Mycetoma caused by<i>Microascus gracilis:</i>a novel agent of human eumycetoma in Sudan

Mhmoud, Najwa Adam; Siddig, Emmanuel Edwar; Nyuykonge, Bertrand; Bakhiet, Sahar Mubarak; Sande, Wendy W. J. van de; Fahal, Ahmed Hassan

doi:10.1093/trstmh/trab010

Cited by 13 publications

(15 citation statements)

References 36 publications

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“…boydii, and Sc. apiospermium [10][11][12]. The most common species that are responsible for more than 90% of the globally reported cases include M. mycetomatis, M. grisea, Sc.…”

Section: Eumycetoma Causative Agentsmentioning

confidence: 99%

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Eumycetoma Medical Treatment: Past, Current Practice, Latest Advances and Perspectives

Siddig

Ahmed

Ali

et al. 2021

Microbiology Research

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Mycetoma is a neglected tropical disease that is associated with poor communities and socioeconomically impaired individuals in the tropical and sub-tropical areas. Interestingly, the disease is caused by either bacteria (actinomycetoma) or fungus (eumycetoma). The latter form of the disease, eumycetoma, is the most common type in Africa. Eumycetoma is characterized by a prolonged disease duration and low cure rate. The effective case management of eumycetoma largely depends on the accurate diagnosis and identification of the causative agent to the species level and evaluating its susceptibility to the available drugs. This review summarizes the currently available and used antifungal agents for the treatment of eumycetoma and discusses optimizing the newly developed antifungals as a potential second line for eumycetoma treatment.

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“…boydii, and Sc. apiospermium [10][11][12]. The most common species that are responsible for more than 90% of the globally reported cases include M. mycetomatis, M. grisea, Sc.…”

Section: Eumycetoma Causative Agentsmentioning

confidence: 99%

“…The most common species that are responsible for more than 90% of the globally reported cases include M. mycetomatis, M. grisea, Sc. boydii, and L. senegalensis [10][11][12].…”

Section: Eumycetoma Causative Agentsmentioning

confidence: 99%

Eumycetoma Medical Treatment: Past, Current Practice, Latest Advances and Perspectives

Siddig

Ahmed

Ali

et al. 2021

Microbiology Research

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“…The infection mainly affects the lower extremities, but any body parts can be involved [ 2 , 4 , 5 ]. Mycetoma presents in two forms according to the causative agent; eumycetoma caused by fungal agents and actinomycetoma caused by a group of filamentous bacteria [ 6 – 9 ]. Young adult males are mostly affected by this condition, although all age groups and gender are susceptible [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Estimating the burden of mycetoma in Sudan for the period 1991–2018 using a model-based geostatistical approach

et al. 2022

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Mycetoma is widespread in tropical and subtropical regions favouring arid areas with low humidity and a short rainy season. Sudan is one of the highly endemic countries for mycetoma. Estimating the population at risk and the number of cases is critical for delivering targeted and equitable prevention and treatment services. In this study, we have combined a large dataset of mycetoma cases recorded by the Mycetoma Research Centre (MRC) in Sudan over 28 years (1991–2018) with a collection of environmental and water and hygiene-related datasets in a geostatistical framework to produce estimates of the disease burden across the country. We developed geostatistical models to predict the number of cases of actinomycetoma and eumycetoma in areas considered environmentally suitable for the two mycetoma forms. Then used the raster dataset (gridded map) with the population estimates for 2020 to compute the potentially affected population since 1991. The geostatistical models confirmed this heterogeneous and distinct distribution of the estimated cases of eumycetoma and actinomycetoma across Sudan. For eumycetoma, these higher-risk areas were smaller and scattered across Al Jazirah, Khartoum, White Nile and Sennar states, while for actinomycetoma a higher risk for infection is shown across the rural districts of North and West Kurdufan. Nationally, we estimated 63,825 people (95%CI: 13,693 to 197,369) to have been suffering from mycetoma since 1991 in Sudan,51,541 people (95%CI: 9,893–166,073) with eumycetoma and 12,284 people (95%CI: 3,800–31,296) with actinomycetoma. In conclusion, the risk of mycetoma in Sudan is particularly high in certain restricted areas, but cases are ubiquitous across all states. Both prevention and treatment services are required to address the burden. Such work provides a guide for future control and prevention programs for mycetoma, highly endemic areas are clearly targeted, and resources are directed to areas with high demand.

