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Open Access Highly Accessed Research article

Genetic diversity and antifungal susceptibility profiles in causative agents of sporotrichosis

Anderson Messias Rodrigues1, G Sybren de Hoog2, Débora de Cássia Pires3, Raimunda Sâmia Nogueira Brihante4, José Júlio da Costa Sidrim4, Marcos Fabio Gadelha5, Arnaldo Lopes Colombo3 and Zoilo Pires de Camargo1*

Author Affiliations

1 Department of Microbiology, Immunology and Parasitology, Cellular Biology Division, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil

2 Centraalbureau voor Schimmelcultures, KNAW Fungal Biodiversity Centre, Utrecht, The Netherlands

3 Department of Medicine, Infectious Diseases Section, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil

4 Specialized Medical Mycology Center, Postgraduate Program in Medical Microbiology, Federal University of Ceará, Fortaleza, Ceará, Brazil

5 Postgraduate Program in Veterinary Science, State University of Ceará, Fortaleza, Ceará, Brazil

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BMC Infectious Diseases 2014, 14:219  doi:10.1186/1471-2334-14-219

Published: 23 April 2014

Abstract

Background

Sporotrichosis is a chronic subcutaneous mycosis of humans and animals, which is typically acquired by traumatic inoculation of plant material contaminated with Sporothrix propagules, or via animals, mainly felines. Sporothrix infections notably occur in outbreaks, with large epidemics currently taking place in southeastern Brazil and northeastern China. Pathogenic species include Sporothrix brasiliensis, Sporothrix schenckii s. str., Sporothrix globosa, and Sporothrix luriei, which exhibit differing geographical distribution, virulence, and resistance to antifungals. The phylogenetically remote species Sporothrix mexicana also shows a mild pathogenic potential.

Methods

We assessed a genetically diverse panel of 68 strains. Susceptibility profiles of medically important Sporothrix species were evaluated by measuring the MICs and MFCs for amphotericin B (AMB), fluconazole (FLC), itraconazole (ITC), voriconazole (VRC), posaconazole (PCZ), flucytosine (5FC), and caspofungin (CAS). Haplotype networks were constructed to reveal interspecific divergences within clinical Sporothrix species to evaluate genetically deviant isolates.

Results

ITC and PCZ were moderately effective against S. brasiliensis (MIC90 = 2 and 2 μg/mL, respectively) and S. schenckii (MIC90 = 4 and 2 μg/mL, respectively). PCZ also showed low MICs against the rare species S. mexicana. 5FC, CAS, and FLC showed no antifungal activity against any Sporothrix species. The minimum fungicidal concentration ranged from 2 to >16 μg/mL for AMB against S. brasiliensis and S. schenckii, while the MFC90 was >16 μg/mL for ITC, VRC, and PCZ.

Conclusion

Sporothrix species in general showed high degrees of resistance against antifungals. Evaluating a genetically diverse panel of strains revealed evidence of multidrug resistant phenotypes, underlining the need for molecular identification of etiologic agents to predict therapeutic outcome.

Keywords:
Sporothrix schenckii; Sporothrix brasiliensis; Multidrug resistance; MIC; MFC; Intraspecific diversity