Maria Isabel de Azevedo

Identification of Pythium insidiosum by nested PCR in cutaneous lesions of Brazilian horses and rabbits.

Pythium insidiosum is a fungus-like organism present in subtropical and tropical areas, such as Brazil, known to infect humans and various animal species. P. insidiosum is the etiological agent of pythiosis, an emerging and granulomatous disease characterized mainly by cutaneous and subcutaneous lesions in horses, the principal species affected. Accurate diagnosis of pythiosis and identification of its causal agent by microbiological and serological tests can be often difficult and inconclusive principally for horses and humans. The aim of this study was to evaluate the application of the previously described P. insidiosum-specific nested polymerase chain reaction (PCR) assay to directly detect P. insidiosum DNA in clinical and experimental lesions. Universal fungal primers (ITS1 and ITS4) were used during the first-round of PCR to amplify ITS1, 5.8s, and ITS2. A second-round of PCR was conducted with P. insidiosum-specific primers (PI1 and PI2) to amplify a variable region within this ITS1. In this study, a total of 21 equine clinical samples (kunkers) and 28 specimens from experimentally infected rabbits were analyzed by nested PCR. The first-round of PCR generated 800-base pair products, and the second-round produced 105-base pair amplicons for each P. insidiosum-specific sample; no amplicons were generated in negative control samples. Our results suggest that nested PCR is an important and efficient tool for diagnosis of both endemic (horse samples) and experimental (rabbit samples) pythiosis.

In Vitro Activity of Terbinafine Combined with Caspofungin and Azoles against Pythium insidiosum

ABSTRACT In this text we evaluated the in vitro antifungal activities of terbinafine combined with caspofungin, miconazole, ketoconazole, and fluconazole against 17 Pythium insidiosum strains by using the microdilution checkerboard method. Synergistic interactions were observed with terbinafine combined with caspofungin (41.2% of the strains), fluconazole (41.2%), ketoconazole (29.4%), and miconazole (11.8%). No antagonistic effects were observed. The combination of terbinafine plus caspofungin or terbinafine plus fluconazole may have significant therapeutic potential for treatment of pythiosis.

In vitro susceptibility of fluconazole-susceptible and -resistant isolates of Malassezia pachydermatis against azoles

OBJECTIVES The first aim of this study was to evaluate the in vitro efficacies of fluconazole, ketoconazole, itraconazole and voriconazole on M. pachydermatis growth inhibition. This study also evaluated M. pachydermatis azole cross-resistance, comparing wild clinical isolates and the same isolates with in vitro-induced fluconazole resistance. METHODS Two techniques were used: (1) a broth microdilution method based on protocol M27-A3 from the Clinical and Laboratory Standards Institute to determine the minimum inhibitory concentration (MIC) and (2) the Fekete-Forgács method to induce fluconazole resistance in vitro. The isolates were divided into two groups: group 1 included fluconazole-susceptible clinical isolates (n=30) and group 2 contained the same isolates with in vitro-induced fluconazole resistance (n=30). RESULTS The two groups exhibited differences in susceptibility (p<0.001). Group 1 isolates were susceptible to azoles: ketoconazole (MIC 0.01-1.0 μg/mL), itraconazole (MIC 0.01-1.0 μg/mL), voriconazole (MIC 0.01-4.0 μg/mL), and fluconazole (MIC 0.01-4.0 μg/mL). Group 2 isolates demonstrated a wider range of MICs to azoles: ITZ (MIC 0.06-64.0 μg/mL), KTZ (MIC 0.25-32.0 μg/mL), VRZ (MIC 2.0-128.0 μg/mL), and FLZ (MIC 64.0-128.0 μg/mL). CONCLUSIONS It was shown that FLZ-resistant M. pachydermatis isolates exhibit cross-resistance to other azoles, reinforcing the importance of susceptibility tests as a guide for the therapeutic prescription of antifungals in medical and veterinary mycology.

In vitro activity of terbinafine associated to amphotericin B, fluvastatin, rifampicin, metronidazole and ibuprofen against Pythium insidiosum.

We evaluated the in vitro activities of terbinafine alone and in combination with amphotericin B, fluvastatin, rifampicin, metronidazole or ibuprofen against 17 clinical isolates of Pythium insidiosum. The assays were based on technique M38-A2, as well as the checkerboard microdilution method. The main synergism observed was by combination of terbinafine plus amphotericin B (41.18%). Antagonisms were observed in combinations of terbinafine with fluvastatin (35.30%) or rifampicin (5.88%).

