In vitro susceptibility of chromoblastomycosis agents to antifungal drugs: A systematic review

Hellwig, Alessandra Helena da Silva; Heidrich, Daiane; Zanette, Régis A.; Scroferneker, Maria Lúcia

doi:10.1016/j.jgar.2018.09.010

Cited by 20 publications

(13 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Another study corroborated the therapeutic potential of voriconazole in a patient refractory to conventional treatment performed with itraconazole, terbinafine, itraconazole, thermotherapy, or cryosurgery, alone or in combination [184]. In fact, a systematic review highlights the great potential of voriconazole to eliminate some etiologic agents of CBM (in vitro) alone or in combination [185], reinforcing that this drug may be useful in the treatment of CBM or at least be the choice in limited cases, especially those refractory to conventional treatment. However, the high costs associated with long-term therapy limit the routine use of this drug, especially in low-income countries.…”

Section: Treatment Of Cbmmentioning

confidence: 74%

Reviewing the Etiologic Agents, Microbe-Host Relationship, Immune Response, Diagnosis, and Treatment in Chromoblastomycosis

Passero

Cavallone

Belda

2021

Journal of Immunology Research

View full text Add to dashboard Cite

Chromoblastomycosis (CBM) is a neglected human disease, caused by different species of pigmented dematiaceous fungi that cause subcutaneous infections. This disease has been considered an occupational disease, occurring among people working in the field of agriculture, particularly in low-income countries. In 1914, the first case of CBM was described in Brazil, and although efforts have been made, few scientific and technological advances have been made in this area. In the field of fungi and host cell relationship, a very reduced number of antigens were characterized, but available data suggest that ectoantigens bind to the cell membrane of host cells and modulate the phagocytic, immunological, and microbicidal responses of immune cells. Furthermore, antigens cleave extracellular proteins in tissues, allowing fungi to spread. On the contrary, if phagocytic cells are able to present antigens in MHC molecules to T lymphocytes in the presence of costimulation and IL-12, a Th1 immune response will develop and a relative control of the disease will be observed. Despite knowledge of the resistance and susceptibility in CBM, up to now, no effective vaccines have been developed. In the field of chemotherapy, most patients are treated with conventional antifungal drugs, such as itraconazole and terbinafine, but these drugs exhibit limitations, considering that not all patients heal cutaneous lesions. Few advances in treatment have been made so far, but one of the most promising ones is based on the use of immunomodulators, such as imiquimod. Data about a standard treatment are missing in the medical literature; part of it is caused by the existence of a diversity of etiologic agents and clinical forms. The present review summarizes the advances made in the field of CBM related to the diversity of pathogenic species, fungi and host cell relationship, antigens, innate and acquired immunity, clinical forms of CBM, chemotherapy, and diagnosis.

show abstract

Section: Treatment Of Cbmmentioning

confidence: 74%

Reviewing the Etiologic Agents, Microbe-Host Relationship, Immune Response, Diagnosis, and Treatment in Chromoblastomycosis

Passero

Cavallone

Belda

2021

Journal of Immunology Research

View full text Add to dashboard Cite

show abstract

“…It may be explained in part that most of these studies were carried out with the filamentous phase and not the yeast phase. This was also suggested in a review that assessed the antifungal susceptibility of chromoblastomycosis agents [60].…”

Section: Resultsmentioning

confidence: 94%

In-vitro antifungal susceptibility of the genus Sporothrix and correlation with treatment options for sporotrichosis: a systematic review

