First case of chronic cutaneous chromoblastomycosis by <i>Rhinocladiella similis</i>
 aquired in Europe

Richarz, Nina A.; Jaka, Ane; Fernández‐Rivas, Gema; Bassas, J.; Bielsa, Isabel; Ferrándiz, Carlos

doi:10.1111/ced.13659

Cited by 11 publications

(9 citation statements)

References 5 publications

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“…In addition, the genetic diversity of black yeast‐like fungi from different geographical areas and consequently the global molecular epidemiology of these important human fungal pathogens are largely unknown. In view of our data that demonstrate R. similis is present in the UK healthcare settings and considering previous reports, 23‐26,29,52 it appears that R. similis has a broad geographical distribution.…”

Section: Discussionsupporting

confidence: 72%

A pseudo‐outbreak of Rhinocladiella similis in a bronchoscopy unit of a tertiary care teaching hospital in London, United Kingdom

Abdolrasouli

Gibani

Groot

et al. 2020

Mycoses

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Outbreaks of fungal infections due to emerging and rare species are increasingly reported in healthcare settings. We investigated a pseudo‐outbreak of Rhinocladiella similis in a bronchoscopy unit of a tertiary care teaching hospital in London, UK. We aimed to determine route of healthcare‐associated transmission and prevent additional infections. From July 2018 through February 2019, we detected a pseudo‐outbreak of R. similis isolated from bronchoalveolar lavage (BAL) fluid samples collected from nine patients who had undergone bronchoscopy in a multispecialty teaching hospital, during a period of 8 months. Isolates were identified by MALDI‐TOF mass spectrometry. Antifungal susceptibility testing was performed by EUCAST broth microdilution. To determine genetic relatedness among R. similis isolates, we undertook amplified fragment length polymorphism analysis. To determine the potential source of contamination, an epidemiological investigation was carried out. We reviewed patient records retrospectively and audited steps taken during bronchoscopy as well as the subsequent cleaning and decontamination procedures. Fungal cultures were performed on samples collected from bronchoscopes and automated endoscope washer‐disinfector systems. No patient was found to have an infection due to R. similis either before or after bronchoscopy. One bronchoscope was identified to be used among all affected patients with positive fungal cultures. Physical damage was found in the index bronchoscope; however, no fungus was recovered after sampling of the affected scope or the rinse water of automated endoscope washer‐disinfectors. Use of the scope was halted, and, during the following 12‐month period, Rhinocladiella species were not isolated from any BAL specimen. All pseudo‐outbreak isolates were identified as R. similis with high genetic relatedness (>90% similarity) on ALFP analysis. The study emphasises the emergence of a rare and uncommon black yeast R. similis, with reduced susceptibility to echinocandins, in a bronchoscope‐related pseudo‐outbreak with a potential water‐related reservoir. Our findings highlight the importance of prolonged fungal culture and species‐level identification of melanised yeasts isolated from bronchoscopy samples. Possibility of healthcare‐associated transmission should be considered when R. similis is involved in clinical microbiology samples.

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Section: Discussionsupporting

confidence: 72%

A pseudo‐outbreak of Rhinocladiella similis in a bronchoscopy unit of a tertiary care teaching hospital in London, United Kingdom

Abdolrasouli

Gibani

Groot

et al. 2020

Mycoses

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“…The 35 European cases (24 autochthonous) were documented in the following countries: Finland (9 cases), Poland (5 cases), United Kingdom (5 cases), Czech and Slovakia (3 cases), Germany (3 cases), France (3 cases), Ukraine (2 cases), Russia (1 case), Belgium (1 case), Spain (1 case), Portugal (1 case) and Netherlands (1 case). All cases of CBM diagnosed in the UK and Netherlands, in addition to 2 cases from Germany and 1 case from France, were imported [ 212 – 218 ].…”

Section: Resultsmentioning

confidence: 99%

“…(1; 3.3%), and Cladophialophora spp. (1; 3.3%) [ 212 , 214 – 218 ]. The primary epidemiologic and clinical data of all CBM cases reported in the region were summarized in Tables 1 and S1 .…”

