ABSTRACT
BACKGROUND Sporotrichosis is a subcutaneous mycosis caused by dimorphic pathogenic fungi belonging to the Sporothrix genus. Pathogenic Sporothrix species typically produce melanin, which is known to be a virulence factor. OBJECTIVES The aim of this study was to perform phenotypic, genotypic, and virulence analyses of two distinct Sporothrix brasiliensis strains isolated from the same lesion on a patient from Rio de Janeiro. METHODS AND FINDINGS Genotypic analyses by partial sequencing of the calmodulin, β-tubulin, and chitin synthase genes, as well as polymerase chain reaction (PCR)-fingerprinting by T3B, M13, and GACA, showed that the isolates were very similar but not identical. Both isolates had similar phenotypic characteristics and effectively produced melanin in their yeast forms, accounting for their ability of causing disease in a murine sporotrichosis model. Remarkably, isolate B was albino in its environmental form but caused more severe disease than the pigmented A isolate. CONCLUSIONS These findings indicate that the patient was infected by two genetically and biologically distinct S. brasiliensis that vary in their production of melanin in their environmental forms. The results underscore the importance of characterizing phenotypically different isolates found in the same clinical specimen or patient.
Subject(s)
Humans , Animals , Mice , Sporotrichosis/pathology , Sporotrichosis/virology , Sporothrix/pathogenicity , Antifungal Agents/pharmacology , Phenotype , Sporothrix/drug effects , Sporothrix/genetics , Virulence , Microbial Sensitivity Tests , Polymerase Chain Reaction , DNA Fingerprinting , Disease Models, Animal , Genotype , Mice, Inbred BALB CABSTRACT
The dynamics of the spread of the AIDS epidemic ranges according to the characteristics of each geographical region in different population groups. The aim of this study was to evaluate spatial and temporal trends of the AIDS epidemic among the elderly in the State of Rio de Janeiro, Brazil. A retrospective study using spatial analysis techniques was conducted among AIDS cases (≥ 60 years) diagnosed from 1997-2011. The Poisson regression model was used to assess the relationship between year of diagnosis and incidence of AIDS, adjusted by sex. The AIDS epidemic began in the south coast of the state and gradually reached neighboring cities. The highest rates were found in regions around Rio de Janeiro and Niterói cities. The highest smoothed rates of the period were observed in Niterói in 2002-2006: 11.87/100,000 (men) and 8,5/100,000 (women). AIDS incidence rates among the elderly have stabilized in recent decades. To prevent HIV from spreading further among the general population, greater attention should be given to the older population.
A dinâmica de espalhamento da epidemia de AIDS varia segundo as características de cada região geográfica nos diferentes grupos populacionais. O objetivo deste trabalho foi avaliar tendências temporais e espaciais da epidemia de AIDS em idosos no Estado do Rio de Janeiro, Brasil. Estudo retrospectivo com técnicas de análise espacial, utilizando-se casos de AIDS (≥ 60 anos) diagnosticados de 1997-2011. O modelo de regressão de Poisson foi utilizado para acessar a relação entre ano diagnóstico e incidência de AIDS ajustada por sexo. A epidemia de AIDS começou no litoral sul do estado e, gradualmente, chegou às cidades vizinhas. As maiores taxas da doença foram encontradas em regiões em torno do Rio de Janeiro e Niterói. Em 2002-2006, na cidade de Niterói, foram observadas as maiores taxas suavizadas no período: 11,87/100 mil (homens) e 5,08/100 mil (mulheres). Os índices de AIDS em idosos têm estabilizado nas últimas décadas. Maior atenção deve ser dada ao grupo idoso para evitar a progressão da doença na população.
El objetivo de este estudio fue evaluar las tendencias espaciales y temporales de la epidemia del SIDA en los adultos de edad avanzada en el Estado de Río de Janeiro, Brasil. Se trata de un estudio retrospectivo de técnicas de análisis espacial, utilizando casos de SIDA (≥ 60 años) diagnosticados 1997-2011. El modelo de regresión de Poisson se utiliza para acceder a la relación entre año de diagnóstico y la incidencia del SIDA ajustada por sexo. La epidemia del SIDA comenzó en la costa sur del estado y, poco a poco, llegó a las ciudades aledañas. Se encontró que las tasas más altas de la enfermedad en las regiones que rodean Río de Janeiro y Niterói. En 2002-2006, en la ciudad de Niterói, hubo tasas más altas de la enfermedad suavizadas durante el período: 11,87/100.000 (hombres) y 8,5/100.000 (mujeres). Las tasas de SIDA en las personas mayores se han estabilizado en las últimas décadas. Se debe proporcionar una mayor atención al grupo de adultos de edad avanzada, con el fin de prevenir la progresión de la enfermedad en la población.
