Actinomycetoma

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Mohamed E Hamid - One of the best experts on this subject based on the ideXlab platform.

  • Diversity and geographic distribution of soil streptomycetes with antagonistic potential against Actinomycetoma-causing Streptomyces sudanensis in Sudan and South Sudan
    BMC Microbiology, 2020
    Co-Authors: Mohamed E Hamid, Thomas Reitz, Martin R. P. Joseph, Kerstin Hommel, Adil Mahgoub, Mogahid M. Elhassan, François Buscot, Mika Tarkka
    Abstract:

    Background Production of antibiotics to inhibit competitors affects soil microbial community composition and contributes to disease suppression. In this work, we characterized whether Streptomyces bacteria, prolific antibiotics producers, inhibit a soil borne human pathogenic microorganism, Streptomyces sudanensis. S. sudanensis represents the major causal agent of Actinomycetoma – a largely under-studied and dreadful subcutaneous disease of humans in the tropics and subtropics. The objective of this study was to evaluate the in vitro S. sudanensis inhibitory potential of soil streptomycetes isolated from different sites in Sudan, including areas with frequent (mycetoma belt) and rare Actinomycetoma cases of illness. Results Using selective media, 173 Streptomyces isolates were recovered from 17 sites representing three ecoregions and different vegetation and ecological subdivisions in Sudan. In total, 115 strains of the 173 (66.5%) displayed antagonism against S. sudanensis with different levels of inhibition. Strains isolated from the South Saharan steppe and woodlands ecoregion (Northern Sudan) exhibited higher inhibitory potential than those strains isolated from the East Sudanian savanna ecoregion located in the south and southeastern Sudan, or the strains isolated from the Sahelian Acacia savanna ecoregion located in central and western Sudan. According to 16S rRNA gene sequence analysis, isolates were predominantly related to Streptomyces werraensis , S. enissocaesilis , S. griseostramineus and S. prasinosporus . Three clusters of isolates were related to strains that have previously been isolated from human and animal Actinomycetoma cases: SD524 ( Streptomyces sp. subclade 6), SD528 ( Streptomyces griseostramineus ) and SD552 ( Streptomyces werraensis ). Conclusion The in vitro inhibitory potential against S. sudanensis was proven for more than half of the soil streptomycetes isolates in this study and this potential may contribute to suppressing the abundance and virulence of S. sudanensis . The streptomycetes isolated from the mycetoma free South Saharan steppe ecoregion show the highest average inhibitory potential. Further analyses suggest that mainly soil properties and rainfall modulate the structure and function of Streptomyces species, including their antagonistic activity against S. sudanensis.

  • diversity and geographic distribution of soil streptomycetes with antagonistic potential against Actinomycetoma causing streptomyces sudanensis in sudan and south sudan
    BMC Microbiology, 2020
    Co-Authors: Mohamed E Hamid, Thomas Reitz, Martin R. P. Joseph, Kerstin Hommel, Adil Mahgoub, Mogahid M. Elhassan, François Buscot, Mika Tarkka
    Abstract:

    Production of antibiotics to inhibit competitors affects soil microbial community composition and contributes to disease suppression. In this work, we characterized whether Streptomyces bacteria, prolific antibiotics producers, inhibit a soil borne human pathogenic microorganism, Streptomyces sudanensis. S. sudanensis represents the major causal agent of Actinomycetoma – a largely under-studied and dreadful subcutaneous disease of humans in the tropics and subtropics. The objective of this study was to evaluate the in vitro S. sudanensis inhibitory potential of soil streptomycetes isolated from different sites in Sudan, including areas with frequent (mycetoma belt) and rare Actinomycetoma cases of illness. Using selective media, 173 Streptomyces isolates were recovered from 17 sites representing three ecoregions and different vegetation and ecological subdivisions in Sudan. In total, 115 strains of the 173 (66.5%) displayed antagonism against S. sudanensis with different levels of inhibition. Strains isolated from the South Saharan steppe and woodlands ecoregion (Northern Sudan) exhibited higher inhibitory potential than those strains isolated from the East Sudanian savanna ecoregion located in the south and southeastern Sudan, or the strains isolated from the Sahelian Acacia savanna ecoregion located in central and western Sudan. According to 16S rRNA gene sequence analysis, isolates were predominantly related to Streptomyces werraensis, S. enissocaesilis, S. griseostramineus and S. prasinosporus. Three clusters of isolates were related to strains that have previously been isolated from human and animal Actinomycetoma cases: SD524 (Streptomyces sp. subclade 6), SD528 (Streptomyces griseostramineus) and SD552 (Streptomyces werraensis). The in vitro inhibitory potential against S. sudanensis was proven for more than half of the soil streptomycetes isolates in this study and this potential may contribute to suppressing the abundance and virulence of S. sudanensis. The streptomycetes isolated from the mycetoma free South Saharan steppe ecoregion show the highest average inhibitory potential. Further analyses suggest that mainly soil properties and rainfall modulate the structure and function of Streptomyces species, including their antagonistic activity against S. sudanensis.

