitivity of dermatophytes to olorofim (MIC= 0.015-0.06 mg/L). Amino acid sequence analysis indicated that DHODH is highly conserved among dermatophytes. The critical residues, in dermatophytes, involved in olorofim binding, were similar to their counterparts in A. fumigatus DHODH, which explains their susceptibility to olorofim. Typical skin lesions of dermatophyte infection, were observed in the guinea pig model, at seven days post-inoculation. Following one week of daily topical administration of olorofim, similar to the clotrimazole group, the skin lesions were resolved and normal hair growth patterns appeared. In light of the in vitro and in vivo activity of olorofim against dermatophytes, this novel agent may be considered as a treatment of choice, against dermatophytosis.

Anti-Fungal Efficacy and Secondary Metabolite Analysis of the Methanolic Extract from Colpomenia peregrina towards Opportunistic Fungal Pathogens

The present study illustrates the antifungal efficacy of methanolic extract from marine brown seaweed Colopomenia peregrina gathered from Leepuram coast, South India, towards opportunistic fungal pathogens comprising of dermatophytes, non-dermatophytes, and yeasts. The opportunistic fungal pathogens used in the study are Aspergillus flavus (ATCC 27692), Aspergillus fumigatus (ATCC 19673), Microsporum gypseum (ATCC 24102), Cryptococcus neoformans (ATCC 14116), and Candida albicans (ATCC14053) which are commonly responsible for nosocomial infections. The NMR analysis revealed the presence of various chemical shifts showing the presence of protons containing Hydroxyl, Methoxy, Methyl groups, and –COO-CH2 groups.The presence of phytochemicals from the extract of seaweed confirmed the nutritional profile. The results revealed greater efficacy of methanolic extract towards Aspergillus fumigatus, Microsporum gypseum, Cryptococcus neoformans, and lower activity with Aspergillus flavus and Candida albicans compared with the standard anti-fungal fluconazole.

PERCEPÇÃO DE TUTORES DE CÃES E GATOS SOBRE A DERMATOFITOSE E SEU POTENCIAL ZOONÓTICO

Introdução: A dermatofitose é uma infecção cutânea superficial que atinge o estrato córneo e tecidos queratinizados causada por fungos dermatófitos, os principais fungos causadores são o Microsporum canis, Microsporum gypseum e Trichophyton mentagrophytes. A dermatofitose é uma zoonose de distribuição cosmopolita que atinge principalmente cães, gatos e humanos devido a sua relação íntima, se apresenta em forma de lesões circulares, eritematosas, de crescimento centrífugo e acompanhadas ou não de prurido. Objetivos: Objetivou- se com a realização deste trabalho evidenciar o conhecimento de tutores de cães e gatos a respeito da dermatofitose com foco na sua transmissão e prevenção. Materiais e métodos: O estudo foi realizado de forma remota por meio de questionário com cinco perguntas afirmativas e de múltipla escolha através da plataforma Google Formulários, concedido por link em redes sociais. O estudo teve caráter quantitativo com população amostral de 128 pessoas no período de 28 de Junho a 05 de Julho de 2021. Resultados: 92,2% dos participantes são tutores de cães ou gatos. 71,9% já apresentaram a doença ou conhecem algum caso de dermatofitose e 28,1% não têm conhecimento. Sobre os animais que podem transmitir a dermatofitose, os participantes afirmam: cães e gatos (43%); gatos, cães, coelhos e roedores (32,8%); apenas gatos (21,9%); alegaram não saber a resposta (2,4%). Referente às formas de transmissão do fungo, alegaram que ocorrem por: contato indireto por fômites (68,8%); contato direto com animal contaminado (52,3%); brigas entre animais contaminados (37,5%); cavar e arranhar solo e árvores contaminadas (15,6%). A respeito das formas de prevenção, assinalaram: isolar animais infectados dos sadios (73,4%); limpeza do ambiente com hipoclorito de sódio ou alvejante (71,9%); limitar acesso do animal a rua e evitar contato com animais que podem estar contaminados (57,8%); usar luvas ao manejar animais infectados (57%); diagnóstico e tratamento precoce (48,4%); castração (7%). Conclusão: Portanto, fica evidente que os tutores não possuem conhecimento necessário a respeito da dermatofitose, principalmente sobre suas formas de transmissão, sendo necessário elaboração de políticas de conscientização e educação a respeito das dermatopatias zoonóticas.

