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Susan M Abdelrahman - One of the best experts on this subject based on the ideXlab platform.
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the prevalence of infections with Trichophyton Tonsurans in schoolchildren the capitis study
Pediatrics, 2010Co-Authors: Susan M Abdelrahman, Barry Preuett, Eric Schuenemann, Nancy Farrand, Tricia K Stering, Richard Magie, Annette CampbellAbstract:BACKGROUND: Although Trichophyton Tonsurans has become the leading cause of tinea capitis in the United States, reported infection rates vary widely, and prevalence estimates for the pediatric population at large remain poorly characterized. METHODS: A prospective, cross-sectional, surveillance study of children attending kindergarten through fifth grade in 44 schools across the bi-state (Kansas/Missouri), Kansas City metropolitan area was conducted. Fungal cultures were collected from all participants, and molecular analyses were used to characterize the patterns of infection within the population. RESULTS: Of 10514 children (age: 8.3 ± 1.9 years) examined for the presence of T Tonsurans on their scalps, 6.6% exhibited positive cultures. Infection rates at participating schools ranged from 0% to 19.4%, exceeding 30% at a given grade level in some schools. Black children demonstrated the highest rates of infection (12.9%), with prevalence estimates for the youngest members of this racial group approaching 18%. Infection rates for Hispanic (1.6%) and white (1.1%) children were markedly lower. A single genetic strain of T Tonsurans was identified in only 16.6% of classrooms, whereas each child harbored a unique genetic strain in 51.4%. CONCLUSIONS: We report a large-scale, citywide, surveillance study of T Tonsurans infection rates among children in primary school in a metropolitan area. The striking prevalence rates and genetic heterogeneity among the fungal isolates confirm the relatively large degree to which this pathogen has become integrated into metropolitan communities.
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clonal outbreak of Trichophyton Tonsurans tinea capitis gladiatorum among wrestlers in adana turkey
Medical Mycology, 2010Co-Authors: Macit Ilkit, Mehmet Ali Saracli, Hatice Kurdak, Aygul Turacbicer, Tuba Yuksel, Mehmet Karakas, Eric Schuenemann, Susan M AbdelrahmanAbstract:Tinea capitis gladiatorum and tinea corporis gladiatorum caused by the anthropophilic dermatophyte Trichophyton Tonsurans are well-known clinical entities in individuals involved in combat sports e.g., wrestlers and judo practitioners. We present an outbreak of Trichophyton Tonsurans tinea capitis gladiatorum among wrestlers at a boarding school in Adana, Turkey. Fourteen of the 29 wrestlers examined (48.3%) harbored the pathogen, including eight asymptomatic scalp carriers, fi ve with tinea capitis superfi cialis, and one asymptomatic trunk carrier. Dermatophytes were isolated from samples of the neck (1), nape (1), trunk (3) and inguinal area (2) in four of the fi ve tinea capitis cases. A total of fi ve inanimate objects, i.e., two wrestling mats, two pillowcases, and one sheet were also found to be positive for T. Tonsurans . Mixed-marker strain typing examining 24 sequence variations in 12 gene loci confi rmed that the outbreak was caused by a single strain of T. Tonsurans .
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comparative analysis of secreted enzymes between the anthropophilic zoophilic sister species Trichophyton Tonsurans and Trichophyton equinum
Fungal Biology, 2010Co-Authors: Barry Preuett, Susan M Abdelrahman, Eric Schuenemann, Jacob T Brown, Michelle E Kovac, Sandeep K KrishnanAbstract:Trichophyton Tonsurans (TT) and Trichophyton equinum (TE) are two closely related dermatophytes with very different host preferences. This study was designed to examine the genetic and transcript level variations of secreted enzymes between TT and TE. Thirty-one genes representing 10 gene families were selected for comparison and complete genomic and cDNA sequences were elucidated. Sequence analyses of the selected genes identified 104 polymorphisms between the two dermatophytes, 37 of which are expected to encode changes in their polypeptide sequence. Quantitative RT-PCR was used to examine the differences in levels of transcript between TT and TE grown over 14 d in aqueous keratin medium. Differences in transcript expression between TT and TE were gene specific and ranged from 1.1-fold to 33-fold. Intra-specific variability across all genes ranged from 41 % to 250 %. Despite their overall genetic similarity, TT and TE exhibit a moderate degree of variability in the genomic make-up of their secreted enzymes and the extent to which they are transcribed when grown in an aqueous keratin medium. Such differences may contribute to how these genetically similar organisms have adapted to infect divergent host organisms.