  • the use of morphological and cell wall chemical markers in the identification of streptomyces species associated with Actinomycetoma
    African Journal of Clinical and Experimental Microbiology, 2013
    Co-Authors: Mohamed E Hamid
    Abstract:

    Most aerobic, filamentous, spore-forming actinomycetes are saprophytes but some are considered pathogens of humans and animals, notable examples are the causal agents of mycetoma. The present study aimed to identify Streptomyces spp. isolated from Actinomycetoma cases in Sudan by examining some morphological traits and analyzing the cell wall composition. Nineteen Streptomyces strains isolated from purulent materials of patients with mycetoma (human) or fistulous withers (donkeys) were included in the study. Isolates were tentatively identified as Streptomyces species based on morphological and cultural characteristics. Cell wall analysis of isolates yielded LLdiaminopimelic acid (LL-DAP) which authenticates that the isolates are members of genus Streptomyces . The isolates, though they are Streptomyces, but are variable phenotypes. The study concluded that using few selected criteria, as above, would allow identification of unknown Actinomycetoma agent to the genus level. The study also assumes that apparently limitless, numbers of saprophytic Streptomyces enter human or animal skin tissue causing Actinomycetoma and perhaps other complications in man and animals. KEYWORDS: Actinomycetoma, Streptomyces species, Madura foot, Sudan

  • Variable antibiotic susceptibility patterns among Streptomyces species causing Actinomycetoma in man and animals
    Annals of Clinical Microbiology and Antimicrobials, 2011
    Co-Authors: Mohamed E Hamid
    Abstract:

    Background Drug therapy is recommended in conjunction with surgery in treatment of Actinomycetoma. The specific prescription depends on the type of bacteria (Actinomycetoma) or fungi (eumycetoma) causing the disease and their in vitro antimicrobial susceptibility. Objectives To investigate the antimicrobial susceptibility among isolates of Streptomyces spp. isolated from cases of Actinomycetoma in man and animals in Sudan. Methods Streptomyces strains (n = 18) isolated from cases of Actinomycetoma were tested in vitro against 15 commonly prescribed antibacterial agents using MIC agar dilution method as per standard guidelines. Results Streptomyces strains isolated from Actinomycetoma fall into various phenotypic groups. All of the strains were inhibited by novobiocin (8 μg/mL), gentamycin (8, 32 μg/mL) and doxycycline (32 μg/mL). Fusidic acid (64 μg/mL) inhibited 94.4% of the strains; bacitracin, streptomycin, cephaloridine, clindamycin, ampicillin, rifampicin and tetracycline (64 μg/mL) inhibited between 61.1 and 77.8% of the strains. All strains were found resistant to amphotericin B (64 μg/mL), penicillin (20 μg/mL) and sulphamethoxazole (64 μg/mL). Conclusions Saprophytic Streptomyces spp. cause Actinomycetoma in man and animal belong to separate phenotypes and have a wide range of susceptibility patterns to antimicrobial agents, which pose a lot of difficulties in selecting effective in vivo treatment for Actinomycetoma.

  • variable antibiotic susceptibility patterns among streptomyces species causing Actinomycetoma in man and animals
    Annals of Clinical Microbiology and Antimicrobials, 2011
    Co-Authors: Mohamed E Hamid
    Abstract:

    Drug therapy is recommended in conjunction with surgery in treatment of Actinomycetoma. The specific prescription depends on the type of bacteria (Actinomycetoma) or fungi (eumycetoma) causing the disease and their in vitro antimicrobial susceptibility. To investigate the antimicrobial susceptibility among isolates of Streptomyces spp. isolated from cases of Actinomycetoma in man and animals in Sudan. Streptomyces strains (n = 18) isolated from cases of Actinomycetoma were tested in vitro against 15 commonly prescribed antibacterial agents using MIC agar dilution method as per standard guidelines. Streptomyces strains isolated from Actinomycetoma fall into various phenotypic groups. All of the strains were inhibited by novobiocin (8 μg/mL), gentamycin (8, 32 μg/mL) and doxycycline (32 μg/mL). Fusidic acid (64 μg/mL) inhibited 94.4% of the strains; bacitracin, streptomycin, cephaloridine, clindamycin, ampicillin, rifampicin and tetracycline (64 μg/mL) inhibited between 61.1 and 77.8% of the strains. All strains were found resistant to amphotericin B (64 μg/mL), penicillin (20 μg/mL) and sulphamethoxazole (64 μg/mL). Saprophytic Streptomyces spp. cause Actinomycetoma in man and animal belong to separate phenotypes and have a wide range of susceptibility patterns to antimicrobial agents, which pose a lot of difficulties in selecting effective in vivo treatment for Actinomycetoma.

Oliverio Welsh - One of the best experts on this subject based on the ideXlab platform.

