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监测猫皮肤病变中 spp. 的真菌负荷和活力以预测抗真菌治疗反应。

Monitoring Fungal Burden and Viability of spp. in Skin Lesions of Cats for Predicting Antifungal Treatment Response.

作者信息

de Miranda Luisa Helena Monteiro, Silva Jéssica Nunes, Gremião Isabella Dib Ferreira, Menezes Rodrigo Caldas, Almeida-Paes Rodrigo, Dos Reis Érica Guerino, de Oliveira Raquel de Vasconcellos Carvalhaes, de Araujo Danuza Salles do Amaral, Ferreiro Laerte, Pereira Sandro Antonio

机构信息

Laboratório de Pesquisa Clínica em Dermatozoonoses em Animais Domésticos, Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro 21040-360, Brazil.

Laboratório de Micologia, Faculdade de Veterinária, Universidade Federal do Rio Grande do Sul, Porto Alegre 91540-000, Brazil.

出版信息

J Fungi (Basel). 2018 Aug 7;4(3):92. doi: 10.3390/jof4030092.

Abstract

Skin lesions in feline sporotrichosis usually present a high fungal burden, making cats an important source of infection. This study evaluated the fungal burden and isolation in skin lesions of feline sporotrichosis during treatment with itraconazole (ITZ), combined with or without potassium iodide (KI). Treatment-naïve cats with culture-confirmed sporotrichosis and presenting skin ulcers were treated for up to 40 weeks with oral ITZ alone ( = 74) or combined with KI ( = 56). These cats were submitted to monthly sampling of the same lesion for mycological culture and cytopathology until healing of lesion or up to twelve weeks. The fungal burden was expressed as the mean yeast cell count in three microscopic fields from imprint smears. The fungal burden before treatment was significantly higher in cats in which the lesion persisted and in cases of treatment failure when using ITZ alone. After twelve weeks, the median fungal burden decreased to zero in both treatment protocols, suggesting a potential decrease in the risk of transmission of spp. from cats. These findings encourage the early treatment of feline sporotrichosis as a control measure. Moreover, the fungal burden in feline sporotrichosis lesions can be a prognostic indicator and a parameter for choosing appropriate therapeutic regimen.

摘要

猫孢子丝菌病的皮肤病变通常真菌负荷较高,使猫成为重要的感染源。本研究评估了在使用伊曲康唑(ITZ)治疗猫孢子丝菌病皮肤病变期间,联合或不联合碘化钾(KI)时的真菌负荷及分离情况。对未经治疗、经培养确诊为孢子丝菌病且有皮肤溃疡的猫,单独口服ITZ(n = 74)或联合KI(n = 56)治疗长达40周。这些猫每月对同一病变进行采样,用于真菌培养和细胞病理学检查,直至病变愈合或长达12周。真菌负荷以印片涂片三个显微镜视野中的酵母细胞平均计数表示。在病变持续的猫以及单独使用ITZ治疗失败的病例中,治疗前的真菌负荷显著更高。12周后,两种治疗方案中的真菌负荷中位数均降至零,提示猫传播申克孢子丝菌的风险可能降低。这些发现鼓励将猫孢子丝菌病的早期治疗作为一种控制措施。此外,猫孢子丝菌病病变中的真菌负荷可以作为一个预后指标以及选择合适治疗方案的参数。

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