Skip to main content

Advertisement

SpringerLink
Log in

Mycoses in northeastern Brazil: epidemiology and prevalence of fungal species in 8 years of retrospective analysis in Alagoas

  • Clinical Microbiology - Research Paper
  • Published:
Brazilian Journal of Microbiology Aims and scope Submit manuscript

Abstract

Superficial and cutaneous mycoses are common in tropical countries, caused by dermatophytes, yeast, and non-dermatophyte molds in different clinical specimens. In order to define the epidemiology of mycoses and the profile of their etiological agents in Alagoas (northeastern Brazil) between 2009 and 2016, we obtained data of patients from the main laboratories of Alagoas, by examining clinical samples with direct microscopy and culture on Sabouraud dextrose agar and Chromagar®Candida. A total of 3316 patients were confirmed with mycoses (595 men/2716 women) and 40.25 of average age. Positive samples totaled 3776, mainly vaginal secretion (1593/42.2%), toenails (876/23.2%), and fingernails (589/15.6%). Yeasts were the most isolated (3129/82.9%), including 3012 Candida spp. (79.8%), 57 Malassezia spp. (1.5%), 42 Trichosporon sp. (1.1%), 10 Geotrichum spp. (0.3%), and 8 Rhodotorula spp. (0.2%). Candida albicans was the most frequent species (715/18.9%), followed by C. krusei (194/5.1%), C. tropicalis (24/0.6%), and 2079 unspecified species (55.1%). Among 17.1% filamentous fungi, 14.8% dermatophytes were distributed as 211 Trichophyton sp. (5.6%), 125 T. rubrum (3.3%), 106 T. tonsurans (2.8%), 72 T. mentagrophytes (1.9%), 2 Microsporum sp. (0.1%), 15 M. canis (0.4%), and 26 Epidermophyton sp. (0.7%). Other fungi represented the minority: Fusarium sp. and Aspergillus sp. These are the first clinical data on the Alagoas population affected by fungi pathogens, confirming a higher incidence of candidiasis (mainly vulvovaginal and onychomycosis) and dermatophytes, providing a better understanding of different mycoses in northeastern Brazil.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Cai W, Lu C, Li X, Zhang J, Zhan P, Xi L, Sun J, Yu X (2016) Epidemiology of superficial fungal infections in Guangdong, southern China: a retrospective study from 2004 to 2014. Mycopathologia 181(5–6):387–395

    PubMed  Google Scholar 

  2. Faure-Cognet O, Frocker-Hidalgo H, Pelloux H, Leccia MT (2016) Superficial fungal infections in a French teaching hospital in Grenoble area: retrospective study on 5470 samples from 2001 to 2011. Mycopathologia. 181(1–2):59–66

    CAS  PubMed  Google Scholar 

  3. Vena GA, Chieco P, Posa F, Garofalo A, Bosco A, Cassano N (2012) Epidemiology of dermatophytoses: retrospective analysis from 2005 to 2010 and comparison with previous data from 1975. New Microbiol 35(2):207–213

    PubMed  Google Scholar 

  4. Peres NTA, Maranhão FCA, Rossi A, Martinez-Rossi NM (2010) Dermatophyte: host-pathogen interaction and antifungal resistance. An Bras Dermatol 85(5):657–667

    PubMed  Google Scholar 

  5. Rodrigues MT, Simões LZ, Diniz CG (2009) Clinical, microbiological and therapeutic aspects of vulvovaginal candidiasis and recurrent vulvovaginal candidiasis: importance of regional surveys. HU Rev 35(3):175–181

    Google Scholar 

  6. Wille MP, Guimaraes T, Furtado GH, Colombo AL (2013) Historical trends in the epidemiology of candidaemia: analysis of an 11-year period in a tertiary care hospital in Brazil. Mem Inst Oswaldo Cruz 108(3):288–292

    PubMed Central  Google Scholar 

  7. Caggiano G, Iatta R, Laneve A, Manca F, Montagna MT (2008) Observational study on candidemia at a university hospital in southern Italy from 1998 to 2004. Mycoses. 51(2):123–128

    PubMed  Google Scholar 

  8. Prohic A, Jovovic ST, Krupalija-Fazlic M, Kuskunovic-Vlahovljak S (2016) Malassezia species in healthy skin and in dermatological conditions. Int J Dermatol 55(5):494–504