  • climate soil type and geographic distribution of Actinomycetoma cases in northeast mexico a cross sectional study
    PLOS ONE, 2020
    Co-Authors: Jesus Alberto Cardenasde La Garza, Oliverio Welsh, Jorge Ocampocandiani, Adrian Cuellarbarboza, Karina Paola Suarezsanchez, Estephania De La Cruzvaladez, Luis Gerardo Cruzgomez, Lucio Veracabrera
    Abstract:

    Background Mycetoma is a chronic, granulomatous infection of subcutaneous tissue, that may involve deep structures and bone. It can be caused by bacteria (Actinomycetoma) or fungi (eumycetoma). There is an epidemiological association between mycetoma and the environment, including rainfall, temperature and humidity but there are still many knowledge gaps in the identification of the natural habitat of actinomycetes, their primary reservoir, and their precise geographical distribution. Knowing the potential distribution of this infection and its ecological niche in endemic areas is relevant to determine disease management strategies and etiological agent habitat or reservoirs. Methodology/principal findings This was an ambispective descriptive study of 31 patients with Actinomycetoma. We determined the biophysical characteristics including temperature, precipitation, soil type, vegetation, etiological agents, and mapped Actinomycetoma cases in Northeast Mexico. We identified two disease cluster areas. One in Nuevo Leon, with a predominantly kastanozems soil type, with a mean annual temperature of 22°, and a mean annual precipitation of 585.2 mm. Herein, mycetoma cases were produced by Actinomadura pelletieri, Actinomadura madurae, Nocardia brasiliensis, and Nocardia spp. The second cluster was in San Luis Potosi, where lithosols soil type predominates, with a mean annual temperature of 23.5° and a mean annual precipitation of 635.4 mm. In this area, all the cases were caused by N. brasiliensis. A. madurae cases were identified in rendzinas, kastanozems, vertisols, and lithosols soils, and A. pelletieri cases in xerosols, kastanozems, and rendzinas soils. Previous thorn trauma with Acacia or Prosopis plants was referred by 35.4% of subjects. In these states, the presence of thorny plants, such as Acacia spp., Prosopis spp., Senegalia greggi, Vachellia farnesiana and Vachellia rigidula, are common. Conclusions/significance Mapping this neglected tropical infection aids in the detection of disease cluster areas, the development of public health strategies for early diagnosis and disease prediction models; this paves the way for more ecological niche etiological agent research.

  • clinical characteristics and treatment of Actinomycetoma in northeast mexico a case series
    PLOS Neglected Tropical Diseases, 2020
    Co-Authors: Jesus Alberto Cardenasde La Garza, Oliverio Welsh, Jorge Ocampocandiani, Adrian Cuellarbarboza, Karina Paola Suarezsanchez, Estephania De La Cruzvaladez, Luis Gerardo Cruzgomez, Anabel Gallardorocha, Lucio Veracabrera
    Abstract:

    Background Mycetoma is a neglected tropical disease characterized by nodules, scars, abscesses, and fistulae that drain serous or purulent material containing the etiological agent. Mycetoma may be caused by true fungi (eumycetoma) or filamentous aerobic bacteria (Actinomycetoma). Mycetoma is more frequent in the so-called mycetoma belt (latitude 15° south and 30° north around the Tropic of Cancer), especially in Sudan, Nigeria, Somalia, India, Mexico, and Venezuela. The introduction of new antibiotics with fewer side effects, broader susceptibility profiles, and different administration routes has made information on Actinomycetoma treatment and outcomes necessary. The objective of this report was to provide an update on clinical, therapeutic, and outcome data for patients with Actinomycetoma attending a reference center in northeast Mexico. Methodology/principal findings This was a retrospective, cross-sectional, descriptive study of 31 patients (male to female ratio 3.4:1) diagnosed with Actinomycetoma by direct grain examination, histopathology, culture, or serology from January 2009 to September 2018. Most lesions were caused by Nocardia brasiliensis (83.9%) followed by Actinomadura madurae (12.9%) and Actinomadura pelletieri (3.2%). About 50% of patients had bone involvement, and the right leg was the most commonly affected region in 38.7% of cases. Farmers/agriculture workers were most commonly affected, representing 41.9% of patients. The most commonly used treatment regimen was the Welsh regimen (35.5% of cases), a combination of trimethoprim/sulfamethoxazole (TMP/SMX) plus amikacin, which had a 90% cure rate, followed by TMP/SMX plus amoxicillin/clavulanic acid in 19.4% of cases with a cure rate of 100%. In our setting, 28 (90.3%) patients were completely cured and three (9.7%) were lost to follow-up. Four patients required multiple antibiotic regimens due to recurrences and adverse effects. Conclusions/significance In our sample, Actinomycetoma was predominantly caused by N. brasiliensis. Most cases responded well to therapy with a combination of TMP/SMX with amikacin or TMP/SMX and amoxicillin/clavulanic acid. Four patients required multiple antibiotics and intrahospital care.