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a large outbreak of Trichophyton Tonsurans among health care workers in a pediatric hospital
American Journal of Infection Control, 2009Co-Authors: Jodi Shroba, Susan M Abdelrahman, Barry Preuett, Cindy OlsonburgessAbstract:Background Although Trichophyton Tonsurans remains a major cause of dermataophytoses in US children, nosocomial spread may go unrecognized in health care settings. We describe a staff outbreak of T Tonsurans infection among health care workers in a freestanding pediatric hospital. Methods Epidemiologic evaluation (retrospective and prospective) was performed in the health care providers and ancillary staff assigned to a 27-bed inpatient medical unit in which the suspected outbreak occurred. Results Twenty-one individuals, including staff, a hospital volunteer, and a patient, developed tinea corporis during a 5-month period. All infections coincided with multiple admissions of a 2-year-old suspected index patient who demonstrated persistent infections of the scalp and arm. Fungal isolates obtained from the index patient and affected staff (when available) were subjected to multilocus strain typing, which revealed an identical genetic match between the index case and infected hospital personnel. Conclusion T Tonsurans can spread widely among staff members caring for children with recalcitrant dermatophyte infections. Recognition that workplace transmission may be the etiology of a succession of infections occurring in a single inpatient unit is necessary to limit the number of infected individuals.
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examining Trichophyton Tonsurans genotype and biochemical phenotype as determinants of disease severity in tinea capitis
Medical Mycology, 2008Co-Authors: Susan M Abdelrahman, Nasreen Talib, Ada Solidar, Amy J Nopper, Gerald J WyckoffAbstract:Trichophyton Tonsurans infections occur in various host populations, on various body sites and with varying degrees of inflammation. This investigation was undertaken to determine whether fungal factors could explain the degree of severity in clinical symptomatology among infected children. Otherwise healthy children (n=54) presenting with tinea capitis were enrolled in this study. A thorough history was performed, the extent and severity of infection graded and a fungal specimen collected from each child. Strain type was determined by genotyping for 11 sequence variations in the rDNA and ALP1 loci. Secreted protease activity was quantitated after 5 days of growth in aqueous medium. Forty participants were evaluable. Infection duration ranged from 1 day to 3 years and clinical severity score (CSS) from 4-19. Seventeen unique fungal genotypes were present. Keratinase, collagenase and elastase activity varied 32.7-fold, 64.9-fold and 303.3-fold, respectively. A significant association was observed between genotype and disease severity with the rDNA sequence variations accounting for over 50% of the variation observed in CSS (r2=0.539; P<0.001). Phylogenetic analyses appear to suggest that the ancestral strain types of T. Tonsurans cause more severe disease. These observations are consistent with reports that recently diverge anthropophilies are associated with diminished inflammatory involvement.
Masataro Hiruma - One of the best experts on this subject based on the ideXlab platform.
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onychomycosis of the middle finger of a japanese judo athlete due to Trichophyton Tonsurans
Medical mycology journal, 2019Co-Authors: Masataro Hiruma, Tomotaka Sato, Hirokazu Kitahara, Haruki Honda, Fuminori Katsukawa, Takashi YaguchiAbstract:We present a 17-year-old Japanese male high school student, who had applied steroid ointment for atopic dermatitis, with fingernail onychomycosis due to Trichophyton Tonsurans. He was found positive for T. Tonsurans infection based on hairbrush culture performed due to an epidemic of T. Tonsurans infection in his judo club. The hairbrush culture method is very important in screening for this infection, and dermatologists should examine the entire body of athletes who are found positive using this method. For the diagnosis of T. Tonsurans infection, other than the skin and hair, the nails should also be checked by dermoscopy because the fingernail may be the origin of this fungus.
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mating type gene mat and itraconazole susceptibility of Trichophyton Tonsurans strains isolated in japan
Mycopathologia, 2016Co-Authors: Junichiro Hiruma, Masataro Hiruma, Miki Okubo, Rui Kano, Mai Kumagawa, Atsuhiko Hasegawa, Hiroshi Kamata, Ryoji TsuboiAbstract:Infection by Trichophyton Tonsurans is an emerging fungal epidemic in Japan. Itraconazole (ITZ) and terbinafine have been used for the treatment of this infection for 15 years. However, patients with T. Tonsurans infections have been shown to remain uncured or to become reinfected, suggesting that subclinical infection or polyphyletic strains and/or antifungal drug-resistant strains might be occurring in Japan. In this study, PCR analysis was performed to confirm the presence of the mating type locus MAT in genomic DNA from 60 Japanese clinical isolates of T. Tonsurans, and to assess the previously postulated clonal origin of clinical isolates of this species. Antifungal susceptibility testing on isolates also was performed to confirm the absence of strains resistant to ITZ. PCR analysis proved that all 60 strains contained the MAT1-1 allele, while none contained the MAT1-2 allele. As determined by E-test, the mean MIC of ITZ in the 60 strains was 0.023 mg/L (range 0.002-0.125 mg/L). All strains of T. Tonsurans isolated in Japan were clonal and were not resistant to ITZ. Therefore, dermatophytosis due to T. Tonsurans is expected to respond to ITZ, since clinical isolates of T. Tonsurans tested to date have been susceptible to this antifungal. This infection is proliferating as a subclinical infection in Japan.
