Ghannoum Mahmoud A, Mukherjee Pranab K, Warshaw Erin M, Evans Scott, Korman Neil J, Tavakkol Amir
Center for Medical Mycology, University Hospitals of Cleveland and Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106, USA.
Cutis. 2013 May;91(5):237-45.
Dermatophyte infection from the same strains may be an important route for transmission of dermatophytoses within a household. In this study, we used molecular methods to identify dermatophytes in members of dermatophyte-infected households and evaluated variables associated with the spread of infection. Fungal species were identified by polymerase chain reaction (PCR) using primers targeting the internal transcribed spacer (ITS) regions (ITS1 and ITS4). For strain differentiation, fungal DNA was probed with a ribosomal DNA-specific probe (containing ITS1, 5.8S ribosomal DNA, and ITS2) to detect restriction fragment length polymorphisms (RFLPs). Associations between the spread of a dermatophyte infection and fungal/host variables were determined using χ² and logistic regression analyses. Among the 50 households enrolled in this study, 18 included multiple infected members (MIMs). Trichophyton rubrum was the most commonly isolated dermatophyte species, followed by Trichophyton mentagrophyts and Epidermophyton floccosum. Sixteen T rubrum strains (TR-A to TR-P) were identified, with spread of infection detected in 8 MIM households. Factors that were significantly (P<.05) associated with the spread of infection included the presence of strains TR-B or TR-D, a history of concomitant tinea pedis and onychomycosis, and plantar scaling and/or nail discoloration. This study is unique in that it used molecular evidence to demonstrate the association of certain strains with the spread of dermatophyte infection among members of the same household.
同一菌株引起的皮肤癣菌感染可能是家庭内皮肤癣菌病传播的重要途径。在本研究中，我们使用分子方法鉴定皮肤癣菌感染家庭中成员的皮肤癣菌，并评估与感染传播相关的变量。使用靶向内部转录间隔区（ITS）区域（ITS1和ITS4）的引物通过聚合酶链反应（PCR）鉴定真菌种类。为了进行菌株区分，用核糖体DNA特异性探针（包含ITS1、5.8S核糖体DNA和ITS2）探测真菌DNA，以检测限制性片段长度多态性（RFLP）。使用χ²检验和逻辑回归分析确定皮肤癣菌感染传播与真菌/宿主变量之间的关联。在本研究纳入的50个家庭中，18个家庭有多名受感染成员（MIM）。红色毛癣菌是最常分离出的皮肤癣菌种类，其次是须癣毛癣菌和絮状表皮癣菌。鉴定出16株红色毛癣菌菌株（TR-A至TR-P），在8个有多名受感染成员的家庭中检测到感染传播。与感染传播显著相关（P<0.05）的因素包括存在TR-B或TR-D菌株、伴有足癣和甲真菌病的病史，以及足底鳞屑和/或指甲变色。本研究的独特之处在于它使用分子证据证明了某些菌株与同一家庭中成员间皮肤癣菌感染传播的关联。