    PubMed  Google Scholar 

  9. Miceli MH, Lee SA (2011) Emerging moulds: epidemiological trends and antifungal resistance. Mycoses. 54(6):666–678

    Google Scholar 

  10. Bombace F, Iovene MR, Galdiero M, Martora F, Nicoletti GF, D'Andrea M, Della Pepa ME, Vitiello M (2016) Nondermatophytic onychomycosis diagnostic criteria: an unresolved question. Mycoses. 59(9):558–565

    PubMed  Google Scholar 

  11. Odds FC, Bernaerts R (1994) CHROMagar Candida, a new differential isolation medium for presumptive identification of clinically important Candida species. J Clin Microbiol 32(8):1923–1929

    CAS  PubMed  PubMed Central  Google Scholar 

  12. Zamani S, Sadeghi G, Yazdinia F, Moosa H, Pazooki A, Ghafarinia Z, Abbasi M, Shams-Ghahfarokhi M, Razzaghi-Abyaneh M (2016) Epidemiological trends of dermatophytosis in Tehran, Iran: a five-year retrospective study. J Mycol Med 26(4):351–358

    CAS  PubMed  Google Scholar 

  13. Cruz CR, Ponce EE, Caderón RL, Delgado VN, Vieille OP, Piontelli LE (2011) Superficial mycoses in the city of Valparaiso, Chile: period 2007-2009. Rev Chil Infectol 28(5):404–409

    Google Scholar 

  14. Yoon HJ, Choi HJ, Kim YK, Song YJ, Ki M (2014) Prevalence of fungal infections using National Health Insurance data from 2009-2013, South Korea. Epidemiol Health 36:e2014017

    PubMed  PubMed Central  Google Scholar 

  15. Di Chiacchio NMC, Madeira CL, Humaire CR, Silva CS, Fernandes LHG, Reis AL (2014) Superficial mycoses at the hospital do Servidor Público Municipal de São Paulo between 2005 and 2011. An Bras Dermatol 89(1):67–71

    PubMed  PubMed Central  Google Scholar 

  16. Araújo AJG, Bastos OMP, Souza MAJ, Oliveira JC (2003) Onychomycosis caused by emergent fungi: clinical analysis, diagnosis and revision. An Bras Dermatol 78(4):445–455

    Google Scholar 

  17. Oliveira JAA, Barros JA, Cortez ACA, Oliveira JSRL (2006) Superficial mycoses in the City of Manaus/AM between March and November/2003. An Bras Dermatol 81(3):238–243

    Google Scholar 

  18. Pires CA, Cruz NF, Lobato AM, Sousa PO, Carneiro FRO, Mendes AMD (2014) Clinical, epidemiological, and therapeutic profile of dermatophytosis. An Bras Dermatol 89(2):259–264

    PubMed  PubMed Central  Google Scholar 

  19. Brilhante RS, Cordeiro RA, Medrano DJ, Rocha MFG, Monteiro AJ, Cavalcante CSP, Meireles TEF, Sidrim JJC (2005) Onychomycosis in Ceará (Northeast Brazil): epidemiological and laboratory aspects. Mem Inst Oswaldo Cruz 100(2):131–135

    CAS  PubMed  Google Scholar 

  20. Damazio PMRBC, Lacerda HR, Lacerda-Filho AM, Magalhaes OM, Neves RP (2007) Epidemiology, etiology and clinical presentation of dermatophytosis in Pernambuco, 1995-2005. Rev Soc Bras Med Trop 40(4):484–486

    PubMed  Google Scholar 

  21. Silva-Rocha WP, de Azevedo MF, Chaves GM (2017) Epidemiology and fungal species distribution of superficial mycoses in Northeast Brazil. J Mycol Med 27(1):57–64

    CAS  PubMed  Google Scholar 

  22. Calado NB, de Sousa-Junior FC, Diniz MG, Fernandes ACS, Cardoso FJR, Zaror LC et al (2011) A 7-year survey of superficial and cutaneous mycoses in a public hospital in Natal, Northeast Brazil. Braz J Microbiol 42(4):1296–1299

    PubMed  PubMed Central  Google Scholar 

  23. Araújo GML, Araújo ND, Farias RP, Cavalcanti FCN, Lima MLF, Braz RAFS (2010) Superficial mycoses in Paraíba: a comparative analysis and bibliographical revision. An Bras Dermatol 2010;85(6):943–946

  24. Capote AM, Ferrara G, Panizo MM, García N, Alarcón V, Reviakina V, Dolande M (2016) Superficial mycoses: casuistry of the mycology Department of the Instituto Nacional de Higiene “Rafael Rangel”, Caracas, Venezuela (2001-2014). Investig Clin 57(1):47–58