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Trichophyton Tonsurans infection in japan epidemiology clinical features diagnosis and infection control
Journal of Dermatology, 2015Co-Authors: Junichiro Hiruma, Yumi Ogawa, Masataro HirumaAbstract:In this review, we summarize the status of Trichophyton Tonsurans infection in Japan in terms of epidemiology, clinical features, diagnosis and infection control. Since approximately 2000, outbreaks of T. Tonsurans infections among combat sports club members have been reported frequently, with the infection then spreading to their friends and family members. The most common clinical features of T. Tonsurans infection are tinea corporis, which is difficult to differentiate from eczema, and tinea capitis. Tinea capitis is classified as the seborrheic form, kerion celsi form or "black dot" form, although 90% or more of patients are asymptomatic carriers. The diagnosis of symptomatic T. Tonsurans infection is established by potassium hydroxide examination and fungal culture. However, because there are many asymptomatic carriers of T. Tonsurans infection, tests using the hairbrush culture method are necessary. An increase in asymptomatic carriers of T. Tonsurans makes assessment of the current prevalence of the infection challenging and underscores the importance of educational efforts and public awareness campaigns to prevent T. Tonsurans epidemics.
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screening examination and treatment of Trichophyton Tonsurans infection in judo athletes affiliated with the university judo federation of tokyo
Mycoses, 2011Co-Authors: Nobuyoshi Hirose, Masataro Hiruma, Morio Suganami, Yumi Shiraki Ogawa, Hideoki OgawaAbstract:In Japan, Trichophyton Tonsurans infection has become an increasing problem among combat sports participants. We investigated the prevalence of T. Tonsurans infection in athletes affiliated to judo clubs in the 21 First Division universities that were registered with the University Judo Federation of Tokyo in 2008. Study procedures performed by the subjects included (i) completion of a questionnaire concerning lifestyle, risk factors for tinea corporis and medical history; (ii) scrubbing the scalp with a circular hairbrush to obtain samples for fungal culture; (iii) anti-fungal treatment as recommended by a dermatologist, based on the number of fungal colonies isolated from the hairbrush; and (iv) repeat testing using the hairbrush method 3 months after treatment recommendations were received. Of 902 study subjects, 102 (11.3%) yielded positive hairbrush culture results. Of these, 14 individuals (13.7%) had tinea corporis; the remainder were asymptomatic. Conversion to negative fungal culture was observed in 85 of 96 culture-positive individuals who performed the second hairbrush culture test following treatment. Control of T. Tonsurans infection among judo athletes could be achieved by educating athletes, trainers and coaches in judo clubs concerning detection, prevention, and treatment of T. Tonsurans infection.
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Divergence Among an International Population of Trichophyton Tonsurans Isolates
Mycopathologia, 2009Co-Authors: Susan M. Abdel-rahman, Masataro Hiruma, Takashi Sugita, Gloria M. González, David Ellis, Michalis Arabatzis, Loranne Vella-zahra, Calude Viguié-vallanet, J. Steven Leeder, Barry PreuettAbstract:Trichophyton Tonsurans is a widely distributed pathogen that demonstrates a significant degree of genetic and phenetic heterogeneity. To date, the degree of genetic relatedness among geographically segregated isolates has not been explored. This investigation evaluates the extent of genetic variation among an international population of T. Tonsurans isolates and examines the relatedness of isolates within and between countries. Molecular strain typing was performed on 198 isolates obtained from 14 countries. A mixed-marker strategy utilizing 27 sequence variations in 13 gene loci was applied to all isolates and cluster analysis was performed to examine the relationship between strains. Phylogenetic analysis was used to corroborate the findings of the cluster analysis with T. equinum strains serving as an out-group. In total, 47 distinct strain types were identified represented by seven clusters and one singleton. There appeared to be a moderate degree of clustering among isolates obtained from North America, Asia and Australia, although European isolates were uniformly distributed among the majority of clusters. The degree of genetic variation observed in this study coupled with the geographic localization would support the argument for allopatric divergence within this species.
Shigaku Ikeda - One of the best experts on this subject based on the ideXlab platform.
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Commonly affected body sites in 92 Japanese combat sports participants with Trichophyton Tonsurans infection.