Subject(s)
Female , Humans , Male , Middle Aged , Acquired Immunodeficiency Syndrome/epidemiology , Age Factors , Brazil/epidemiology , Incidence , Retrospective Studies , Sex Factors , Socioeconomic Factors , Spatio-Temporal AnalysisABSTRACT
A ocorrência de esporotricose em animais e sua transmissão ao ser humano têm sido relatadas em diversos países. Contudo, em nenhum lugar a doença assumiu proporções epidêmicas, envolvendo pessoas e gatos, como no Estado do Rio de Janeiro, Brasil. Dados preliminares apontam para aproximadamente 2200 casos humanos diagnosticados até dezembro de 2009. No Laboratório de Pesquisa Clínica em Dermatozoonoses em Animais Domésticos foram atendidos, até essa data, aproximadamente 3244 gatos. A distribuição geográfica mostra concentração de casos na região metropolitana da Cidade do Rio de Janeiro. O grupo mais acometido são as mulheres de baixo nível socioeconômico, com idade de 40 a 59 anos, que realizam atividades domésticas. O itraconazol foi a droga de primeira escolha para o tratamento. Embora a esporotricose normalmente não acometa órgãos além da pele, mucosa e subcutâneo, tem um custo social indireto - pelo absenteísmo ao trabalho, pelo sofrimento durante a doença ativa e pelo aspecto desagradável das lesões cicatriciais. Por sua vez, nos gatos, é comum o acometimento sistêmico, levando a formas graves de difícil tratamento e evolução para o óbito. Considerando que o tempo de tratamento dos animais é maior do que nos seres humanos, tratar gatos com esporotricose tem sido um dos maiores entraves e permanece como o grande desafio para o controle da epidemia.
In the state of Rio de Janeiro, Brazil, sporotrichosis reached epidemic levels, involving humans and cats. Preliminary data indicate that approximately 2200 human cases were diagnosed between 1998 and December of 2009, and 3244 cats were treated. The geographic distribution of cases reveals a concentration in the City of Rio de Janeiro metropolitan area. The disease affects mostly women of a low socioeconomic status, aged 40 to 55 years, who work as housekeepers. Itraconazole has been the drug of choice for treatment. Although sporotrichosis does not usually affect organs other than the skin, mucosa, and subcutaneous tissue, it has an indirect social impact resulting from absenteeism, pain, and discomfort during the active disease stage, and the unpleasant appearance of the scars. In turn, systemic involvement is frequent in cats, leading to serious and difficult- to-treat forms of the disease and death. Considering that treatment time in animals is longer than in human beings, treating cats with sporotrichosis has been the greatest obstacle and the most important challenge for the control of this epidemic infection.
Subject(s)
Adult , Animals , Cats , Child , Female , Humans , Male , Middle Aged , Cat Diseases/epidemiology , Disease Outbreaks , Sporotrichosis/epidemiology , Sporotrichosis/veterinary , Antifungal Agents/therapeutic use , Brazil/epidemiology , Cat Diseases/drug therapy , Cat Diseases/transmission , Disease Outbreaks/veterinary , Health Services Accessibility , Itraconazole/therapeutic use , Occupational Exposure , Residence Characteristics , Risk Factors , Socioeconomic Factors , Sporotrichosis/drug therapy , Sporotrichosis/prevention & control , Sporotrichosis/transmission , Urban HealthABSTRACT
During the period from 1987 to 1998, 13 cases of human sporotrichosis were recorded at the Research Center Evandro Chagas Hospital (CPqHEC) in Rio de Janeiro. Two of these patients related scratch by a sick cat. During the subsequent period from July 1998 to July 2000, 66 human, 117 cats and 7 dogs with sporotrichosis were diagnosed at the CPqHEC. Fifty-two humans (78.8 percent) reported contact with cats with sporotrichosis, and 31 (47 percent) of them reporting a history of a scratch or bite. This epidemic, unprecedented in the literature, involving cats, dogs and human beings may have started insidiously before 1998