Fusarioid keratitis and other superficial infections: A 10-years prospective study from Northeastern Brazil

Jose Ferreira da Cunha Neto; Walicyranison Plinio da Silva Rocha; Georgios Makris; Marcelo Sandoval-Denis; Ferry Hagen; Pedro Willem Crous; Guilherme Maranhão Chaves

doi:10.1371/journal.pntd.0012247

Fusarioid keratitis and other superficial infections: A 10-years prospective study from Northeastern Brazil

Jose Ferreira da Cunha Neto, Walicyranison Plinio da Silva Rocha, Georgios Makris, Marcelo Sandoval-Denis, Ferry Hagen, Pedro Willem Crous, Guilherme Maranhão Chaves

Research output: Contribution to journal/periodical › Article › Scientific › peer-review

Abstract

BACKGROUND: Fusarium and allied genera (fusarioid) species are common colonizers of roots and aerial plant parts, or act as phytopathogens in forestry and horticultural or grain crops. However, they can also cause a wide range of infections in humans, including onychomycosis, cutaneous and invasive infections. Fusarioid keratitis is characterized by an infection of the cornea with a suppurative and ulcerative appearance, which may cause damage to vision and permanent blindness. The aim of the present study was to investigate the prevalence of fusarioid species, biofilm formation and antifungal susceptibility profiling of clinical isolates recovered from patients with keratitis and dermatomycoses.

METHODOLOGY/PRINCIPAL FINDINGS: The study was performed between March, 2012-December, 2022. Demographic, clinical and epidemiological data of patients were also collected. In the present study, most of the patients with keratitis were male (74%), had a median age of 42 years old, worked with plant material or debris and 26% of them reported eye trauma. Regarding dermatomycosis, most of patients were female and exhibited toenail lesions. Forty-seven isolates belonged to the genus Neocosmospora (78.33%), nine to the Fusarium fujikuroi (15%) and four to the Fusarium oxysporum (6.66%) species complexes. Several strains were moderate biofilm producers, specifically among Fusarium annulatum. Most strains showed increased MICs to amphotericin B and ketoconazole and low MICs to itraconazole. MICs ranged from 0.25 to 16 μg/mL for amphotericin B, 0.0625 to >16 μg/mL for ketoconazole and 0.125 to 8 for itraconazole.

CONCLUSIONS/SIGNIFICANCE: It is possible to conclude that fusarioid keratitis in Northeastern Brazil is an important and neglected disease, given the high number of cases, increased need for keratoplasty and poor outcome of the disease.

Original language	English
Pages (from-to)	e0012247
Journal	PLoS Neglected Tropical Diseases
Volume	18
Issue number	6
DOIs	https://doi.org/10.1371/journal.pntd.0012247
Publication status	Published - Jun 2024

Keywords

Humans
Female
Male
Adult
Brazil/epidemiology
Keratitis/microbiology
Prospective Studies
Middle Aged
Antifungal Agents/pharmacology
Microbial Sensitivity Tests
Fusarium/drug effects
Fusariosis/microbiology
Young Adult
Dermatomycoses/epidemiology
Aged
Biofilms/drug effects
Prevalence
Adolescent
Eye Infections, Fungal/microbiology

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10.1371/journal.pntd.0012247

Cite this

@article{d6cf27b318b9483eba5fb59887967c7f,

title = "Fusarioid keratitis and other superficial infections: A 10-years prospective study from Northeastern Brazil",

abstract = "BACKGROUND: Fusarium and allied genera (fusarioid) species are common colonizers of roots and aerial plant parts, or act as phytopathogens in forestry and horticultural or grain crops. However, they can also cause a wide range of infections in humans, including onychomycosis, cutaneous and invasive infections. Fusarioid keratitis is characterized by an infection of the cornea with a suppurative and ulcerative appearance, which may cause damage to vision and permanent blindness. The aim of the present study was to investigate the prevalence of fusarioid species, biofilm formation and antifungal susceptibility profiling of clinical isolates recovered from patients with keratitis and dermatomycoses.METHODOLOGY/PRINCIPAL FINDINGS: The study was performed between March, 2012-December, 2022. Demographic, clinical and epidemiological data of patients were also collected. In the present study, most of the patients with keratitis were male (74%), had a median age of 42 years old, worked with plant material or debris and 26% of them reported eye trauma. Regarding dermatomycosis, most of patients were female and exhibited toenail lesions. Forty-seven isolates belonged to the genus Neocosmospora (78.33%), nine to the Fusarium fujikuroi (15%) and four to the Fusarium oxysporum (6.66%) species complexes. Several strains were moderate biofilm producers, specifically among Fusarium annulatum. Most strains showed increased MICs to amphotericin B and ketoconazole and low MICs to itraconazole. MICs ranged from 0.25 to 16 μg/mL for amphotericin B, 0.0625 to >16 μg/mL for ketoconazole and 0.125 to 8 for itraconazole.CONCLUSIONS/SIGNIFICANCE: It is possible to conclude that fusarioid keratitis in Northeastern Brazil is an important and neglected disease, given the high number of cases, increased need for keratoplasty and poor outcome of the disease.",

keywords = "Humans, Female, Male, Adult, Brazil/epidemiology, Keratitis/microbiology, Prospective Studies, Middle Aged, Antifungal Agents/pharmacology, Microbial Sensitivity Tests, Fusarium/drug effects, Fusariosis/microbiology, Young Adult, Dermatomycoses/epidemiology, Aged, Biofilms/drug effects, Prevalence, Adolescent, Eye Infections, Fungal/microbiology",

author = "{Ferreira da Cunha Neto}, Jose and {da Silva Rocha}, {Walicyranison Plinio} and Georgios Makris and Marcelo Sandoval-Denis and Ferry Hagen and Crous, {Pedro Willem} and Chaves, {Guilherme Maranh{\~a}o}",

note = "Copyright: {\textcopyright} 2024 Ferreira da Cunha Neto et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.",

year = "2024",

month = jun,

doi = "10.1371/journal.pntd.0012247",

language = "English",

volume = "18",

pages = "e0012247",

journal = "PLoS Neglected Tropical Diseases",

issn = "1935-2727",

publisher = "Public Library of Science",

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Fusarioid keratitis and other superficial infections: A 10-years prospective study from Northeastern Brazil. / Ferreira da Cunha Neto, Jose; da Silva Rocha, Walicyranison Plinio; Makris, Georgios et al.
In: PLoS Neglected Tropical Diseases, Vol. 18, No. 6, 06.2024, p. e0012247.

