Mattos Karine, Cocio Tiago Alexandre, Chaves Edilânia Gomes Araújo, Borges Clayton Luiz, Venturini James, de Carvalho Lídia Raquel, Mendes Rinaldo Poncio, Paniago Anamaria Mello Miranda, Weber Simone Schneider
Programa de Pós-Graduação em Doenças Infecciosas e Parasitárias, Faculdade de Medicina, Universidade Federal de Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil.
Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto (FMRP/USP), Universidade de São Paulo, São Paulo, Ribeirão Preto, Brazil.
PLoS Negl Trop Dis. 2021 Apr 7;15(4):e0009317. doi: 10.1371/journal.pntd.0009317. eCollection 2021 Apr.
Paracoccidioidomycosis (PCM) is a systemic and endemic fungal infection in Latin American, mainly in Brazil. The majority of PCM cases occur in large areas in Brazil, comprising the South, Southeast and Midwest regions, with the latter demonstrating a higher incidence of the species Paracoccidioides lutzii.
This study presents clinical, molecular and serological data of thirteen new PCM cases during 2016 to 2019 from the state of Mato Grosso do Sul, located in the Midwest region, Brazil. From these thirteen cases, sixteen clinical isolates were obtained and their genomic DNAs were subjected to genotyping by tub1 -PCR-RFLP. Results showed Paracoccidioides brasiliensis sensu stricto (S1) (11/16; 68.8%), Paracoccidioides restrepiensis (PS3) (4/16; 25.0%) and P. lutzii (1/16; 6.2%) as Paracoccidiodes species. Therefore, in order to understand whether the type of phylogenetic species that are circulating in the state influence the reactivity profile of serological tests, we performed double agar gel immunodiffusion (DID), using exoantigens from genotyped strains found in this series of PCM cases. Overall, our DID tests have been false negative in about 30% of confirmed PCM cases. All patients were male, most with current or previous rural activity, with ages ranging from 17 to 59 years, with 11 patients (84.6%) over 40 years of age. No clinical or epidemiological differences were found between Paracoccidioides species. However, it is important to note that the only case of P. lutzii died as an outcome.
This study suggests P. brasiliensis sensu stricto (S1) as the predominant species, showing its wide geographic distribution in Brazil. Furthermore, our findings revealed, for the first time, the occurrence of P. restrepiensis (PS3) in the state of Mato Grosso do Sul, Brazil. Despite our setbacks, it would be interesting to provide the complete sequencing of these clinical isolates to complement the molecular information presented.
副球孢子菌病（PCM）是拉丁美洲的一种系统性地方性真菌感染，主要发生在巴西。大多数PCM病例发生在巴西的大片地区，包括南部、东南部和中西部地区，后者显示出卢氏副球孢子菌的发病率较高。
本研究展示了2016年至2019年期间来自巴西中西部地区南马托格罗索州的13例新PCM病例的临床、分子和血清学数据。从这13例病例中获得了16株临床分离株，并通过tub1-PCR-RFLP对其基因组DNA进行基因分型。结果显示，巴西副球孢子菌狭义种（S1）（11/16；68.8%）、雷斯垂皮副球孢子菌（PS3）（4/16；25.0%）和卢氏副球孢子菌（1/16；6.2%）为副球孢子菌属物种。因此，为了了解该州流行的系统发育物种类型是否会影响血清学检测的反应谱，我们使用了本系列PCM病例中基因分型菌株的外抗原进行双琼脂凝胶免疫扩散（DID）试验。总体而言，我们的DID试验在约30%的确诊PCM病例中出现假阴性。所有患者均为男性，大多数有当前或既往农村活动史，年龄在17至59岁之间，11名患者（84.6%）年龄超过40岁。在副球孢子菌属物种之间未发现临床或流行病学差异。然而，需要注意的是，唯一一例卢氏副球孢子菌感染病例最终死亡。
本研究表明巴西副球孢子菌狭义种（S1）是主要物种，显示出其在巴西广泛的地理分布。此外，我们的研究结果首次揭示了雷斯垂皮副球孢子菌（PS3）在巴西南马托格罗索州的出现。尽管遇到了挫折，但对这些临床分离株进行全序列测序以补充所呈现的分子信息将是很有意义的。