Mycoses, 2008Co-Authors: Yumi Shiraki, Masataro Hiruma, Nobuyoshi Hirose, Shigaku IkedaAbstract:Summary Outbreaks of Trichophyton Tonsurans infection constitute one of the serious problems among combat sports practitioners in Japan. To facilitate the diagnosis of individuals at risk, we undertook a study to determine which body sites are most commonly infected. We reviewed medical data, hairbrush culture results and questionnaire information from patients with T. Tonsurans infection who were admitted to the dermatology clinic of Juntendo University hospital from 2000 to 2004. The study included 92 patients (87 males), aged 6–38 years (mean age: 18.4 years old). Eighty-nine patients were judo practitioners and three were wrestlers. Twenty-eight patients (30.4%) were asymptomatic carriers. In 64 patients, 51 patients (55.4%) with tinea corporis, 27 patients (29.3%) with tinea capitis, and/or one patient (1.1%) with tinea manuum were seen. Tinea corporis was observed on the forehead, auricles, nape of the neck, bilateral shoulders, left side of the upper chest, both elbows, back of the left hand to the wrist and both knees. Tinea capitis was most common in the occipitonuchal region at the hairline and in the temporal and frontal regions, at both auricles. Initial screening of these sites might facilitate the identification of the infection especially in judo practitioners.
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assessment of the treatment protocol described in the guidelines for Trichophyton Tonsurans infection
Nippon Ishinkin Gakkai Zasshi, 2008Co-Authors: Yumi Shiraki, Masataro Hiruma, Takashi Sugita, Shigaku IkedaAbstract:Background Infection with the anthropophilic fungus Trichophyton Tonsurans has spread among members of combat sports clubs and has become a serious public health problem in Japan and other countries. Infection usually provokes only a weak inflammatory response, and treatment compliance tends to be poor. Objective To evaluate the hairbrush method and the treatment protocol described in the guidelines for T. Tonsurans infection. Method The study subjects were 69 individuals with positive hairbrush culture from among 327 members of 12 judo clubs participating in the survey. (a) Subjects with no more than 4 colonies by the hairbrush method were treated with miconazole nitrate shampoo. (b) Subjects with 5 or more colonies were treated with (1) itraconazole at a dose of 100 mg/day for 6 weeks or at a dose of 400 mg/day for 1 week, or (2) terbinafine at a dose of 125 mg/day for 6 weeks or at a dose of 500 mg/day for 1 week. Treatment efficacy was monitored by the hairbrush method at 1.5 and 3 months after treatment. Results Of the 46 subjects with 5 or more colonies isolated by the hairbrush method, 32 (69.6%) took itraconazole or terbinafine in compliance with their treatment schedules and were negative for T. Tonsurans after treatment. Of the 23 subjects with 4 or fewer colonies, 15 (65.2%) were negative for T. Tonsurans after treatment with miconazole nitrate shampoo. Conclusion The treatment protocol seems promising, but poor compliance is a problem with the oral treatment regimens. The shampoo therapy is only partially effective, with 35% of subjects remaining positive for T. Tonsurans after this therapy. In order to eradicate this disease, we have renewed the guidelines for T. Tonsurans infection.
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cytokine secretion profiles of human keratinocytes during Trichophyton Tonsurans and arthroderma benhamiae infections
Journal of Medical Microbiology, 2006Co-Authors: Yumi Shiraki, Masataro Hiruma, Akemi Nishikawa, Yoshio Ishibashi, Shigaku IkedaAbstract:Dermatophytes cause intractable superficial infections in humans. Arthroderma benhamiae ,a zoophilic dermatophyte, triggers severe inflammatory responses in humans, while Trichophyton Tonsurans, an anthropophilic dermatophyte, triggers minimal ones. Cytokines and other factors derived from keratinocytes play important roles in inflammatory and immune responses in the skin. The authors performed an in vitro investigation to determine the human keratinocyte cytokine profiles during dermatophyte infection. The human keratinocyte cell line PHK16-0b was infected with A. benhamiae or T. Tonsurans for 24 h, and the cytokines secreted were analysed using a human cytokine antibody array. Marked differences were observed in the cytokine profiles of the cells infected with the two dermatophytes. A. benhamiae infection resulted in the secretion of a broad spectrum of cytokines, including proinflammatory cytokines, chemokines, and immunomodulatory cytokines. In contrast, T. Tonsurans-infected keratinocytes secreted only limited cytokines, including eotaxin-2, interleukin (IL)-8 and IL-16. cDNA microarray analysis confirmed that A. benhamiae infection upregulated genes encoding IL-1b, IL-2, IL-4, IL-6, IL-10, IL-13, IL-15, IL-16, IL-17 and interferon (IFN)-c, while T. Tonsurans infection upregulated only a few genes, such as those encoding IL-1b and IL-16. RT-PCR demonstrated that infection by both dermatophytes enhanced IL-8 mRNA expression in keratinocytes. These results suggest that A. benhamiaeinduced secretion of several cytokines from keratinocytes may be involved in a severe inflammatory response, and that the limited cytokine secretion from keratinocytes in response to T. Tonsurans infectionmayresultinaminimalinflammatoryresponseintheskin.Thesecytokineprofilesmayaidin proving the clinical features of dermatophytosis.