Effect of Clove essential oil (Syzygium aromaticum) against the growth of dandruff scalps-causing fungal pathogen using Kirby- Bauer method in vitro

One of the strongest contributing factors in dandruff scalps is the presence of fungal pathogen or called as Malassezia. Several studies have found a connection between Malassezia and scalp health, one of which is caused by pathogenic fungal infections including Pityrosporum ovale, Microsporum gypseum, and Candida albicans. Clove flowers are known to contain eugenol and its derivative compounds which have antimicrobial, antifungal, antiseptic, and local anesthetic activity. This research aims to determine the effect of clove flower essential oil (Syzygium aromaticum) against some dandruff-causing fungi. The research method was to test the inhibitory power of clove flower essential oil using the diffusion method (Kirby Bauer technique). Samples of pathogenic fungi were cultured on SDA media (Saboroud Dextrose Agar) and given discs that had been given several concentrations of clove flower essential oil. The concentrations used were 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, 100%, positive control using 2% ketoconazole and negative control using virgin coconut oil (VCO). The results showed a significant effect between the ability of essential oils to inhibit the growth of some fungi that cause dandruff. The treatment of clove flower essential oil against M. gypseum at the concentration of 10% has an inhibitory ability of 33,05 mm and at the concentration of 100% amounted to 63.95 mm. Meanwhile, the inhibition percentage in P. ovale with a concentration of 10% and 100% of extract were 14,75 mm and 46,15 mm, respectively. The inhibition rate in C. albicans with the concentration of 10% extract and 100% of extract was 13,5 mm and 39,35 mm. The research shows that clove flower essential oil inhibits the growth of several pathogenic fungal in vitro.

Presumptive Zoonotic Kerion by Nannizzia gypsea: Case Report

Nannizzia gypsea (formerly Microsporum gypseum) belongs to geophilic dermatophytes, fungi involved in keratin degradation in the soil; however, they are also found in dogs and cats. Transmission to humans can occur directly by contact with soil, but indirect transmission via domestic animals is reported too. The exact source of the infection is usually difficult to assess and in most cases only hypothesised and rarely investigated. This case report describes a kerion caused by N. gypsea in a 2-year-old boy, where the contagion was probably secondary to domestic healthy carrier dogs. A “One-Health” approach involving human dermatologists and veterinarians, combined with the use of conventional and molecular-based techniques, allowed tracing of the epidemiological chain and managing of not only the treatment but also the prevention of a recurrence. The child's lesion began to regress after about 8 weeks of treatment with both systemic and topical therapy, while the dogs were given chlorhexidine and miconazole baths. No recurrences nor new infections occurred, demonstrating the effectiveness of the strategies used.

CLINICO-MYCOLOGICAL PROFILE OF DERMATOPHYTOSIS AND DERMATOMYCOSIS AMONG PATIENTS ATTENDING OUTPATIENT DEPARTMENT IN A TERTIARY CARE HOSPITAL.

This study was conducted to determine the common isolates causing dermatophytosis and other fungi causing dermatomycosis in patients presenting with skin lesions with or without involvement of hair and nails. A total of 75 patients were included in the study with 86 distinctive clinical lesions, of which Tinea corporis (46.7%,) was the most predominant followed by T. cruris (22.7%), T. unguium (14.7%) with a male to female ratio of 1.3:1. KOH mounts were made from samples and examined for fungal elements and samples were sent to Microbiology laboratory for culture, and identication among them 77.3% were skin scrapings alone and 14.7% were nail clippings along with skin scrapings and 8% were hair samples along with skin scrapings. Most common isolate was Trichophyton rubrum (40%) followed by Trichophyton mentagrophytes (17.3%), Trichophyton tonsurans (9.3%), Microsporum gypseum (4%) and no fungal growth was found in 17.3% of the samples. The study signies the importance of mycological examination in the diagnosis of dermatophytosis.