1. Diagnostic implications of mycetoma derived from Madurella pseudomycetomatis isolates from Mexico
- Author
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Bertrand Nyuykonge, W. W. J. van de Sande, Marie Desnos-Ollivier, G.S. de Hoog, Sarah A. Ahmed, Willemien H A Zandijk, Alexandro Bonifaz, Annelies Verbon, Corné H. W. Klaassen, Erasmus University Medical Center [Rotterdam] (Erasmus MC), Westerdijk Fungal Biodiversity Insitute [Utrecht] (WI), Royal Netherlands Academy of Arts and Sciences (KNAW), University of Khartoum, Mycologie moléculaire - Molecular Mycology, Centre National de la Recherche Scientifique (CNRS)-Institut Pasteur [Paris], Centre National de Référence Mycoses Invasives et Antifongiques - National Reference Center Invasive Mycoses & Antifungals (CNRMA), Institut Pasteur [Paris], Hospital General de México Dr. Eduardo Liceaga (HGM), W.W.J.vdS. was supported by an EUR fellowship of the Erasmus University and Aspasia grant 015.013.033 from the Dutch Scientific Organisation., Medical Microbiology & Infectious Diseases, Westerdijk Fungal Biodiversity Institute [Utrecht] (WI), Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS), and Institut Pasteur [Paris] (IP)
- Subjects
0301 basic medicine ,MESH: DNA Primers ,Posaconazole ,Madurella ,030106 microbiology ,030231 tropical medicine ,Dermatology ,Eumycetoma ,Skin Infectiology, Venereology and Sexual Health ,Microbiology ,Flucytosine ,03 medical and health sciences ,0302 clinical medicine ,Species Specificity ,medicine ,MESH: Madurella ,Humans ,MESH: Species Specificity ,Internal transcribed spacer ,Genotyping ,Mexico ,MESH: Mexico ,[SDV.MP.MYC]Life Sciences [q-bio]/Microbiology and Parasitology/Mycology ,DNA Primers ,MESH: Humans ,biology ,business.industry ,Madurella mycetomatis ,Amplicon ,biology.organism_classification ,medicine.disease ,3. Good health ,MESH: Mycetoma ,Infectious Diseases ,Mycetoma ,Original Article ,business ,medicine.drug - Abstract
International audience; BackgroundAt 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.ObjectiveTo 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.MethodsThe 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.ResultsBy 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.ConclusionMadurella 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.
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- 2020