Human Pythiosis

Pupaibool, Jakrapun; Chindamporn, Ariya; Patarakul, Kanitha; Suankratay, Chusana; Sindhuphak, Wannasri; Kulwichit, Wanla

doi:10.3201/eid1203.051044

Cited by 22 publications

(12 citation statements)

References 8 publications

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“…Human pythiosis was first documented in 1985 (3). Since then, several cases have been reported, with high rates of morbidity and mortality (12). It is found mostly in Thailand, and two factors contribute to importance of pythiosis in that country: the prevalence of ␤-thalassemia and the presence of large flooded areas used for agriculture (18).…”

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confidence: 99%

In Vitro Activities of Voriconazole, Itraconazole, and Terbinafine Alone or in Combination against Pythium insidiosum Isolates from Brazil

Argenta

Santúrio

Alves

et al. 2008

Antimicrob Agents Chemother

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We evaluated the in vitro activities of voriconazole, itraconazole, and terbinafine against 30 clinical isolates of Pythium insidiosum using a checkerboard macrodilution method. The combined activity of terbinafine plus itraconazole or plus voriconazole was synergic against 17% of the strains. Antagonism was not observed.Pythium insidiosum is classified in the kingdom Stramenopila, class Oomycetes (3). It causes pythiosis, a disease mainly diagnosed in horses, dogs, and humans (14). Human pythiosis was first documented in 1985 (3). Since then, several cases have been reported, with high rates of morbidity and mortality (12). It is found mostly in Thailand, and two factors contribute to importance of pythiosis in that country: the prevalence of ␤-thalassemia and the presence of large flooded areas used for agriculture (18). Combinations of antifungal agents have been poorly studied in medical mycology, and their activities against P. insidiosum are almost unknown (17).The aim of the present study was to investigate the in vitro activity of terbinafine (TRB) combined with itraconazole (ITC) and of TRB combined with voriconazole (VRC) against 30 isolates of Pythium insidiosum from animal pythiosis by using a macrodilution methodology based on the M38-A technique (10).This study included 28 Brazilian P. insidiosum strains obtained from animal pythiosis (horses, dogs, and sheep) and two standard strains (ATCC 58637 and CBS 101555). The identities of the isolates were confirmed by a PCR-based assay (13). The inocula consisted of P. insidiosum zoospores obtained as previously described (11). These were counted in a hemacytometer and diluted in RPMI 1640 broth containing L-glutamine and buffered to pH 7.0 with 0.165 M morpholinepropanesulfonic acid, yielding a final concentration of 2 ϫ 10 3 to 3 ϫ 10 3 zoospores/ml. Candida parapsilosis (ATCC 22019) and Aspergillus flavus (ATCC 204304) were used as quality control organisms (10).The antifungal agents tested were TRB (Novartis) at 1 to 64 mg/liter, ITC (Sigma Pharma) at 0.125 to 32 mg/liter, and VRC (Pfizer) at 0.125 to 32 mg/liter. The interactions of the combinations (TRB-ITC and TRB-VRC) were evaluated by using the checkerboard technique according to the broth macrodilution design (2). The range of drug concentrations for use in the checkerboard assay was the same used in individual tests. Aliquots (50 l) containing different concentrations of each antifungal agent (seven of TRB and nine of triazole agents) were placed in tubes to provide 63 drug combinations; 0.9 ml of inoculum was added to each tube. The interactions were interpreted as synergistic (fractional inhibitory concentration index [FICI] Յ 0.5), indifferent (0.5 Ͻ FICI Յ 4), or antagonistic (FICI Ͼ 4) based on the respective FICI (5), using the following formula: FICI ϭ (MIC A in combination/MIC A) ϩ (MIC B in combination/MIC B). Off-scale MICs were converted to the next higher dilution for calculation purposes.MIC-1 and MIC-0 were used as the reading criteria for TRB and were determined as the lowest dru...

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confidence: 99%

In Vitro Activities of Voriconazole, Itraconazole, and Terbinafine Alone or in Combination against Pythium insidiosum Isolates from Brazil

Argenta

Santúrio

Alves

et al. 2008

Antimicrob Agents Chemother

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“…Pereira et al, 2010;Rakich et al, 2005;Rodrigues et al, 2006;Santurio et al, 2008;Ubiali et al, 2013) besides mainly immunocompromised patients (e.g. Laohapensang et al, 2005;Laohapensang et al, 2009;Pupaibool et al, 2006). Reports on Trichoderma species associated with human infections involved exclusively immunocompromised individuals (e.g.…”

Section: Pathogenicity Traits Of Selected Microorganisms Within the Smentioning

confidence: 99%

Literature search and data collection on RA for human health for microorganisms used as plant protection products

Hackl

Pacher‐Zavisin

Sedman

et al. 2015

EFSA Supporting Publications

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A knowledge base of scientific and regulatory data relevant in the context of risk assessment of microbial plant protection products (PPPs) for human health was established, taking into consideration conditions 1 to 4 in Regulation (EU) 546/2011 that must be met before authorisation can be granted. We screened scientific publications and documents from governmental and institutional sources and extracted relevant information into a database, performed comparative genome analyses to explore possibilities and limitations of applying read-across among PPP strains, and discussed the collective findings among a group of experts in relevant fields. Besides information on factors relevant for the evaluation of microbial PPP strains regarding pathogenicity, infectivity, and toxicity, information was collected on methods used to analyse the PPP species' ability to persist and grow in test animals, for detecting microbial DNA transfer, for testing microbial compounds for potential toxicity, and for detecting toxin production from PPP strains. Questions arising from the reviewed scientific and grey literature were how to address the specific biological properties of PPP strains and how to take into consideration realistic exposure scenarios and a natural background of environmental microorganisms in the risk assessment. Results from the present work imply that pathogenicity traits have to be considered as strain specific and that, hence, read-across comparison cannot be used. From a scientific point of view, it was highly recommended to provide whole genome sequencing data of PPP strains to allow their unambiguous identification, while other technological developments such as the use of metabolomics data were seen as an option for future implementation. It is envisaged to further develop the key topics of the present work at a joint stakeholder workshop as the next step towards the preparation of a guidance document by the PPR panel on how to conduct the regulatory risk assessment for microbial pesticides. © Efsa 2015Key words: microorganism, pesticide, risk assessment, human health, toxicity, read-across, DNA sequencing Disclaimer: The present document has been produced and adopted by the bodies identified above as authors. This task has been carried out exclusively by the authors in the context of a contract between the European Food Safety Authority and the authors, awarded following a tender procedure. The present document is published complying with the transparency principle to which the Authority is subject. It may not be considered as an output adopted by the Authority. The European Food Safety Authority reserves its rights, view and position as regards the issues addressed and the conclusions reached in the present document, without prejudice to the rights of the authors.Suggested citation: Evelyn Hackl1), Margit Pacher-Zavisin2), Laura Sedman1), Stefan Arthaber1), Ulla Bernkopf1), Günter Brader1), Markus Gorfer1), Birgit Mitter1), Aspasia Mitropoulou1), Monika Schmoll1), Willem van Hoesel1), Elisabeth Wis...

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“…Infections have been described in humans, some domestic and wild animals and recently in an aquatic bird. [5][6][7][8][9][10][11][12] The most commonly affected animal is the horse, for which no breed, age or sex predilection has been documented. Lesions are tumour like, with serosanguinous exudate, ulceration, pruritus and odour.…”

Section: Introductionmentioning

confidence: 99%