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cytokine secretion profiles of human keratinocytes during Trichophyton Tonsurans and arthroderma benhamiae infections
Journal of Medical Microbiology, 2006Co-Authors: Yumi Shiraki, Masataro Hiruma, Akemi Nishikawa, Yoshio Ishibashi, Shigaku IkedaAbstract:Dermatophytes cause intractable superficial infections in humans. Arthroderma benhamiae, a zoophilic dermatophyte, triggers severe inflammatory responses in humans, while Trichophyton Tonsurans, an anthropophilic dermatophyte, triggers minimal ones. Cytokines and other factors derived from keratinocytes play important roles in inflammatory and immune responses in the skin. The authors performed an in vitro investigation to determine the human keratinocyte cytokine profiles during dermatophyte infection. The human keratinocyte cell line PHK16-0b was infected with A. benhamiae or T. Tonsurans for 24 h, and the cytokines secreted were analysed using a human cytokine antibody array. Marked differences were observed in the cytokine profiles of the cells infected with the two dermatophytes. A. benhamiae infection resulted in the secretion of a broad spectrum of cytokines, including proinflammatory cytokines, chemokines, and immunomodulatory cytokines. In contrast, T. Tonsurans-infected keratinocytes secreted only limited cytokines, including eotaxin-2, interleukin (IL)-8 and IL-16. cDNA microarray analysis confirmed that A. benhamiae infection upregulated genes encoding IL-1beta, IL-2, IL-4, IL-6, IL-10, IL-13, IL-15, IL-16, IL-17 and interferon (IFN)-gamma, while T. Tonsurans infection upregulated only a few genes, such as those encoding IL-1beta and IL-16. RT-PCR demonstrated that infection by both dermatophytes enhanced IL-8 mRNA expression in keratinocytes. These results suggest that A. benhamiae-induced secretion of several cytokines from keratinocytes may be involved in a severe inflammatory response, and that the limited cytokine secretion from keratinocytes in response to T. Tonsurans infection may result in a minimal inflammatory response in the skin. These cytokine profiles may aid in proving the clinical features of dermatophytosis.
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a nationwide survey of Trichophyton Tonsurans infection among combat sport club members in japan using a questionnaire form and the hairbrush method
Journal of The American Academy of Dermatology, 2006Co-Authors: Yumi Shiraki, Masataro Hiruma, Nobuyoshi Hirose, Takashi Sugita, Shigaku IkedaAbstract:Background The emerging outbreak of Trichophyton Tonsurans infection among members of combat sports clubs in Japan during the last 4 years has become a serious public health problem. To overcome this outbreak, a survey for T. Tonsurans infection in Japan may be essential. Objectives We sought to clarify the prevalence of T. Tonsurans infection among members of combat sports clubs in Japan. Methods We conducted a survey of members of participating combat sports clubs using a standardized questionnaire to assess background factors and using the hairbrush method to identify T. Tonsurans infection. Statistical significance of the correlation between data from the questionnaire and the hairbrush culture results was determined. Results We surveyed 1000 people (826 male) from 49 institutions and found 115 (11.5%) were positive for T. Tonsurans infection revealed by the hairbrush method. Demographic factors associated with high positive rates (≥20%) of the infection were familial T. Tonsurans infection (20.0%), history of tinea corporis (24.2%), increased dandruff (32.1%), and concomitant tinea corporis (31.6%). Those with positive hairbrush culture results without current or previous tinea were considered asymptomatic carriers. Limitations The study population was limited to members of judo clubs all over Japan; they were asked to participate in this survey via the All Japan Judo Federation. Conclusion Infection of T. Tonsurans appears to have spread widely among members of combat sports club in Japan. The questionnaire used in this study is a simple and useful tool to estimate epidemiology of this infection.
Yumi Shiraki - One of the best experts on this subject based on the ideXlab platform.
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Commonly affected body sites in 92 Japanese combat sports participants with Trichophyton Tonsurans infection.