Phylogenetic relationships of Brazilian isolates of Pythium insidiosum based on ITS rDNA and cytochrome oxidase II gene sequences

Pythium insidiosum is an aquatic oomycete that is the causative agent of pythiosis. Advances in molecular methods have enabled increased accuracy in the diagnosis of pythiosis, and in studies of the phylogenetic relationships of this oomycete. To evaluate the phylogenetic relationships among isolates of P. insidiosum from different regions of Brazil, and also regarding to other American and Thai isolates, in this study a total of thirty isolates of P. insidiosum from different regions of Brazil was used and had their ITS1, 5.8S rRNA and ITS2 rDNA (ITS) region and the partial sequence of cytochrome oxidase II (COX II) gene sequenced and analyzed. The outgroup consisted of six isolates of other Pythium species and one of Lagenidium giganteum. Phylogenetic analyses of ITS and COX II genes were conducted, both individually and in combination, using four different methods: Maximum parsimony (MP); Neighbor-joining (NJ); Maximum likelihood (ML); and Bayesian analysis (BA). Our data supported P. insidiosum as monophyletic in relation to the other Pythium species, and COX II showed that P. insidiosum appears to be subdivided into three major polytomous groups, whose arrangement provides the Thai isolates as paraphyletic in relation to the Brazilian ones. The molecular analyses performed in this study suggest an evolutionary proximity among all American isolates, including the Brazilian and the Central and North America isolates, which were grouped together in a single entirely polytomous clade. The COX II network results presented signals of a recent expansion for the American isolates, probably originated from an Asian invasion source. Here, COX II showed higher levels bias, although it was the source of higher levels of phylogenetic information when compared to ITS. Nevertheless, the two markers chosen for this study proved to be entirely congruent, at least with respect to phylogenetic relationships between different isolates of P. insidiosum.

Echinococcus canadensis (G7) and Echinococcus granulosus sensu stricto (G1) in swine of southern Brazil

The cystic echinococcosis (CE) is an important zoonotic disease caused by the parasite Echinococcus spp. In Brazil, this parasite is present in Rio Grande do Sul (RS) state, border with Argentina and Uruguay, causing several damages to human and animal health. This study aimed to identify Echinococcus spp. in hydatid cysts of swine and evaluate the similarity of the genotypes through the phylogenetic analysis. A total of 3,101,992 swine were slaughtered in the central/northern region of RS/Brazil, during 2008-2012. Five isolates were characterized as hydatid cyst by molecular analysis, based on the mitochondrial gene cytochrome c oxidase subunit I (cox-I). The genotypes E. granulosus sensu stricto (G1) (n=2) and E. canadensis (G7) (n=3) were identified in the hydatid cysts. The swine represents a potential intermediate host for different genotypes of Echinococcus spp., besides it can contribute to the perpetuation of the parasites life cycle in rural areas.

Adenosine deaminase activity in serum, erythrocytes and lymphocytes of rats infected with Leptospira icterohaemorrhagiae.

Leptospirosis is a systemic disease of humans and domestic animals, mainly dogs, cattle and swine. The course of human leptospirosis varies from mild to severe fatal forms and the most severe form of human leptospirosis is principally caused by Leptospira interrogans serovar icterohaemorrhagiae (L. icterohaemorrhagiae). The enzyme adenosine deaminase (ADA) plays an important role in the production and differentiation of blood cells. The aim of this study was to evaluate the activity of ADA in serum, erythrocytes and lymphocytes of rats infected with L. icterohaemorrhagiae, as compared with non-infected rats. Twenty-four adult rats, divided into two uniform groups (A and B) were used for the enzymatic assays. The animals in Group B were inoculated intraperitoneally with 2×10(8) leptospires/rat, and the rodents in Group A (control) were not-inoculated. Blood collection was performed on days 5 and 15 post-infection (PI) and the blood used to assess the ADA activity. The infection by L.icterohaemorrhagiae altered erythrocyte count, hemoglobin concentration and hematocrit, causing a decrease in all these parameters on day 15 PI. Lymphocytes decreased significantly on day 15 PI, and ADA activity in serum was inhibited in infected rats on days 5 and 15 PI and its activity in erythrocytes were increased on day 5 PI. On day 5 PI, we found an increase in ADA activity in erythrocytes of infected rats. No correlation was observed between hematocrit and erythrocyte ADA activity on days 5 and 15 PI. The ADA activity was inhibited in rats infected on day 15 PI. A positive correlation (r(2)=60) was also observed between the number of lymphocytes and ADA activity in lymphocytes on day 15 PI (P<0.05). In conclusion, our results showed that the ADA activity is altered in serum, lymphocytes and erythrocytes in experimental infection by L.icterohaemorrhagiae in rats, concomitantly with hematological parameters.