Section: Resultsmentioning

confidence: 99%

The global burden of chromoblastomycosis

et al. 2021

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Background Chromoblastomycosis (CBM), represents one of the primary implantation mycoses caused by melanized fungi widely found in nature. It is characterized as a Neglected Tropical Disease (NTD) and mainly affects populations living in poverty with significant morbidity, including stigma and discrimination. Methods and findings In order to estimate the global burden of CBM, we retrospectively reviewed the published literature from 1914 to 2020. Over the 106-year period, a total of 7,740 patients with CBM were identified on all continents except Antarctica. Most of the cases were reported from South America (2,619 cases), followed by Africa (1,875 cases), Central America and Mexico (1,628 cases), Asia (1,390 cases), Oceania (168 cases), Europe (35 cases), and USA and Canada (25 cases). We described 4,022 (81.7%) male and 896 (18.3%) female patients, with the median age of 52.5 years. The average time between the onset of the first lesion and CBM diagnosis was 9.2 years (range between 1 month to 50 years). The main sites involved were the lower limbs (56.7%), followed by the upper limbs (19.9%), head and neck (2.9%), and trunk (2.4%). Itching and pain were reported by 21.5% and 11%, respectively. Malignant transformation was described in 22 cases. A total of 3,817 fungal isolates were cultured, being 3,089 (80.9%) Fonsecaea spp., 552 (14.5%) Cladophialophora spp., and 56 Phialophora spp. (1.5%). Conclusions and significance This review represents our current knowledge on the burden of CBM world-wide. The global incidence remains unclear and local epidemiological studies are required to improve these data, especially in Africa, Asia, and Latin America. The recognition of CBM as NTD emphasizes the need for public health efforts to promote support for all local governments interested in developing specific policies and actions for preventing, diagnosing and assisting patients.

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“…Species of the genus Rhinocladiella have been described as less common agents of chromoblastomycosis 31 , 32 , i.e. R. aquaspersa, R. similis and R. tropicalis 3 .…”

Section: Discussionmentioning

confidence: 99%

Environmental prospecting of black yeast-like agents of human disease using culture-independent methodology

Costa

Silva

Voidaleski

et al. 2020

Sci Rep

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Melanized fungi and black yeasts in the family Herpotrichiellaceae (order chaetothyriales) are important agents of human and animal infectious diseases such as chromoblastomycosis and phaeohyphomycosis. the oligotrophic nature of these fungi enables them to survive in adverse environments where common saprobes are absent. Due to their slow growth, they lose competition with common saprobes, and therefore isolation studies yielded low frequencies of clinically relevant species in environmental habitats from which humans are thought to be infected. this problem can be solved with metagenomic techniques which allow recognition of microorganisms independent from culture. the present study aimed to identify species of the family Herpotrichiellaceae that are known to occur in Brazil by the use of molecular markers to screen public environmental metagenomic datasets from Brazil available in the Sequence Read Archive (SRA). Species characterization was performed with the BLASt comparison of previously described barcodes and padlock probe sequences. A total of 18,329 sequences was collected comprising the genera Cladophialophora, Exophiala, Fonsecaea, Rhinocladiella and Veronaea, with a focus on species related to the chromoblastomycosis. the data obtained in this study demonstrated presence of these opportunists in the investigated datasets. the used techniques contribute to our understanding of environmental occurrence and epidemiology of black fungi. A large number of species of black yeast-like fungi that belong to the ascomycetous order Chaetothyriales in the family Herpotrichiellaceae are renowned as opportunistic pathogens in immunocompetent vertebrate hosts 1,2. Agents are particularly involved in subcutaneous, and systemic or disseminated infections, known as chromoblastomycosis and phaeohyphomycosis, respectively 2-4. These infections are invariably chronic and can be severely mutilating or even fatal. Chromoblastomycosis is a relatively common disease in rural tropical climate zones around the world. This implantation disorder is characterized by the presence of a specialized tissue form of the fungus known as the muriform cell 2,5,6. Infection is hypothesized to take place via traumatic inoculation of environmental material such as plant thorns and/or wood fragments 7,8. Epidemiological data confirmed by studies using selective

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First case of chronic cutaneous chromoblastomycosis by Rhinocladiella similis aquired in Europe

Cited by 11 publications

References 5 publications

A pseudo‐outbreak of Rhinocladiella similis in a bronchoscopy unit of a tertiary care teaching hospital in London, United Kingdom

A pseudo‐outbreak of Rhinocladiella similis in a bronchoscopy unit of a tertiary care teaching hospital in London, United Kingdom

The global burden of chromoblastomycosis

Environmental prospecting of black yeast-like agents of human disease using culture-independent methodology

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