  25. Daves G, Canteros CE (2007) Epidemiological status of mycoses in the Argentine Republic. Rev Argent Microbiol 39(1):28–33

    Google Scholar 

  26. Sigurgeirsson B, Steingrimsson O (2004) Risk factors associated with onychomycosis. J Eur Acad Dermatol Venereol 18(1):48–51

    CAS  PubMed  Google Scholar 

  27. Papini M, Piraccini BM, Difonzo E, Brunoro A (2015) Epidemiology of onychomycosis in Italy: prevalence data and risk factor identification. Mycoses. 58(11):659–664

    PubMed  Google Scholar 

  28. Elavarashi E, Kindo AJ, Kalyani J (2013) Optimization of PCR—RFLP directly from the skin and nails in cases of dermatophytosis, targeting the ITS and the 18S ribosomal DNA regions. J Clin Diagn Res 7(4):646–651

    CAS  PubMed  PubMed Central  Google Scholar 

  29. Gunther LSA, Martins HPR, Gimenes F, Abreu AL, Consolaro ME, Svidzinski TI (2014) Prevalence of Candida albicans and no-albicans isolates from vaginal secretions: comparative evaluation of colonization, vaginal candidiasis and recurrent vaginal candidiasis in diabetic and non-diabetic women. São Paulo Med J 132(2):116–120

    PubMed  Google Scholar 

  30. Sivakumar VG, Shankar P, Nalina K, Menon T (2009) Use of CHROMagar in the differentiation of common species of Candida. Mycopathologia. 167(1):47–49

    CAS  PubMed  Google Scholar 

  31. Jain N, Mathur P, Misra MC, Behera B, Xess I, Sharma SP (2012) Rapid identification of yeast isolates from clinical specimens in critically ill trauma ICU patients. J Lab Physicians 4(1): 30–34

    PubMed  PubMed Central  Google Scholar 

  32. Daef E, Moharram A, Eldin SS, Elsherbinv N, Mohammed M (2014) Evaluation of chromogenic media and seminested PCR in the identification of Candida species. Braz J Microbiol 45(1):255–262

    PubMed  PubMed Central  Google Scholar 

  33. Cafarchia C, Gasser RB, Figueiredo LA, Latrofa MS, Otranto D (2011) Advances in identification of Malassezia. Mol Cell Probes 25(1):1–7

    CAS  PubMed  Google Scholar 

  34. Tragiannidis A, Bispingg G, Koehler G, Groll AH (2010) Minireview: Malassezia infections in immunocompromised patients. Mycoses. 53(3):187–195

    PubMed  Google Scholar 

  35. Heidrich D, Daboit TC, Stopiglia CD, Magagnin CM, Vetoratto G, Amaro TG et al (2015) Sixteen years of pityriasis versicolor in metropolitan area of Porto Alegre, Southern Brazil. Rev Inst Med Trop Sao Paulo 57(4):277–280

    CAS  PubMed  PubMed Central  Google Scholar 

  36. Theelen B, Cafarchia C, Gaitanis G, Bassukas ID, Boekhout T, Dawson TL (2018) Malassezia ecology, pathophysiology, and treatment. Med Mycol 56(1):10–25

    Google Scholar 

  37. Colombo AL, Padovan ACB, Chaves GM (2011) Current knowledge of Trichosporon spp. and trichosporonosis. Clin Microbiol Rev 24(4):682–700

    CAS  PubMed  PubMed Central  Google Scholar 

  38. Shen XX, Opulente DA, Kominek J, Zhou X, Steenwyk JL, Buh KV, Haase MAB, Wisecaver JH, Wang M, Doering DT, Boudouris JT, Schneider RM, Langdon QK, Ohkuma M, Endoh R, Takashima M, Manabe RI, Čadež N, Libkind D, Rosa CA, DeVirgilio J, Hulfachor AB, Groenewald M, Kurtzman CP, Hittinger CT, Rokas A (2018) Tempo and mode of genome evolution in the budding yeast subphylum. Cell. 175(6):1533–1545

    CAS  PubMed  PubMed Central  Google Scholar 

  39. Gupta A, Drummond-Main C, Cooper E, Brintnell W, Piraccini BM, Tosti A (2011) Systematic review of nondermatophyte mold onychomycosis: diagnosis, clinical types, epidemiology, and treatment. J Am Acad Dermatol 66(3):494–502