  • Current Treatment of Mycetoma
    Current Treatment Options in Infectious Diseases, 2018
    Co-Authors: Oliverio Welsh, Jesus Alberto Cardenasde La Garza, Mario Cesar Salinas-carmona, Irene Montserrat Rodriguez-escamilla, Emmanuel Sanchez-meza
    Abstract:

    Purpose of review The purpose of this review is to update the status of treatment of Actinomycetoma and eumycetoma. Specific information is presented to describe the best medical management for uncomplicated and complicated actinomycetic and fungal mycetomas. Recent findings Localized Actinomycetoma that involves the skin without affecting underlying organs is treated with trimethoprim/sulfamethoxazole for 3 to 12 months. In extensive infections with bone or deep organ involvement and in those with no therapeutic response, amikacin can be added. Duration of treatment varies from 5 to 20 weeks and will depend on clinical response, development of adverse effects, and patient comorbidities. Other antibiotics including diaminodiphenylsulfone (DDS), amoxicillin/clavulanic acid, rifampicin, minocycline, moxifloxacin, imipenem, meropenem, and linezolid may be employed in different combinations in selected cases. If available, an antibiogram should guide antimicrobial therapy. Eumycetoma treatment includes itraconazole, voriconazole, posaconazole, and terbinafine. Surgery is indicated depending on disease extension, antifungal clinical response, and localization. Summary Trimethoprim/sulfamethoxazole (TMP/SMZ) is the drug of choice for actynomicetoma but amikacin can be added in complicated cases. When aminoglycosides are contraindicated, other antimicrobials can be employed; surgery is seldom indicated. In eumycetoma, itraconazole is currently the first-line therapy, and terbinafine can be added in complicated cases. Other azoles are unavailable or expensive. Experimental in vitro and in vivo studies with different antimicrobials are currently underway for Actinomycetoma. In eumycetoma, a comparative double-blind randomized study with itraconazole and fosravuconazole along with surgical treatment is being carried out at the Mycetoma Research Center in Khartoum, Sudan. Clinical awareness about mycetoma among physicians will allow a prompt diagnosis and treatment.

  • disseminated Actinomycetoma due to nocardia wallacei
    International Journal of Dermatology, 2018
    Co-Authors: Oliverio Welsh, Mario C Salinascarmona, Barbara A Brownelliott, Terry Smith, Jesus Alberto Cardenasde La Garza, Richard J Wallace
    Abstract:

    BACKGROUND: Actinomycetoma caused by Nocardia usually responds well to antibiotics. Emerging species of Nocardia, such as N. wallacei, can be a therapeutic challenge. AIMS: Confirm the therapeutic effectivity of linezolid in multidrug resistant Nocardia Wallacei Actinomycetoma. MATERIALS AND METHODS: We evaluated the medical management of an 18-year-old man with multidrug resistant Actinomycetoma of the left leg caused by N. transvalensis complex treated 17 years ago with linezolid 1200 mg a day. This bacteria was recently reclassified as Nocardia Wallacei by specific molecular biology technique. RESULTS: The infection was cured after 3 months of treatment; the patient remained asymptomatic for the past 17 years. No adverse effects were found. DISCUSSION: Frequently, strains of N. transvalensis complex have aminoglycoside resistance; in this case, we highlight the effectiveness of linezolid for the successful medical management of multidrug resistant Actinomycetoma. CONCLUSION: Linezolid can be an alternative for the treatment of multidrug resistant Nocardia Wallacei.

  • Actinomycetoma a therapeutic challenge
    Postgraduate Medical Journal, 2018
    Co-Authors: Sylvia Aide Martinezcabriales, Jorge Ocampocandiani, Minerva Gomezflores, Esperanza Welsh, Ana Sofia Ayalacortes, Oliverio Welsh
    Abstract:

    A 34-year-old otherwise healthy male patient developed multiple nodules with a purulent exudate involving 80% of his left thigh and knee after a cactus-thorn injury 13 years' earlier. He received several unspecified treatments with antibiotics without improvement. The patient presented with swelling of the thigh, multiple abscesses and fistulae draining pus (figure 1). Direct examination of the exudate with 20% KOH as well as histopathology revealed a Nocardia sp. grain. Additionally, Nocardia brasiliensis (Nbr) was isolated in culture, and antibodies against Nbr were positive (1.3917 O.D.).1 Unfortunately, antibiotic susceptibility tests …

Mika Tarkka - One of the best experts on this subject based on the ideXlab platform.