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“…Other fungi associated with BG eumycetoma are commonly from the order Pleosporales, including Falciformispora senegalensis (F. senegalensis), Falciformispora tompkinsii and Medicopsis romeroi [10]. In contrast, pale grain eumycetoma species are typically from the order Hypocreales, including Acremonium spp, Cylindrocarpon spp, and Fusarium spp or the orders Eurotiales or Microascales including Aspergillus spp and Microascus gracilis respectively [11].…”

Section: Introductionmentioning

confidence: 99%

Metagenomic detection of eumycetoma causative agents from households of patients residing in two Sudanese endemic villages in White Nile State

et al. 2022

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Eumycetoma is a chronic debilitating fungal disease endemic to tropical and subtropical regions, with Sudan featuring the highest eumycetoma incidence. Among the 50 species of fungi most commonly associated with eumycetoma Madurella mycetomatis (M. mycetomatis) is often referenced as the most common pathogen. However, there is an enormous knowledge gap related to this neglected disease and its pathogenesis, epidemiological features, and host-specific factors that could contribute to either the host susceptibility and resistance. In this study, we were able to utilize a metagenomic approach and samples collected from clinical black grains (BG) and familiar household environments aimed to assay both the habitat of eumycetoma-associated fungi and its possible connection with eumycetoma patients living in two different eumycetoma endemic villages within the White Nile State of Sudan. DNA sequencing targeting the fungal ITS2 domain was performed on soil, animal dung, housing walls and roofs, and Acacia-species thorn samples and compared with culture-dependent methods of fungal isolation. Additionally, we compared the soil samples obtained in the endemic zone with that from non-endemic zones, including Wagga village in Kassala State and Port Sudan suburb in Port Sudan State. Overall, a total of 392 Amplicon Sequence Variants (ASVs) were detected by ITS2 metagenomics Eumycetoma causative organisms accounted for 10% of total ASVs which included 11 genera: Exserohilum (2%), Aspergillus (1.7%), Curvularia (1%), Alternaria (0.9%), Madurella (0.5%), Fusarium (0.4%), Cladosporium (0.2%) Exophiala (0.15%), and, in a lesser extent, Microascus (0.05%) Bipolaris and Acremonium (0.01%) for each. Only five genera were identified by culture method, which included Fusarium (29%), Aspergillus (28%), Alternaria (2.5%), Bipolaris (1.6%), and Chaetomium (0.8%). M. mycetomatis was detected within all the studied patients’ houses, accounting for 0.7% of total sequences. It was the first common eumycetoma-associated agent detected in soil samples and the third common in the dung and wall samples. In contrast, it was not detected in the roof or thorn samples nor in the soils from non-endemic regions. Exserohilum rostratum, Aspergillus spp and Cladosporium spp were detected in all samples. M. mycetomatis and other eumycetoma-associated fungal identified in the patients’ black grains (BG) samples by metagenomics were identified in the environmental samples. Only Acremonium alternatum and Falciformispora senegalensis, responsible for eumycetoma in two patients were not detected, suggesting the infections in these patients happened outside these endemic areas. The soil, animal dung, and houses built from the same soil and dung are the main risk factors for M. mycetomatis infection in these endemic villages. Furthermore, the poor hygienic and environmental conditions, walking barefooted, and the presence of animals within the houses increase the risk of M. mycetomatis and other fungi causing eumycetoma.

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Mycetoma caused byMicroascus gracilis:a novel agent of human eumycetoma in Sudan

Cited by 13 publications

References 36 publications

Eumycetoma Medical Treatment: Past, Current Practice, Latest Advances and Perspectives

Eumycetoma Medical Treatment: Past, Current Practice, Latest Advances and Perspectives

Estimating the burden of mycetoma in Sudan for the period 1991–2018 using a model-based geostatistical approach

Metagenomic detection of eumycetoma causative agents from households of patients residing in two Sudanese endemic villages in White Nile State

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