Research output: Contribution to journal/periodical › Article › Scientific › peer-review

TY - JOUR

T1 - Fusarioid keratitis and other superficial infections

T2 - A 10-years prospective study from Northeastern Brazil

AU - Ferreira da Cunha Neto, Jose

AU - da Silva Rocha, Walicyranison Plinio

AU - Makris, Georgios

AU - Sandoval-Denis, Marcelo

AU - Hagen, Ferry

AU - Crous, Pedro Willem

AU - Chaves, Guilherme Maranhão

N1 - Copyright: © 2024 Ferreira da Cunha Neto et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

PY - 2024/6

Y1 - 2024/6

N2 - BACKGROUND: Fusarium and allied genera (fusarioid) species are common colonizers of roots and aerial plant parts, or act as phytopathogens in forestry and horticultural or grain crops. However, they can also cause a wide range of infections in humans, including onychomycosis, cutaneous and invasive infections. Fusarioid keratitis is characterized by an infection of the cornea with a suppurative and ulcerative appearance, which may cause damage to vision and permanent blindness. The aim of the present study was to investigate the prevalence of fusarioid species, biofilm formation and antifungal susceptibility profiling of clinical isolates recovered from patients with keratitis and dermatomycoses.METHODOLOGY/PRINCIPAL FINDINGS: The study was performed between March, 2012-December, 2022. Demographic, clinical and epidemiological data of patients were also collected. In the present study, most of the patients with keratitis were male (74%), had a median age of 42 years old, worked with plant material or debris and 26% of them reported eye trauma. Regarding dermatomycosis, most of patients were female and exhibited toenail lesions. Forty-seven isolates belonged to the genus Neocosmospora (78.33%), nine to the Fusarium fujikuroi (15%) and four to the Fusarium oxysporum (6.66%) species complexes. Several strains were moderate biofilm producers, specifically among Fusarium annulatum. Most strains showed increased MICs to amphotericin B and ketoconazole and low MICs to itraconazole. MICs ranged from 0.25 to 16 μg/mL for amphotericin B, 0.0625 to >16 μg/mL for ketoconazole and 0.125 to 8 for itraconazole.CONCLUSIONS/SIGNIFICANCE: It is possible to conclude that fusarioid keratitis in Northeastern Brazil is an important and neglected disease, given the high number of cases, increased need for keratoplasty and poor outcome of the disease.

AB - BACKGROUND: Fusarium and allied genera (fusarioid) species are common colonizers of roots and aerial plant parts, or act as phytopathogens in forestry and horticultural or grain crops. However, they can also cause a wide range of infections in humans, including onychomycosis, cutaneous and invasive infections. Fusarioid keratitis is characterized by an infection of the cornea with a suppurative and ulcerative appearance, which may cause damage to vision and permanent blindness. The aim of the present study was to investigate the prevalence of fusarioid species, biofilm formation and antifungal susceptibility profiling of clinical isolates recovered from patients with keratitis and dermatomycoses.METHODOLOGY/PRINCIPAL FINDINGS: The study was performed between March, 2012-December, 2022. Demographic, clinical and epidemiological data of patients were also collected. In the present study, most of the patients with keratitis were male (74%), had a median age of 42 years old, worked with plant material or debris and 26% of them reported eye trauma. Regarding dermatomycosis, most of patients were female and exhibited toenail lesions. Forty-seven isolates belonged to the genus Neocosmospora (78.33%), nine to the Fusarium fujikuroi (15%) and four to the Fusarium oxysporum (6.66%) species complexes. Several strains were moderate biofilm producers, specifically among Fusarium annulatum. Most strains showed increased MICs to amphotericin B and ketoconazole and low MICs to itraconazole. MICs ranged from 0.25 to 16 μg/mL for amphotericin B, 0.0625 to >16 μg/mL for ketoconazole and 0.125 to 8 for itraconazole.CONCLUSIONS/SIGNIFICANCE: It is possible to conclude that fusarioid keratitis in Northeastern Brazil is an important and neglected disease, given the high number of cases, increased need for keratoplasty and poor outcome of the disease.

KW - Humans

KW - Female

KW - Male

KW - Adult

KW - Brazil/epidemiology

KW - Keratitis/microbiology

KW - Prospective Studies

KW - Middle Aged

KW - Antifungal Agents/pharmacology

KW - Microbial Sensitivity Tests

KW - Fusarium/drug effects

KW - Fusariosis/microbiology

KW - Young Adult

KW - Dermatomycoses/epidemiology

KW - Aged

KW - Biofilms/drug effects

KW - Prevalence

KW - Adolescent

KW - Eye Infections, Fungal/microbiology

U2 - 10.1371/journal.pntd.0012247

DO - 10.1371/journal.pntd.0012247

M3 - Article

C2 - 38885283

SN - 1935-2727

VL - 18

SP - e0012247

JO - PLoS Neglected Tropical Diseases

JF - PLoS Neglected Tropical Diseases

IS - 6

ER -