  • Diversity and geographic distribution of soil streptomycetes with antagonistic potential against Actinomycetoma-causing Streptomyces sudanensis in Sudan and South Sudan
    BMC Microbiology, 2020
    Co-Authors: Mohamed E Hamid, Thomas Reitz, Martin R. P. Joseph, Kerstin Hommel, Adil Mahgoub, Mogahid M. Elhassan, François Buscot, Mika Tarkka
    Abstract:

    Background Production of antibiotics to inhibit competitors affects soil microbial community composition and contributes to disease suppression. In this work, we characterized whether Streptomyces bacteria, prolific antibiotics producers, inhibit a soil borne human pathogenic microorganism, Streptomyces sudanensis. S. sudanensis represents the major causal agent of Actinomycetoma – a largely under-studied and dreadful subcutaneous disease of humans in the tropics and subtropics. The objective of this study was to evaluate the in vitro S. sudanensis inhibitory potential of soil streptomycetes isolated from different sites in Sudan, including areas with frequent (mycetoma belt) and rare Actinomycetoma cases of illness. Results Using selective media, 173 Streptomyces isolates were recovered from 17 sites representing three ecoregions and different vegetation and ecological subdivisions in Sudan. In total, 115 strains of the 173 (66.5%) displayed antagonism against S. sudanensis with different levels of inhibition. Strains isolated from the South Saharan steppe and woodlands ecoregion (Northern Sudan) exhibited higher inhibitory potential than those strains isolated from the East Sudanian savanna ecoregion located in the south and southeastern Sudan, or the strains isolated from the Sahelian Acacia savanna ecoregion located in central and western Sudan. According to 16S rRNA gene sequence analysis, isolates were predominantly related to Streptomyces werraensis , S. enissocaesilis , S. griseostramineus and S. prasinosporus . Three clusters of isolates were related to strains that have previously been isolated from human and animal Actinomycetoma cases: SD524 ( Streptomyces sp. subclade 6), SD528 ( Streptomyces griseostramineus ) and SD552 ( Streptomyces werraensis ). Conclusion The in vitro inhibitory potential against S. sudanensis was proven for more than half of the soil streptomycetes isolates in this study and this potential may contribute to suppressing the abundance and virulence of S. sudanensis . The streptomycetes isolated from the mycetoma free South Saharan steppe ecoregion show the highest average inhibitory potential. Further analyses suggest that mainly soil properties and rainfall modulate the structure and function of Streptomyces species, including their antagonistic activity against S. sudanensis.

  • diversity and geographic distribution of soil streptomycetes with antagonistic potential against Actinomycetoma causing streptomyces sudanensis in sudan and south sudan
    BMC Microbiology, 2020
    Co-Authors: Mohamed E Hamid, Thomas Reitz, Martin R. P. Joseph, Kerstin Hommel, Adil Mahgoub, Mogahid M. Elhassan, François Buscot, Mika Tarkka
    Abstract:

    Production of antibiotics to inhibit competitors affects soil microbial community composition and contributes to disease suppression. In this work, we characterized whether Streptomyces bacteria, prolific antibiotics producers, inhibit a soil borne human pathogenic microorganism, Streptomyces sudanensis. S. sudanensis represents the major causal agent of Actinomycetoma – a largely under-studied and dreadful subcutaneous disease of humans in the tropics and subtropics. The objective of this study was to evaluate the in vitro S. sudanensis inhibitory potential of soil streptomycetes isolated from different sites in Sudan, including areas with frequent (mycetoma belt) and rare Actinomycetoma cases of illness. Using selective media, 173 Streptomyces isolates were recovered from 17 sites representing three ecoregions and different vegetation and ecological subdivisions in Sudan. In total, 115 strains of the 173 (66.5%) displayed antagonism against S. sudanensis with different levels of inhibition. Strains isolated from the South Saharan steppe and woodlands ecoregion (Northern Sudan) exhibited higher inhibitory potential than those strains isolated from the East Sudanian savanna ecoregion located in the south and southeastern Sudan, or the strains isolated from the Sahelian Acacia savanna ecoregion located in central and western Sudan. According to 16S rRNA gene sequence analysis, isolates were predominantly related to Streptomyces werraensis, S. enissocaesilis, S. griseostramineus and S. prasinosporus. Three clusters of isolates were related to strains that have previously been isolated from human and animal Actinomycetoma cases: SD524 (Streptomyces sp. subclade 6), SD528 (Streptomyces griseostramineus) and SD552 (Streptomyces werraensis). The in vitro inhibitory potential against S. sudanensis was proven for more than half of the soil streptomycetes isolates in this study and this potential may contribute to suppressing the abundance and virulence of S. sudanensis. The streptomycetes isolated from the mycetoma free South Saharan steppe ecoregion show the highest average inhibitory potential. Further analyses suggest that mainly soil properties and rainfall modulate the structure and function of Streptomyces species, including their antagonistic activity against S. sudanensis.

Alexandro Bonifaz - One of the best experts on this subject based on the ideXlab platform.

