Comparing the performance of the common used eumycetoma diagnostic tests

Siddig, Emmanuel Edwar; Nyuykonge, Bertrand; Mhmoud, Najwa Adam; Abdallah, Omnia Babekir; Bahar, Mustafa El Nour; Ahmed, Eiman Siddig; Nyaoke, Borna; Zijlstra, Eduard E.; Verbon, Annelies; Bakhiet, Sahar Mubarak; Fahal, Ahmed Hassan; Sande, Wendy W. J. van de

doi:10.1111/myc.13561

Cited by 4 publications

(6 citation statements)

References 24 publications

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“…The Mycetoma Research Centre (MRC), the University of Khartoum, WHO Collaborating Centre on Mycetoma, the main reference center in the country, which was established in Sudan in 1991, provides medical care and research on mycetoma. According to the MRC patient records, M. mycetomatis was the most common specimen isolated and identified in 70% of the patients, followed by actinomycetoma pathogens ( Streptomyces somaliensis and Actinomadura madurae ) [ 8 , 10 ]. F. senegalensis and F. tompkinsii are occasionally isolated from patients but are uncommon pathogen species [ 10 , 18 ].…”

Section: Discussionmentioning

confidence: 99%

“…In Sudan, the country with the highest number of reported cases globally, eumycetoma is responsible for more than 70% of the cases. The common culprits behind these infections include Madurella mycetomatis , Falciformispora senegalensis, and F. tompkinsii [ 7 – 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…A few drugs are currently used for eumycetoma treatment; however, none of them are able to eradicate pathogenic fungi completely. As a result, extensive surgical excisions and, in severe cases, limb amputations may be required as a part of the treatment process [ 10 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

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Environmental detection of eumycetoma pathogens using multiplex real-time PCR for soil DNA in Sennar State, Sudan

Hashizume,

Taga,

Sakata

et al. 2023

Trop Med Health

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Background Mycetoma is a chronic disease affecting the skin and subcutaneous tissue endemic in the tropical and subtropical regions. Several bacteria and fungi can cause mycetoma, but fungal mycetoma (eumycetoma) is challenging because the treatment requires a combination of a long-term antifungal agent and surgery. Although the transmission route has not yet been elucidated, infection from the soil is a leading hypothesis. However, there are few soil investigation studies, and the geographical distribution of mycetoma pathogens is not well documented. Here, we used multiplex real-time PCR technology to identify three fungal species from soil samples. Methods In total, 64 DNA samples were extracted from soil collected in seven villages in an endemic area in Sennar State, Sudan, in 2019. Primers and fluorescent probes specifically targeting the ribosomal DNA of Madurella mycetomatis, Falciformispora senegalensis, and F. tompkinsii were designed. Results Multiplex real-time PCR was performed and identified the major pathogen, M. mycetomatis that existed in most sites (95%). In addition, two other pathogens were identified from some sites. This is the first report on the use of this technique for identifying the eumycetoma causative microorganisms. Conclusions This study demonstrated that soil DNA investigation can elucidate the risk area of mycetoma-causative agents. The results will contribute to the design of prevention measures, and further large-scale studies may be effective in understanding the natural habitats of mycetoma pathogens.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Environmental detection of eumycetoma pathogens using multiplex real-time PCR for soil DNA in Sennar State, Sudan

Hashizume,

Taga,

Sakata

et al. 2023

Trop Med Health

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“…For mycetoma caused by Madurella mycetomatis , two species‐specific PCR assays have been developed. Using these assays on DNA isolated from grains obtained via deep‐seated excisional biopsies, a specificity of 100% and a sensitivity of 98.9% were obtained 7 . However, these PCRs were never performed on DNA isolated from the FNA material.…”

Section: Introductionmentioning

confidence: 99%

“…Using these assays on DNA isolated from grains obtained via deep-seated excisional biopsies, a specificity of 100% and a sensitivity of 98.9% were obtained. 7 However, these PCRs were never performed on DNA isolated from the FNA material. Therefore, in the current study, we aimed to determine the accuracy, specificity and sensitivity of these PCRs when they were performed on DNA isolated from the US-FNA material obtained from patients who were clinically suspected for a eumycetoma infection.…”

Section: Introductionmentioning

confidence: 99%

Using a Madurella mycetomatis‐specific PCR on grains obtained via non‐invasive fine‐needle aspirated material is more accurate than cytology

Siddig

Ahmed

Hassan

et al. 2023

Mycoses

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Background: Eumycetoma is a chronic subcutaneous inflammatory fungal infection most often caused by the fungus Madurella mycetomatis. Using a species-specific PCR on DNA directly isolated from grains is currently the most reliable method for species identification. However, so far, PCR has been performed on grains obtained through deep-seated surgical biopsies, which are invasive procedures. Grains can also be obtained via ultrasound-guided fine-needle aspiration (US-FNA). Here we determined the diagnostic performance of species-specific PCRs performed on samples obtained through US-FNA. Methods:From 63 patients, US-FNA was performed to obtain eumycetoma grains; 34 patients also underwent a deep-seated biopsy. From the grains, DNA was isolated, and one pan-fungal and two M. mycetomatis-specific PCRs were performed. The sensitivity and specificity were determined.Results: Of the 63 patients who underwent US-FNA, 78% (49/63) had evidence of eumycetoma based on cytology and 93.7% (59/63) based on species-specific PCRs.In the 34 patients for whom surgical biopsies were performed as well, 31 patients had a positive PCR for M. mycetomatis when DNA was isolated from the deep-seated biopsy, and 30 had a positive PCR when DNA was obtained from the US-FNA material. This resulted in a 96.8% sensitivity, and 100% specificity with 97.1% diagnostic accuracy for PCR performed on US-FNA. Conclusion:PCR performed on the US-FNA material has a similar sensitivity and specificity as PCR performed on deep-seated biopsies. Therefore, when using PCR, a deep-seated biopsy may not be necessary to obtain grains.

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An updated list of eumycetoma causative agents and their differences in grain formation and treatment response

van de Sande,

Fahal

2024

Clin Microbiol Rev

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SUMMARY In 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. Madurella mycetomatis 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 Fusarium species were less responsive to treatment than those caused by Madurella mycetomatis . However, further research is imperative for a comprehensive understanding.

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Comparing the performance of the common used eumycetoma diagnostic tests

Cited by 4 publications

References 24 publications

Environmental detection of eumycetoma pathogens using multiplex real-time PCR for soil DNA in Sennar State, Sudan

Environmental detection of eumycetoma pathogens using multiplex real-time PCR for soil DNA in Sennar State, Sudan

Using a Madurella mycetomatis‐specific PCR on grains obtained via non‐invasive fine‐needle aspirated material is more accurate than cytology

An updated list of eumycetoma causative agents and their differences in grain formation and treatment response

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