Koehler¹,

Pagani²,

Hellwig³

et al. 2021

Reviews in Medical Microbiology

View full text Add to dashboard Cite

Sporotrichosis is an infection with global distribution caused by the dimorphic fungi of the genus Sporothrix, whose main pathogenic species include Sporothrix schenckii, Sporothrix brasiliensis, Sporothrix globosa, and Sporothrix luriei. Itraconazole and amphotericin B are the most used antifungals for the treatment. The aim of this review was to compile the in-vitro susceptibility data of Sporothrix spp. found in literature and correlate this data with the treatment guidelines for sporotrichosis. The systematic review was performed according to the Cochrane methodology and with PICOS (Participants, Intervention, Comparators, Outcomes, Study Design) strategy. Thirty-six studies were included that used the filamentous and/or the yeast phases to perform the susceptibility tests. Three studies that evaluated the association of antifungals using the checkerboard method were also included. The data found were, whenever possible, compared with the defined Epidemiological Cutoff Values (ECVs). Analyzing only the minimum inhibitory concentration (MIC) values, the most effective antifungal in vitro was terbinafine. However, this is not the same result as observed in vivo. Both itraconazole and amphotericin B presented in-vitro activity. However, many studies have shown that isolates can acquire resistance mechanisms to these antifungals (MIC > ECV), which deserves attention. Further studies are needed to translate in-vitro susceptibility data into clinical practice, and also to determine ECVs for more antifungals and Sporothrix species.

show abstract

“…30 The antifungal susceptibility profile of F. pedrosoi isolates was similar to those reported in other studies, regardless of the susceptibility method used. 39,[91][92][93] However, a survey carried out in the Rondônia state, Brazil, reported lower MIC values for eight F. pedrosoi isolates, using the same antifungal agents and methodology. 21 There are no cut-off values to define antifungal sensitivity or resistance for the aetiologic agents of chromoblastomycosis.…”

Section: Discussionmentioning

confidence: 99%

Molecular epidemiology and clinical‐laboratory aspects of chromoblastomycosis in Mato Grosso, Brazil

Guevara

Nery

Melhem

et al. 2022

Mycoses

View full text Add to dashboard Cite

Introduction Chromoblastomycosis is a disease caused by melanized fungi, primarily belonging to the genera Fonsecaea and Cladophialophora, mainly affecting individuals who are occupationally exposed to soil and plant products. This research aimed to determine the clinical, epidemiological and laboratory characteristics of chromoblastomycosis in the state of Mato Grosso, Brazil. Materials and Methods Patients diagnosed with chromoblastomycosis treated at the Júlio Müller University Hospital, Cuiabá, Brazil, from January 2015 to December 2020, whose isolates were preserved in the Research Laboratory of the Faculty of Medicine of the Federal University of Mato Grosso. Isolates were identified by partly sequencing the Internal Transcribed Spacer (ITS) and β‐tubulin (BT2) loci. AFLP fingerprinting was used to explore the genetic diversity. Susceptibility to itraconazole, voriconazole, 5‐fluorocytosine, terbinafine and amphotericin B was determined by the broth microdilution technique. Results Ten patients were included, nine were male (mean age = 64.1 years). Mean disease duration was 8.6 years. Lesions were mainly observed in the lower limbs. Predominant clinical forms were verrucous and scarring. Systemic arterial hypertension and type II diabetes mellitus were the predominant comorbidities. Leprosy was the main concomitant infectious disease. Fonsecaea pedrosoi was the unique aetiological agent identified with moderate genetic diversity (H = 0.3934–0.4527; PIC = 0.3160–0.3502). Antifungal agents with the highest activity were terbinafine, voriconazole and itraconazole. Conclusion Chromoblastomycosis is affecting the poor population in rural and urban areas, mainly related to agricultural activities, with F. pedrosoi being the dominant aetiologic agent. All isolates had low MICs for itraconazole, voriconazole and terbinafine, confirming their importance as therapeutic alternatives for chromoblastomycosis.

show abstract

In vitro susceptibility of chromoblastomycosis agents to antifungal drugs: A systematic review

Cited by 20 publications

References 48 publications

Reviewing the Etiologic Agents, Microbe-Host Relationship, Immune Response, Diagnosis, and Treatment in Chromoblastomycosis

Reviewing the Etiologic Agents, Microbe-Host Relationship, Immune Response, Diagnosis, and Treatment in Chromoblastomycosis

In-vitro antifungal susceptibility of the genus Sporothrix and correlation with treatment options for sporotrichosis: a systematic review

Molecular epidemiology and clinical‐laboratory aspects of chromoblastomycosis in Mato Grosso, Brazil

Contact Info

Product

Resources

About