  • Actinomycetoma by Actinomadura madurae. Clinical and therapeutic characteristics of 18 cases with two treatment modalities.
    Journal of Dermatological Treatment, 2020
    Co-Authors: Alexandro Bonifaz, Andrés Tirado-sánchez, Denisse Vázquez-gonzález, Leonel Fierro-arias, Javier Araiza, Gloria M. González
    Abstract:

    Background. Actinomycetoma due to Actinomadura madurae is susceptible to numerous chemotherapeutic agents, however, the response to those treatments is variable and closely related to several factors.Objective. We aimed to evaluate the clinical-therapeutic characteristics of patients with Actinomycetoma due to Actinomadura madurae with two treatment modalities.Methods. This was a retrospective study of eighteen patients with a diagnosis of Actinomycetoma. The most widely used therapeutic scheme was streptomycin 1g every third day plus TMP/SMX 800mg/160mg/12h, followed by TMP/SMX with DDS 100mg/day. In six patients (33%), ciprofloxacin 500mg every 12h was used instead of DDS.Results: Conventional scheme achieved clinical and mycological cure in 58% of the cases, improvement in 16%, and 25% of the patients failed to treatment; in the cases treated with ciprofloxacin, clinical and microbiological cure was achieved in 83% of patients and clinical improvement in 16%. The treatment time to achieve clinical and mycological did not have a statistically significant difference (median 10 ± 1.38 vs. 12 ± 4.6).Conclusion. Treatment based on streptomycin + TMP/SMX with ciprofloxacin was found to be effective in treating patients with Actinomycetoma, and comparable to the conventional treatment with DDS in Actinomycetoma due to A. madurae with minimal bone involvement.

  • Actinomycetoma by actinomadura madurae clinical and therapeutic characteristics of 18 cases with two treatment modalities
    Journal of Dermatological Treatment, 2020
    Co-Authors: Alexandro Bonifaz, Javier Araiza, Andres Tiradosanchez, Denisse Vazquezgonzalez, Leonel Fierroarias, Gloria M. González
    Abstract:

    Background. Actinomycetoma due to Actinomadura madurae is susceptible to numerous chemotherapeutic agents, however, the response to those treatments is variable and closely related to several facto...

  • Actinomycetoma by nocardia brasiliensis in a girl with down syndrome
    Dermatology Online Journal, 2008
    Co-Authors: Martha Pardo, Alexandro Bonifaz, Javier Araiza, Adriana Valencia, Silvia Anett Mejia, Carlos Menacedillos
    Abstract:

    : We describe the case of a 14-year-old girl with Down syndrome and a large cutaneous plaque localized to the right neck and shoulder that had enlarged over five years after a minor traumatic injury. The plaque was characterized by numerous inflammatory nodules and fistulae that secreted purulent discharge. Nocardia grains were identified and Nocardia brasiliensis was identified by culture. Histopathology examination showed a chronic inflammatory infiltrate with granuloma development. The treatment scheme was with Diaminodiphenylsulfone 50/mg/d and Trimethoprim-Sulfamethoxazole 800/160 mg BID. Therapy was continued over 1(1/2) years, with a tapering dose. After 2(1/2) years of continuous treatment, clinical and microbiological healing was achieved.

  • Actinomycetoma by in a girl with down syndrome
    Dermatology Online Journal, 2008
    Co-Authors: Martha Pardo, Alexandro Bonifaz, Javier Araiza, Adriana Valencia, Silvia Anett Mejia, Carlos Menacedillos
    Abstract:

    Author(s): Pardo, Martha; Bonifaz, Alexandro; Valencia, Adriana; Araiza, Javier; Mejia, Silvia Anett; Mena-Cedillos, Carlos

  • utility of helical computed tomography to evaluate the invasion of Actinomycetoma a report of 21 cases
    British Journal of Dermatology, 2008
    Co-Authors: Alexandro Bonifaz, Amado Saul, A Gonzalezsilva, A Albrandtsalmeron, M Del Carmen Padilla, Maria R Ponce
    Abstract:

    Summary Background  Actinomycetoma is a chronic infection caused by several aerobic actinomycetes; it is a relatively frequent condition in tropical countries like Mexico. It is important to be aware of the extension and depth of the disease (bone and visceral) to make the prognosis and select treatment. Objectives  Our objective was to evaluate Actinomycetomas using helical computed tomography (HCT) as well as its three-dimensional (3D) reconstruction. Material and methods  Prospective study of clinically and microbiologically proven cases of Actinomycetomas, all of them recently diagnosed and untreated or unresponsive to various treatments. All patients underwent simple and contrast HCT with various helical slices of the involved zones. Then three-dimensional reconstructions on the sagittal and coronal planes were made. Results  Twenty-one patients with Actinomycetomas were included, 19 males and two females, with a mean age of 35·5 years and mean duration of disease of 4·1 years. The disease was located in the lower limbs in 81%, and in the upper limbs and trunk in 19%. Twenty of the 21 cases were caused by Nocardia brasiliensis and one by Actinomadura madurae. In all patients the disease was localized to the skin and subcutaneous tissue; 76·2% had muscular involvement; 23·8% visceral involvement; 9·5% had bone involvement and 9·5% vascular involvement. The affected area was determined in each case. Conclusions  HCT provides precise information about the grade of invasion at diverse levels such as visceral, muscular and vascular systems, and the calculation of the affected area.

Lucio Veracabrera - One of the best experts on this subject based on the ideXlab platform.