    PubMed  Google Scholar 

  40. Gianni C, Cerri A, Crosti C (2000) Non-dermatophytic onychomycosis (2000) an understimated entity? A study of 51 cases. Mycoses. 43(1–2):29–33

    CAS  PubMed  Google Scholar 

  41. Nir-Paz R, Strahilevitz J, Shapiro M, Keller N, Goldschmied-Reouven A, Yarden O, Block C, Polacheck I (2004) Clinical and epidemiological aspects of infections caused by Fusarium species: a collaborative study from Israel. J Clin Microbiol 42(8):3456–3461

    PubMed  PubMed Central  Google Scholar 

  42. Tsentemeidou A, Vyzantiadis TA, Kyriakou A, Sotiriadis D, Patsatsi A (2017) Prevalence of onychomycosis among patients with nail psoriasis who are not receiving immunosuppressive agents: results of a pilot study. Mycoses. 60(12):830–835

    CAS  PubMed  Google Scholar 

  43. Garces HG, Hrycyk MF, Giacobino J, Capela-Machado G, Domingos-Arantes T, Theodoro RC et al (2016) Molecular identification and phylogenetical analysis of dermatophyte fungi from Latin American. Mycoses. 59(12):787–797

    Google Scholar 

  44. Ala-Houhala M, Koukila-Kahkola P, Antikainen J, Valve J, Kirveskari J, Anttila VJ (2018) Clinical use of fungal PCR from deep tissue samples in the diagnosis of invasive fungal diseases: a retrospective observational study. Clin Microbiol Infect 24(3):301–305

    CAS  PubMed  Google Scholar 

Download references

Acknowledgments

We thank Alex Lemos and Flávia Soares for the technical support in the tertiary laboratories, and  Abilio Borghi for the review of the grammar in this manuscript.

Authors contribution:

 Maranhão, FCA: Conception and planning of the study; Obtaining, analyzing and interpreting data; Effective participation in research orientation; Statistical analysis; Intellectual participation in the propaedeutic conduction of studied cases; Critical review of the literature; Elaboration and writing of the manuscript; Critical review of the manuscript; Approval of the final version of the manuscript. Oliveira-Júnior, JB: Obtaining, analyzing and interpreting data; Statistical analysis; Critical review of the manuscript. Araújo, MAS: Obtaining, analyzing and interpreting data; Critical review of the manuscript. Silva, DMW: Statistical analysis; Critical review of the manuscript.

Funding

This study was financially supported by the Brazilian research agency CNPq and the Alagoas State agency FAPEAL (20110829-011-0025-0009).

Author information

Authors and Affiliations

  1. Universidade Federal de Alagoas, Instituto de Ciências Biológicas e da Saúde (ICBS), Departamento de Microbiologia, Laboratório de Microbiologia Clínica (LMC), Maceió, AL, 57022-222, Brazil

    Fernanda Cristina de Albuquerque Maranhão

  2. Fundação Oswaldo Cruz (Fiocruz), Centro de Pesquisas Aggeu Magalhães, Departamento de Parasitologia, Laboratório de Biologia Celular e Molecular, Recife, PE, Brazil

    Jorge Belém Oliveira-Júnior

  3. Centro Universitário Tiradentes, Maceió, AL, Brazil

    Maria Anilda dos Santos Araújo

  4. Universidade Federal de Alagoas, Instituto de Ciências Biológicas e da Saúde (ICBS), Departamento de Microbiologia, Laboratório de Micologia (LabMicol), Maceió, AL, Brazil

    Denise Maria Wanderlei Silva

Authors
  1. Fernanda Cristina de Albuquerque Maranhão
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jorge Belém Oliveira-Júnior
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Maria Anilda dos Santos Araújo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Denise Maria Wanderlei Silva
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Fernanda Cristina de Albuquerque Maranhão.

Ethics declarations

This project was approved by the Research Ethics Committee under the no. 23065.017665/201164 and ethical principles were safeguarded through ethical secrecy, codifying, and not mentioning the patients’ names (SisGen access no. A5B1165).

Conflict of interest

The authors declare that they have no conflicts of interest.

Additional information

Responsible Editor: Rosana Puccia

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

de Albuquerque Maranhão, F.C., Oliveira-Júnior, J.B., dos Santos Araújo, M.A. et al. Mycoses in northeastern Brazil: epidemiology and prevalence of fungal species in 8 years of retrospective analysis in Alagoas. Braz J Microbiol 50, 969–978 (2019). https://doi.org/10.1007/s42770-019-00096-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s42770-019-00096-0

Keywords

Search

Navigation