Mycoses, 2008Co-Authors: Yumi Shiraki, Masataro Hiruma, Nobuyoshi Hirose, Shigaku IkedaAbstract:Summary Outbreaks of Trichophyton Tonsurans infection constitute one of the serious problems among combat sports practitioners in Japan. To facilitate the diagnosis of individuals at risk, we undertook a study to determine which body sites are most commonly infected. We reviewed medical data, hairbrush culture results and questionnaire information from patients with T. Tonsurans infection who were admitted to the dermatology clinic of Juntendo University hospital from 2000 to 2004. The study included 92 patients (87 males), aged 6–38 years (mean age: 18.4 years old). Eighty-nine patients were judo practitioners and three were wrestlers. Twenty-eight patients (30.4%) were asymptomatic carriers. In 64 patients, 51 patients (55.4%) with tinea corporis, 27 patients (29.3%) with tinea capitis, and/or one patient (1.1%) with tinea manuum were seen. Tinea corporis was observed on the forehead, auricles, nape of the neck, bilateral shoulders, left side of the upper chest, both elbows, back of the left hand to the wrist and both knees. Tinea capitis was most common in the occipitonuchal region at the hairline and in the temporal and frontal regions, at both auricles. Initial screening of these sites might facilitate the identification of the infection especially in judo practitioners.
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management and follow up survey of Trichophyton Tonsurans infection in a university judo club
Mycoses, 2008Co-Authors: Nobuyoshi Hirose, Yumi Shiraki, Masataro Hiruma, Morio Suganami, Hideoki OgawaAbstract:The prevalence of Trichophyton Tonsurans infection of the scalp in members of a university judo club (combat sport) was investigated over a 3.5-year period using a questionnaire survey and an assay based on fungal culture by the hairbrush method. In November 2002, 11 (35%) of 31 athletes were found to be positive for T. Tonsurans infection by the hairbrush method and provided treatment with oral and topical antifungal agents according to a prescribed protocol. All the infected subjects became culture-negative following this treatment. We continued to conduct screening examinations every year in the month of April, when new university enrolment occurs. During three-and-a-half years of follow-up, there have been no outbreaks of the infection among the members of the university judo club. There were some positive culture results among the newly enrolled students, but these cases also became culture-negative with treatment. No re-infection has been noted after graduation among the club members who had been educated about and treated for the infection. Our findings indicate that the spread of T. Tonsurans infection in sports clubs can be controlled by regular mass screening examination, therapy and measures at regular intervals to prevent the infection.
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assessment of the treatment protocol described in the guidelines for Trichophyton Tonsurans infection
Nippon Ishinkin Gakkai Zasshi, 2008Co-Authors: Yumi Shiraki, Masataro Hiruma, Takashi Sugita, Shigaku IkedaAbstract:Background Infection with the anthropophilic fungus Trichophyton Tonsurans has spread among members of combat sports clubs and has become a serious public health problem in Japan and other countries. Infection usually provokes only a weak inflammatory response, and treatment compliance tends to be poor. Objective To evaluate the hairbrush method and the treatment protocol described in the guidelines for T. Tonsurans infection. Method The study subjects were 69 individuals with positive hairbrush culture from among 327 members of 12 judo clubs participating in the survey. (a) Subjects with no more than 4 colonies by the hairbrush method were treated with miconazole nitrate shampoo. (b) Subjects with 5 or more colonies were treated with (1) itraconazole at a dose of 100 mg/day for 6 weeks or at a dose of 400 mg/day for 1 week, or (2) terbinafine at a dose of 125 mg/day for 6 weeks or at a dose of 500 mg/day for 1 week. Treatment efficacy was monitored by the hairbrush method at 1.5 and 3 months after treatment. Results Of the 46 subjects with 5 or more colonies isolated by the hairbrush method, 32 (69.6%) took itraconazole or terbinafine in compliance with their treatment schedules and were negative for T. Tonsurans after treatment. Of the 23 subjects with 4 or fewer colonies, 15 (65.2%) were negative for T. Tonsurans after treatment with miconazole nitrate shampoo. Conclusion The treatment protocol seems promising, but poor compliance is a problem with the oral treatment regimens. The shampoo therapy is only partially effective, with 35% of subjects remaining positive for T. Tonsurans after this therapy. In order to eradicate this disease, we have renewed the guidelines for T. Tonsurans infection.