Massive cryptococcal disseminated infection in an immunocompetent cat

Cryptococcus neoformans and gattii are ubiquitous and opportunistic yeasts that affect many animal species, more frequently adult intact dogs and cats. They cause cryptococcosis, an often fatal zoonotic disease that is thought to result primarily from inhalation of infectious propagules with initial localization in the respiratory tract and then dissemination to other tissues, particularly brain. Members of the species C. neoformans have ecological niche related to avian excreta (mainly pigeons), whereas members of the species C. gattii are usually found in eucalyptus and other tropical and subtropical trees. The traditional diagnosis of cryptococcosis is based on cytology and histological findings, with the evidence of yeasts with a sometimes-prominent capsule, and on microbial isolation and identification. Herein, we present the case history of a 4-year-old cat with a massive cryptococcal disseminated infection. A 4-year-old male cross-bred cat with poor body condition was referred to the Veterinary Hospital of the Federal University of Santa Maria showing a large number of skin nodules, 1–12 mm in diameter, mainly on the head and mucocutaneous junctions, as well on the gums, prepuce and anus (Figure 1). The owner reported apathy, anorexia and vomiting. The presence of urinary clots was also observed on clinical examination, as well as discrete lymphadenopathy. The body temperature was normal (38.1 C). Fine-needle aspirates were obtained from the nodules, according to Martins et al. Microscopy revealed a large number of macrophages and numerous encapsulated yeasts resembling Cryptococcus spp. (Figure 2). Urinalysis, haematology and a biochemical panel were done. Some discrete alterations were observed, such as lymphopenia, presence of platelet agglomerates, hyperproteinaemia (10.4 g ⁄ dL) and hypoalbuminaemia (1.3 g ⁄ dL). The cat tested negative for both the feline leukaemia virus (FeLV) and feline immunodeficiency virus (FIV). Culture on Sabouraud’s dextrose agar and bird-seed agar at 28 C for 5 days yielded highly mucoid yeast-like colonies, compatible with features of members of the genus Cryptococcus. Polymerase chain reaction and sequencing of the rDNA ITS1 ⁄ ITS4 regions were performed for species confirmation. Through a search of the GenBank database, a 99% homology was found with a sequence previously published for Cryptococcus neoformans var. grubii. The sequence data obtained were deposited in GenBank under the accession number HQ148880. The animal died 3 days after the clinical diagnosis due to severe dyspnoea caused by the disease. At necropsy, nodular superficial and deep granulomatous disseminated dermatitis, mild multifocal granulomatous encephalitis and lymphadenitis and marked multifocal to coalescent granulomatous pneumonia were observed. Variable numbers of globose to oval yeast cells (3–10 lm in diameter) containing a basophilic nucleus and an unstained capsulelike apparatus consistent with the genus Cryptococcus were present within these lesions. In animals, cryptococcosis is mainly reported in adult intact cats, with peak incidence at 2–3 years of age. Immunosuppression was formerly considered to be an Correspondence: Danieli Brolo Martins, Departamento de Pequenos Animais, Hospital Veterinário (Prédio 97), Universidade Federal de Santa Maria, RS, 97105-900, Brazil. E-mail: vetdanielimartins@yahoo.com.br (a)

Diphenyl diselenide and sodium selenite associated with chemotherapy in experimental toxoplasmosis: influence on oxidant/antioxidant biomarkers and cytokine modulation.

SUMMARY The aim of this study was to assess the effect of sulfamethoxazole/trimethoprim (ST) supplemented with diphenyl diselenide and sodium selenite in experimental toxoplasmosis, on oxidant/antioxidant biomarkers and cytokine levels. Eighty-four BALB/c mice were divided in seven groups: group A (negative control), and groups B to G (infected). Blood and liver samples were collected on days 4 and 20 post infection (p.i.). Levels of thiobarbituric acid (TBA) reactive substances and advanced oxidation protein products (AOPP) were assessed in liver samples. Both biomarkers were significantly increased in infected groups on day 4 p.i., while they were reduced on day 20 p.i., compared with group A. Glutathione reductase (GR) activity significantly (P<0·01) increased on day 4 p.i., in group G, compared with group A. INF-γ was significantly increased (P<0·001) in both periods, day 4 (groups B, C, F and G) and 20 p.i. (groups C, F and G). IL-10 significantly reduced (P<0·001) on day 4 p.i. in group B; however, in the same period, it was increased (P<0·001) in groups C and G, compared with group A. On day 20 p.i., IL-10 increased (P<0·001) in groups F and G. Therefore, our results highlighted that these forms of selenium, associated with the chemotherapy, were able to reduce lipid peroxidation and protein oxidation, providing a beneficial immunological balance between the production of pro- and anti-inflammatory cytokines.

Pythium insidiosum: morphological and molecular identification of Brazilian isolates

Pythium insidiosum is an oomycete belonging to the kingdom Stramenipila and it is the etiologic agent of pythiosis. Pythiosis is a life-threatening infectious disease characterized by the development of chronic lesions on cutaneous and subcutaneous, intestinal, and bone tissues in humans and many species of animals. The identification of P. insidiosum is important in order to implement a rapid and definitive diagnosis and an effective treatment. This study reports the identification of 54 isolates of P. insidiosum of horses, dogs and sheep that presented suspicious clinical lesions of pythiosis from different regions in Brazil, by using morphological and molecular assays. Throughout the PCR it was possible to confirm the identity of all Brazilian isolates as being P. insidiosum.