  • climate soil type and geographic distribution of Actinomycetoma cases in northeast mexico a cross sectional study
    PLOS ONE, 2020
    Co-Authors: Jesus Alberto Cardenasde La Garza, Oliverio Welsh, Jorge Ocampocandiani, Adrian Cuellarbarboza, Karina Paola Suarezsanchez, Estephania De La Cruzvaladez, Luis Gerardo Cruzgomez, Lucio Veracabrera
    Abstract:

    Background Mycetoma is a chronic, granulomatous infection of subcutaneous tissue, that may involve deep structures and bone. It can be caused by bacteria (Actinomycetoma) or fungi (eumycetoma). There is an epidemiological association between mycetoma and the environment, including rainfall, temperature and humidity but there are still many knowledge gaps in the identification of the natural habitat of actinomycetes, their primary reservoir, and their precise geographical distribution. Knowing the potential distribution of this infection and its ecological niche in endemic areas is relevant to determine disease management strategies and etiological agent habitat or reservoirs. Methodology/principal findings This was an ambispective descriptive study of 31 patients with Actinomycetoma. We determined the biophysical characteristics including temperature, precipitation, soil type, vegetation, etiological agents, and mapped Actinomycetoma cases in Northeast Mexico. We identified two disease cluster areas. One in Nuevo Leon, with a predominantly kastanozems soil type, with a mean annual temperature of 22°, and a mean annual precipitation of 585.2 mm. Herein, mycetoma cases were produced by Actinomadura pelletieri, Actinomadura madurae, Nocardia brasiliensis, and Nocardia spp. The second cluster was in San Luis Potosi, where lithosols soil type predominates, with a mean annual temperature of 23.5° and a mean annual precipitation of 635.4 mm. In this area, all the cases were caused by N. brasiliensis. A. madurae cases were identified in rendzinas, kastanozems, vertisols, and lithosols soils, and A. pelletieri cases in xerosols, kastanozems, and rendzinas soils. Previous thorn trauma with Acacia or Prosopis plants was referred by 35.4% of subjects. In these states, the presence of thorny plants, such as Acacia spp., Prosopis spp., Senegalia greggi, Vachellia farnesiana and Vachellia rigidula, are common. Conclusions/significance Mapping this neglected tropical infection aids in the detection of disease cluster areas, the development of public health strategies for early diagnosis and disease prediction models; this paves the way for more ecological niche etiological agent research.

  • clinical characteristics and treatment of Actinomycetoma in northeast mexico a case series
    PLOS Neglected Tropical Diseases, 2020
    Co-Authors: Jesus Alberto Cardenasde La Garza, Oliverio Welsh, Jorge Ocampocandiani, Adrian Cuellarbarboza, Karina Paola Suarezsanchez, Estephania De La Cruzvaladez, Luis Gerardo Cruzgomez, Anabel Gallardorocha, Lucio Veracabrera
    Abstract:

    Background Mycetoma is a neglected tropical disease characterized by nodules, scars, abscesses, and fistulae that drain serous or purulent material containing the etiological agent. Mycetoma may be caused by true fungi (eumycetoma) or filamentous aerobic bacteria (Actinomycetoma). Mycetoma is more frequent in the so-called mycetoma belt (latitude 15° south and 30° north around the Tropic of Cancer), especially in Sudan, Nigeria, Somalia, India, Mexico, and Venezuela. The introduction of new antibiotics with fewer side effects, broader susceptibility profiles, and different administration routes has made information on Actinomycetoma treatment and outcomes necessary. The objective of this report was to provide an update on clinical, therapeutic, and outcome data for patients with Actinomycetoma attending a reference center in northeast Mexico. Methodology/principal findings This was a retrospective, cross-sectional, descriptive study of 31 patients (male to female ratio 3.4:1) diagnosed with Actinomycetoma by direct grain examination, histopathology, culture, or serology from January 2009 to September 2018. Most lesions were caused by Nocardia brasiliensis (83.9%) followed by Actinomadura madurae (12.9%) and Actinomadura pelletieri (3.2%). About 50% of patients had bone involvement, and the right leg was the most commonly affected region in 38.7% of cases. Farmers/agriculture workers were most commonly affected, representing 41.9% of patients. The most commonly used treatment regimen was the Welsh regimen (35.5% of cases), a combination of trimethoprim/sulfamethoxazole (TMP/SMX) plus amikacin, which had a 90% cure rate, followed by TMP/SMX plus amoxicillin/clavulanic acid in 19.4% of cases with a cure rate of 100%. In our setting, 28 (90.3%) patients were completely cured and three (9.7%) were lost to follow-up. Four patients required multiple antibiotic regimens due to recurrences and adverse effects. Conclusions/significance In our sample, Actinomycetoma was predominantly caused by N. brasiliensis. Most cases responded well to therapy with a combination of TMP/SMX with amikacin or TMP/SMX and amoxicillin/clavulanic acid. Four patients required multiple antibiotics and intrahospital care.