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cytokine secretion profiles of human keratinocytes during Trichophyton Tonsurans and arthroderma benhamiae infections
Journal of Medical Microbiology, 2006Co-Authors: Yumi Shiraki, Masataro Hiruma, Akemi Nishikawa, Yoshio Ishibashi, Shigaku IkedaAbstract:Dermatophytes cause intractable superficial infections in humans. Arthroderma benhamiae ,a zoophilic dermatophyte, triggers severe inflammatory responses in humans, while Trichophyton Tonsurans, an anthropophilic dermatophyte, triggers minimal ones. Cytokines and other factors derived from keratinocytes play important roles in inflammatory and immune responses in the skin. The authors performed an in vitro investigation to determine the human keratinocyte cytokine profiles during dermatophyte infection. The human keratinocyte cell line PHK16-0b was infected with A. benhamiae or T. Tonsurans for 24 h, and the cytokines secreted were analysed using a human cytokine antibody array. Marked differences were observed in the cytokine profiles of the cells infected with the two dermatophytes. A. benhamiae infection resulted in the secretion of a broad spectrum of cytokines, including proinflammatory cytokines, chemokines, and immunomodulatory cytokines. In contrast, T. Tonsurans-infected keratinocytes secreted only limited cytokines, including eotaxin-2, interleukin (IL)-8 and IL-16. cDNA microarray analysis confirmed that A. benhamiae infection upregulated genes encoding IL-1b, IL-2, IL-4, IL-6, IL-10, IL-13, IL-15, IL-16, IL-17 and interferon (IFN)-c, while T. Tonsurans infection upregulated only a few genes, such as those encoding IL-1b and IL-16. RT-PCR demonstrated that infection by both dermatophytes enhanced IL-8 mRNA expression in keratinocytes. These results suggest that A. benhamiaeinduced secretion of several cytokines from keratinocytes may be involved in a severe inflammatory response, and that the limited cytokine secretion from keratinocytes in response to T. Tonsurans infectionmayresultinaminimalinflammatoryresponseintheskin.Thesecytokineprofilesmayaidin proving the clinical features of dermatophytosis.
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real time pcr taqman assay for detecting Trichophyton Tonsurans a causative agent of tinea capitis from hairbrushes
Medical Mycology, 2006Co-Authors: Takashi Sugita, Yumi Shiraki, Masataro HirumaAbstract:Tinea capitis caused by Trichophyton Tonsurans is currently an epidemic in the United States, Europe, and Japan, and the cultivation of this microorganism is necessary for a definitive diagnosis. We recently developed a real-time PCR TaqMan assay as a culture-independent method for the rapid detection of T. Tonsurans from hairbrushes.
Nobuyoshi Hirose - One of the best experts on this subject based on the ideXlab platform.
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screening examination and treatment of Trichophyton Tonsurans infection in judo athletes affiliated with the university judo federation of tokyo
Mycoses, 2011Co-Authors: Nobuyoshi Hirose, Masataro Hiruma, Morio Suganami, Yumi Shiraki Ogawa, Hideoki OgawaAbstract:In Japan, Trichophyton Tonsurans infection has become an increasing problem among combat sports participants. We investigated the prevalence of T. Tonsurans infection in athletes affiliated to judo clubs in the 21 First Division universities that were registered with the University Judo Federation of Tokyo in 2008. Study procedures performed by the subjects included (i) completion of a questionnaire concerning lifestyle, risk factors for tinea corporis and medical history; (ii) scrubbing the scalp with a circular hairbrush to obtain samples for fungal culture; (iii) anti-fungal treatment as recommended by a dermatologist, based on the number of fungal colonies isolated from the hairbrush; and (iv) repeat testing using the hairbrush method 3 months after treatment recommendations were received. Of 902 study subjects, 102 (11.3%) yielded positive hairbrush culture results. Of these, 14 individuals (13.7%) had tinea corporis; the remainder were asymptomatic. Conversion to negative fungal culture was observed in 85 of 96 culture-positive individuals who performed the second hairbrush culture test following treatment. Control of T. Tonsurans infection among judo athletes could be achieved by educating athletes, trainers and coaches in judo clubs concerning detection, prevention, and treatment of T. Tonsurans infection.
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Commonly affected body sites in 92 Japanese combat sports participants with Trichophyton Tonsurans infection.
Mycoses, 2008Co-Authors: Yumi Shiraki, Masataro Hiruma, Nobuyoshi Hirose, Shigaku IkedaAbstract:Summary Outbreaks of Trichophyton Tonsurans infection constitute one of the serious problems among combat sports practitioners in Japan. To facilitate the diagnosis of individuals at risk, we undertook a study to determine which body sites are most commonly infected. We reviewed medical data, hairbrush culture results and questionnaire information from patients with T. Tonsurans infection who were admitted to the dermatology clinic of Juntendo University hospital from 2000 to 2004. The study included 92 patients (87 males), aged 6–38 years (mean age: 18.4 years old). Eighty-nine patients were judo practitioners and three were wrestlers. Twenty-eight patients (30.4%) were asymptomatic carriers. In 64 patients, 51 patients (55.4%) with tinea corporis, 27 patients (29.3%) with tinea capitis, and/or one patient (1.1%) with tinea manuum were seen. Tinea corporis was observed on the forehead, auricles, nape of the neck, bilateral shoulders, left side of the upper chest, both elbows, back of the left hand to the wrist and both knees. Tinea capitis was most common in the occipitonuchal region at the hairline and in the temporal and frontal regions, at both auricles. Initial screening of these sites might facilitate the identification of the infection especially in judo practitioners.
