1. An update on the occurrence of Paracoccidioides species in the Midwest region, Brazil: Molecular epidemiology, clinical aspects and serological profile of patients from Mato Grosso do Sul State
- Author
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Rinaldo Poncio Mendes, Karine Mattos, Edilânia Gomes Araújo Chaves, Anamaria Mello Miranda Paniago, Clayton Luiz Borges, Simone Schneider Weber, Tiago Alexandre Cocio, James Venturini, Lídia Raquel de Carvalho, Universidade Federal de Mato Grosso do Sul (UFMS), Universidade de São Paulo (USP), Universidade Federal de Goiás (UFG), Universidade Estadual Paulista (Unesp), and Universidade Federal do Amazonas more...
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0301 basic medicine ,Male ,Veterinary medicine ,Paracoccidioides Brasiliensis ,RC955-962 ,Pathology and Laboratory Medicine ,Polymerase Chain Reaction ,Paracoccidioides ,Geographical locations ,Serology ,0302 clinical medicine ,Medical Conditions ,Arctic medicine. Tropical medicine ,Epidemiology ,Medicine and Health Sciences ,Data Management ,Fungal Pathogens ,Molecular Epidemiology ,Geography ,Paracoccidioidomycosis ,Incidence (epidemiology) ,Fungal Diseases ,Eukaryota ,Middle Aged ,BIOLOGIA MOLECULAR ,Phylogenetics ,Phylogeography ,Infectious Diseases ,Biogeography ,Medical Microbiology ,Public aspects of medicine ,RA1-1270 ,Pathogens ,Brazil ,Polymorphism, Restriction Fragment Length ,Research Article ,Neglected Tropical Diseases ,Adult ,medicine.medical_specialty ,Computer and Information Sciences ,Antigens, Fungal ,Adolescent ,030106 microbiology ,030231 tropical medicine ,Mycology ,Biology ,Microbiology ,03 medical and health sciences ,Young Adult ,Signs and Symptoms ,medicine ,Genetics ,Humans ,Evolutionary Systematics ,Serotyping ,Genotyping ,Microbial Pathogens ,Antibodies, Fungal ,Taxonomy ,Paracoccidioides brasiliensis ,Evolutionary Biology ,Molecular epidemiology ,Population Biology ,Ecology and Environmental Sciences ,Public Health, Environmental and Occupational Health ,Organisms ,Fungi ,Biology and Life Sciences ,South America ,medicine.disease ,biology.organism_classification ,Tropical Diseases ,Earth Sciences ,Lesions ,People and places ,Clinical Medicine ,Population Genetics - Abstract
Background Paracoccidioidomycosis (PCM) is a systemic and endemic fungal infection in Latin American, mainly in Brazil. The majority of PCM cases occur in large areas in Brazil, comprising the South, Southeast and Midwest regions, with the latter demonstrating a higher incidence of the species Paracoccidioides lutzii. Methodology and main findings This study presents clinical, molecular and serological data of thirteen new PCM cases during 2016 to 2019 from the state of Mato Grosso do Sul, located in the Midwest region, Brazil. From these thirteen cases, sixteen clinical isolates were obtained and their genomic DNAs were subjected to genotyping by tub1 -PCR-RFLP. Results showed Paracoccidioides brasiliensis sensu stricto (S1) (11/16; 68.8%), Paracoccidioides restrepiensis (PS3) (4/16; 25.0%) and P. lutzii (1/16; 6.2%) as Paracoccidiodes species. Therefore, in order to understand whether the type of phylogenetic species that are circulating in the state influence the reactivity profile of serological tests, we performed double agar gel immunodiffusion (DID), using exoantigens from genotyped strains found in this series of PCM cases. Overall, our DID tests have been false negative in about 30% of confirmed PCM cases. All patients were male, most with current or previous rural activity, with ages ranging from 17 to 59 years, with 11 patients (84.6%) over 40 years of age. No clinical or epidemiological differences were found between Paracoccidioides species. However, it is important to note that the only case of P. lutzii died as an outcome. Conclusions This study suggests P. brasiliensis sensu stricto (S1) as the predominant species, showing its wide geographic distribution in Brazil. Furthermore, our findings revealed, for the first time, the occurrence of P. restrepiensis (PS3) in the state of Mato Grosso do Sul, Brazil. Despite our setbacks, it would be interesting to provide the complete sequencing of these clinical isolates to complement the molecular information presented., Author summary Paracoccidioides spp. complex and P. lutzii are etiological agents of paracoccidioidomycosis (PCM), one of the most important systemic mycosis of Latin America. This study aimed to describe the molecular epidemiology associated with clinical and serological data of Paracoccidiodes spp. in the Mato Grosso do Sul, located in the Midwest region, Brazil. Thus, for the first time in this state, the clinical Paracoccidioides species were molecularly identified. Previous findings have frequently been misinterpreted as proving that P. lutzii predominates in this region. In fact, we observed that this state differs from others in the Midwest, presenting a higher proportion of PCM cases due to P. brasiliensis sensu stricto (S1). In addition, we described the first report of P. restrepiensis (PS3) occurrence in the Brazilian Midwest region. Then, we presented an update on the occurrence of Paracoccidioides species in the Midwest region from Brazil. On the other hand, our results do not demonstrate clinical and epidemiological differences between Paracoccidioides spp. Nevertheless, this study reinforces that other researches should be carried out in order to evaluate an association of clinical manifestations and epidemiology with Paracoccidioides species. more...
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- 2021