  • nocardia brasiliensis cell wall lipids modulate macrophage and dendritic responses that favor development of experimental Actinomycetoma in balb c mice
    Infection and Immunity, 2012
    Co-Authors: Humberto J Trevinovillarreal, Lucio Veracabrera, Pedro L Valeroguillen, Mario C Salinascarmona
    Abstract:

    Nocardia brasiliensis is a Gram-positive facultative intracellular bacterium frequently isolated from human Actinomycetoma. However, the pathogenesis of this infection remains unknown. Here, we used a model of bacterial delipidation with benzine to investigate the role of N. brasiliensis cell wall-associated lipids in experimental Actinomycetoma. Delipidation of N. brasiliensis with benzine resulted in complete abolition of Actinomycetoma without affecting bacterial viability. Chemical analyses revealed that trehalose dimycolate and an unidentified hydrophobic compound were the principal compounds extracted from N. brasiliensiswith benzine. By electron microscopy, the extracted lipids were found to be located in the outermost membrane layer of the N. brasiliensis cell wall. They also appeared to confer acid-fastness. In vitro, the extractable lipids from the N. brasiliensis cell wall induced the production of the proinflammatory cytokines interleukin-1(IL-1), IL-6, and CCL-2 in macrophages. The N. brasiliensis cell wall extractable lipids inhibited important macrophage microbicidal effects, such as tumor necrosis factor alpha (TNF-) and nitric oxide (NO) production, phagocytosis, bacterial killing, and major histocompatibility complex class II (MHCII) expression in response to gamma interferon (IFN-). In dendritic cells (DCs), N. brasiliensis cell wall-associated extractable lipids suppressed MHC-II, CD80, and CD40 expression while inducing tumor growth factor (TGF-) production. Immunization with delipidated N. brasiliensis induced partial protection preventing Actinomycetoma. These findings suggest that N. brasiliensis cell wall-associated lipids are important for Actinomycetoma development by inducing inflammation and modulating the responses of macrophages and DCs to N. brasiliensis.

  • Actinomycetoma and advances in its treatment
    Clinics in Dermatology, 2012
    Co-Authors: Oliverio Welsh, Lucio Veracabrera, Esperanza Welsh, M C Salinas
    Abstract:

    Abstract Actinomycetoma is a chronic subcutaneous infection caused by aerobic branching actinomycetes. Its clinical features are firm tumefaction of the affected site and the presence of abscesses, nodules, and sinuses that drain a seropurulent exudate containing filamenting granules. The disease is caused by inoculation of the infectious agent through minor trauma in susceptible individuals. Nocardia brasiliensis, Actinomadura madurae, and Streptomyces somaliensis are among the most frequent agents in the Americas. Cellular and humoral immunity have been studied in animal models. Standard therapy for uncomplicated cases is sulfamethoxazole-trimethoprim given for many months. Bone involvement, disseminated cases, and special locations require combined treatment with amikacin and sulfamethoxazole-trimethoprim. Isolated reports include the addition of other antibiotics such as rifampicin, imipenem, or meropenem. When needed, other aminoglycosides can be used. Amoxicillin-clavulanic acid is indicated in specific cases as alternative treatment. Oxazolidinone antibiotics, such as linezolid and other similar compounds (DA-7218 and DA-7157), have been studied in experimental infections in animal models as well as in vitro and ex vivo, with encouraging results.

  • evaluation of the combined therapy of da 7218 a new oxazolidinone and trimethoprim sulfamethoxazole in the treatment of experimental Actinomycetoma by nocardia brasiliensis
    Current Drug Delivery, 2010
    Co-Authors: Nelly Alejandra Espinozagonzalez, Oliverio Welsh, Jorge Ocampocandiani, Salvador Saidfernandez, Gerardo Lozanogarza, Sunghak Choi, Lucio Veracabrera
    Abstract:

    Objectives: Currently, for Actinomycetoma, combined antimicrobial therapy is preferred to the use of a single compound. This is in order to provide a broader-spectrum coverage due to a combinatory or synergistic effect between the drugs, and to decrease the possibility of emergence of natural resistant strains. A new oxazolidinone pro-drug, DA-7218 [(R)-3-(4-(2-(2-methyltetrazol-5-yl)-pyridin-5-yl)-3-fluorophenyl)-2-oxo-5-oxazolidinyl) methyl-disodium-phosphate] (recently re-named TR-701), has shown very good in vitro and in vivo activities against several gram-positive bacteria including Nocardia spp. Methods: In the present work we evaluated the effect of DA-7218 at two different doses, alone and combined with trimethoprim/ sulfamethoxazole (SXT), in an experimental Nocardia brasiliensis Actinomycetoma murine model. We also included a negative and a positive control group (linezolid and saline solution respectively). Results: At the end of the treatment period, we observed a clinically and statistically significant difference among the drug receiving groups (combined, alone and linezolid) and the control group (P=0.004). The difference was higher (P= 0.004) between the groups receiving DA-7218 (25mg/kg) alone or combined with SXT, and the control group (saline solution). Conclusions: In this work we proved that DA-7218 alone and combined with SXT is effective in the treatment of experimental Actinomycetoma by Nocardia brasiliensis and that it could be potentially useful in the treatment of human Actinomycetoma.