An outbreak of trichophyton tonsurans dermatophytosis in a chronic care institution for the elderly

Kane, Jennifer B.; Leavitt, Erica; Summerbell, Richard C.; Krajden, Sigmund; Kasatiya, S. S.

doi:10.1007/bf00144741

Cited by 19 publications

(16 citation statements)

References 26 publications

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“…It is possible that they may dissociate from skin cells in the environment and come in contact with new potential hosts as disseminated arthroconidia. Their persistence as an environmental source of contagion may lead to recurrent outbreaks of dermatophytosis in individuals and in institutions (128,162). According to Rippon (200), the arthroconidia of T. rubrum do not survive as long as do those of other species, e.g., E. floccosum.…”

Section: Epidemiology and Ecologymentioning

confidence: 99%

The dermatophytes

1995

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The etiologic agents of the dermatophytoses (ringworm) are classified in three anamorphic (asexual or imperfect) genera, Epidermophyton, Microsporum, and Trichophyton. Species capable of reproducing sexually belong in the teleomorphic genus, Arthroderma, of the Ascomycota. On the basis of primary habitat association, they may be grouped as geophilic (soil associated), zoophilic, and anthropophilic. Adaptation to growth on humans by most geophilic species resulted in diminished loss of sporulation, sexuality, and other soil-associated characteristics. The dermatophytes have the ability to invade keratinized tissue (skin, hair, and nails) but are usually restricted to the nonliving cornified layer of the epidermis because of their inability to penetrate viable tissue of an immunocompetent host. However, invasion does elicit a host response ranging from mild to severe. Acid proteinases, elastase, keratinases, and other proteinases reportedly act as virulence factors. The development of cell-mediated immunity correlated with delayed hypersensitivity and an inflammatory response is associated with clinical cure, whereas the lack of or a defective cell-mediated immunity predisposes the host to chronic or recurrent dermatophyte infection. Chronic dermatophytosis is mostly caused by Trichophyton rubrum, and there is some evidence that mannan produced by this fungus suppresses or diminishes the inflammatory response. Since dermatophytes cause a communicable disease, modes of transmission and control are discussed as well as a survey of recent trends in therapy. Collection of specimens, culture media, and tests for identification are also presented. Genetic studies have led to an understanding of incompatibility mechanisms, pleomorphism and variation, resistance to griseofulvin, and virulence. Molecular biology has contributed to our knowledge of the taxonomy and phylogenetic relationships of dermatophytes.

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Section: Epidemiology and Ecologymentioning

confidence: 99%

The dermatophytes

1995

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“…Furthermore, there are differences in clinical associations and in geographic distribution between species (20,29). Because Trichophyton comprise anthropophilic and zoophilic species, accurate identification is important, not only to guide clinical management but for epidemiological purposes, case clusters have occurred in long-term care facilities and in response to increased public participation in fitness-related activities (19,25). Standard culture-based identification methods, however, are slow (2 to 4 weeks) and imprecise due to fungal phenotypic pleomorphism (11,24).…”

mentioning

confidence: 99%

Rapid Identification and Differentiation of Trichophyton Species, Based on Sequence Polymorphisms of the Ribosomal Internal Transcribed Spacer Regions, by Rolling-Circle Amplification

et al. 2008

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Although the use of two "group-specific" probes targeting both the ITS1 and the ITS2 regions were required to identify T. soudanense, the other species were identified by single ITS1-or ITS2-targeted species-specific probes. There was good agreement between ITS sequencing and the RCA assay. Despite limited genetic variation between Trichophyton spp., the sensitive, specific RCA-based SNP detection assay showed potential as a simple, reproducible method for the rapid (2-h) identification of Trichophyton spp.

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“…The persistent nature of T. tonsurans as a primary pathogen of pediatric dermatophytoses in the U.S. along with the increasing number of T. tonsurans epidemics that are reported in non-U.S. countries support the efficiency by which this organism is transmitted between individuals in the community 2,13,16. Previously described institutional outbreaks allude to a similar risk for the nosocomial transmission of T. tonsurans along with other dermatophytes (Table).…”

Section: Discussionmentioning

confidence: 99%