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management and follow up survey of Trichophyton Tonsurans infection in a university judo club
Mycoses, 2008Co-Authors: Nobuyoshi Hirose, Yumi Shiraki, Masataro Hiruma, Morio Suganami, Hideoki OgawaAbstract:The prevalence of Trichophyton Tonsurans infection of the scalp in members of a university judo club (combat sport) was investigated over a 3.5-year period using a questionnaire survey and an assay based on fungal culture by the hairbrush method. In November 2002, 11 (35%) of 31 athletes were found to be positive for T. Tonsurans infection by the hairbrush method and provided treatment with oral and topical antifungal agents according to a prescribed protocol. All the infected subjects became culture-negative following this treatment. We continued to conduct screening examinations every year in the month of April, when new university enrolment occurs. During three-and-a-half years of follow-up, there have been no outbreaks of the infection among the members of the university judo club. There were some positive culture results among the newly enrolled students, but these cases also became culture-negative with treatment. No re-infection has been noted after graduation among the club members who had been educated about and treated for the infection. Our findings indicate that the spread of T. Tonsurans infection in sports clubs can be controlled by regular mass screening examination, therapy and measures at regular intervals to prevent the infection.
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a nationwide survey of Trichophyton Tonsurans infection among combat sport club members in japan using a questionnaire form and the hairbrush method
Journal of The American Academy of Dermatology, 2006Co-Authors: Yumi Shiraki, Masataro Hiruma, Nobuyoshi Hirose, Takashi Sugita, Shigaku IkedaAbstract:Background The emerging outbreak of Trichophyton Tonsurans infection among members of combat sports clubs in Japan during the last 4 years has become a serious public health problem. To overcome this outbreak, a survey for T. Tonsurans infection in Japan may be essential. Objectives We sought to clarify the prevalence of T. Tonsurans infection among members of combat sports clubs in Japan. Methods We conducted a survey of members of participating combat sports clubs using a standardized questionnaire to assess background factors and using the hairbrush method to identify T. Tonsurans infection. Statistical significance of the correlation between data from the questionnaire and the hairbrush culture results was determined. Results We surveyed 1000 people (826 male) from 49 institutions and found 115 (11.5%) were positive for T. Tonsurans infection revealed by the hairbrush method. Demographic factors associated with high positive rates (≥20%) of the infection were familial T. Tonsurans infection (20.0%), history of tinea corporis (24.2%), increased dandruff (32.1%), and concomitant tinea corporis (31.6%). Those with positive hairbrush culture results without current or previous tinea were considered asymptomatic carriers. Limitations The study population was limited to members of judo clubs all over Japan; they were asked to participate in this survey via the All Japan Judo Federation. Conclusion Infection of T. Tonsurans appears to have spread widely among members of combat sports club in Japan. The questionnaire used in this study is a simple and useful tool to estimate epidemiology of this infection.
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an investigation of Trichophyton Tonsurans infection in university students participating in sports clubs
Nippon Ishinkin Gakkai Zasshi, 2005Co-Authors: Nobuyoshi Hirose, Yumi Shiraki, Masataro Hiruma, Hideoki OgawaAbstract:Trichophyton Tonsurans感染症は,日本において格闘競技選手を中心に急増している.この感染症の拡大を阻止するためには,格闘競技選手をとりまく他競技選手の感染拡大状況を調べることが極めて重要である.対象と方法:某スポーツ系大学運動部学生497名を対象として,調査用紙とhairbrush法による頭髪の白癬菌保有の有無を調査した.結果:(1)柔道部学生31名は,当初11名(35%),hairbrush法で本菌陽性であった.本群は1.5年間に9回にわたる集団検診と陽性者の抗真菌剤治療を行い,日常の感染予防指導を受けながら多くの試合や合同練習を継続していたが,全員がhairbrush法で陰性化し,体部白癬の発生は消失した.(2)他競技学生466名のうち138名は2003年度1回/週の柔道実技授業を受講しており,185名は同施設内での寮生活を行っている.他競技学生については白癬を疑わせる皮疹の発生を申告した者はなく,hairbrush法も全員陰性であった.今回の調査より,日本におけるTrichophyton Tonsurans感染症の拡大の現状は,対人格闘技を運動特性とする競技種目が中心であり,本感染症について充分に啓蒙された集団では,トレーニングを継続しながらの治療で,感染拡大を阻止できることが示唆された.
