| Author | Fichman, Vivian | |
| Author | Almeida-Silva, Fernando | |
| Author | Freitas, Dayvison Francis Saraiva | |
| Author | Zancopé-Oliveira, Rosely Maria | |
| Author | Gutierrez-Galhardo, Maria Clara | |
| Author | Almeida-Paes, Rodrigo | |
| Access date | 2023-03-18T01:53:44Z | |
| Available date | 2023-03-18T01:53:44Z | |
| Document date | 2023 | |
| Citation | FICHMAN, Vivian et al. Severe Sporotrichosis Caused by Sporothrix brasiliensis: Antifungal Susceptibility and Clinical Outcomes. Journal of Fungi, v. 9, n. 1, p. 1-9, Dec. 28, 2022. | en_US |
| ISSN | 2309-608X | en_US |
| URI | https://www.arca.fiocruz.br/handle/icict/57439 | |
| Description | Institutional Review Board Statement: The study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Ethics Committee of the Instituto Nacional de Infectologia Evandro Chagas/FIOCRUZ, protocol code CAAE: 08625819.0.0000.5262 (date of approval: 1 March 2019). | en_US |
| Sponsorship | This work was supported in part by Programa Jovens Pesquisadores—INI/FIOCRUZ (INI-003-FIO-19-2-7 and INI-003-FIO-19-2-13); Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq 302796/2017-7); Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brasil (CAPES) (Finance Code 001); and Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ E-26/202.527/2019 and 201441/2021). | en_US |
| Language | eng | en_US |
| Publisher | MDPI | en_US |
| Rights | open access | en_US |
| Title | Severe Sporotrichosis Caused by Sporothrix brasiliensis: Antifungal Susceptibility and Clinical Outcomes | en_US |
| Type | Article | en_US |
| DOI | 10.3390/jof9010049 | |
| Abstract | Itraconazole is the first choice for treating sporotrichosis. Amphotericin B is indicated for severe and disseminated forms. The aim of the study was to evaluate the antifungal susceptibility of Sporothrix brasiliensis strains isolated from patients with severe sporotrichosis treated with amphotericin B and correlate with clinical outcomes. Clinical and epidemiological data were obtained from severe sporotrichosis cases caused by S. brasiliensis. Antifungal susceptibility tests against amphotericin B, itraconazole, terbinafine, posaconazole, and 5-flucytosine were performed. Moreover, possible synergisms between amphotericin B and posaconazole or 5-flucytosine were assessed. Relationships between clinical and laboratorial data were then analyzed. Forty-six S. brasiliensis isolates from 37 patients were studied. Clinical forms included disseminated (94.6%) and disseminated cutaneous sporotrichosis (5.4%). The median treatment time was 784 days (range: 7 to 3115 days). Cure occurred in 45.9% of the cases and death due to sporotrichosis in 24.3%. Forty-three (93.5%) S. brasiliensis isolates were classified as wild-type for all the antifungals tested according to their in vitro antifungal susceptibility. There was no synergism for the combinations studied. Finally, we found no association between higher Minimal Inhibitory Concentration (MIC) values of amphotericin B or itraconazole with unfavorable outcomes; however, there were higher MIC values of itraconazole in strains isolated from alcoholic patients. Possibly, clinical factors, such as the extent of dissemination, immunosuppression, and late treatment onset, are the main determinants of patient outcomes, rather than antifungal resistance. The current study suggests that the need to use amphotericin B therapy is not associated with the emergence of S. brasiliensis resistant strains. | en_US |
| Affilliation | Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Laboratory of Clinical Research in Infectious Dermatology. Rio de Janeiro, RJ, Brazil. | en_US |
| Affilliation | Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Laboratory of Mycology. Rio de Janeiro, RJ, Brazil. | en_US |
| Affilliation | Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Laboratory of Clinical Research in Infectious Dermatology. Rio de Janeiro, RJ, Brazil. | en_US |
| Affilliation | Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Laboratory of Mycology. Rio de Janeiro, RJ, Brazil. | en_US |
| Affilliation | Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Laboratory of Clinical Research in Infectious Dermatology. Rio de Janeiro, RJ, Brazil. | en_US |
| Affilliation | Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Laboratory of Mycology. Rio de Janeiro, RJ, Brazil. | en_US |
| Subject | Sporotrichosis | en_US |
| Subject | Amphotericin B | en_US |
| Subject | Antifungal susceptibility | en_US |
| Subject | Minimal inhibitory concentration | en_US |
| Subject | Synergism | en_US |
| Subject | Alcoholism | en_US |
