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Microsporum canis and other dermatophytes isolated from humans, dogs and cats in mexico city

Authors:
  • Centro Dermatológico de Yucatán
Research Article
Global Dermatology
ISSN: 2056-7863
Glob Dermatol, 2016 doi: 10.15761/GOD.1000173 Volume 3(2): 275-278
Microsporum canis and other dermatophytes isolated from
humans, dogs and cats in mexico city
Torres–Guerrero E1, González de Cossío AC1, Segundo ZC2, Cervantes ORA3, Ruiz- Esmenjaud J1 and Arenas R1
1Sección de Micología. Hospital “Dr. Manuel Gea González”, Ciudad de México, México
2Laboratorio de Micología Veterinaria, Unidad de Servicios de Diagnóstico y Constatación del Centro de Enseñanza, Investigación y Extensión en Producción
Animal en Altiplano. FMVZ.UNAM, México
3Laboratorio de Micología del Depto. de Microbiología e Inmunología de la FMVZ. UNAM. México
Abstract
Introduction: Tineas or ringworm are infections caused by dermatophytes, a group of keratinophilic fungi.
According to origin and tropism can be classied as anthropophilics, zoophilics and geophilics.
Objectives: To obtain current data in zoophilic dermatophytes in humans and animals in Mexico City.
Material and methods: We performed an observational, descriptive and retrospective study, in two dierent Departments of Mycology. In a General Hospital we
studied dermatophytic infections in 8,684 patients, (human cases), and in 480 animals (377 dogs and 103 cats) at the Faculty of Medical Veterinary, University of
Mexico.
Results: 57 of the 8,684 human patients (0.65%), had zoophilic dermatophytes: M. canis 43 (75.5%), T. mentagrophytes var. mentagrophytes 13 (22.9%) and M. nanum
1 (1.6%); 40.8% were men and 59.2% females.
At the Veterinary Faculty, 377 samples from dogs and 103 from cats were studied, with 33 (8.73 %) and 36 (34.95%) positive cultures respectively. In dogs M. canis
72.70% Trichophytonterrestre 12.15%, M. gypseum 9.10% and T. mentagrophytes 6.10%, and in cats only M. canis was isolated.
Conclusions: In humans and in animals M. canis is still the main causal zoophilic agent. In children tineacapitis is the most frequent dermatopytosis.Tineacorporis
is the second one, and usually related to close contact with infected pets.
Introduction
Tineas or ringworm are infections caused by keratinophilic fungi
called dermatophytes that can also invade the skin and its appendages
[1]. ere are three anamorphic genders: Trichophyton, Epidermophyton
and Microsporum, none of which form part of the cutaneous ora. ey
can be classied according to its origin and tropism in anthropophilics,
zoophilics and geophilics. ese infections constitute 70 to 80% of all
the mycoses and represent 5% of the dermatological consults [2,3].
Infection is by direct contact with the causal agent and it can appear
in any race, sex, socioeconomic level or occupation [3]. e animals act
as reservoirs and can be symptomatic or just be carriers.
Among the zoophilic dermatophytes, Microsporumcanis and
Trichophytonmentagrophytes, are of main medical relevance in Mexico.
e tineas are frequent in domestic and savage animals; they are
found in bovine, pigs and equine as well as in poultry, the most aected
ones, are the small species, such as dogs, cats and rodents. To acquire
infection, a direct contact with the contaminated source is needed, soil
or animal or it can also be transmitted from person to person or by
fomites [3].
Our aim is to obtain the current frequency of the zoophilic dermatophytes
in samples collected from patients and animals with a clinical diagnosis of tinea
in a general hospital and in a veterinary clinic res pective ly.
Material and methods
We performed an observational, descriptive and retrospective
study, in two departments of mycology, at “Dr. Manuel Gea
Gonzalez” General Hospital, and at the Faculty of Medical Veterinary,
Autonomous National University of Mexico (UNAM).
During a 10 year-period, a mycological study was performed,
in 8684 patients with cutaneous lesions suggestive of tinea in the
hospital and in the same period, 480 animals at the Faculty of Medical
Veterinary, 377 dogs and 103 cats with suspected dermatophytes. All
of them were included.
A direct exam with 20% potassium hydroxyde (KOH) and a culture
in Sabouraud dextrose agar with cycloheximide and chloramphenicol
at 30°C were performed in samples from humans and animals.
Identication was performed based in the morphologic criteria by the
microscopic observation with lactophenol cotton blue.
Correspondence to: Dr. Roberto Arenas. Sección de Micología. División de Investigación.
Hospital “Dr. Manuel Gea González”. Calzada de Tlalpan 4800, Colonia “Belisario
Domínguez, sección XVI”, Ciudad de México C.P. 14080. E-mail: rarenas98@hotmail.com
Received: March 01, 2016; Accepted: March 31, 2016; Published: April 04, 2016
Torres–Guerrero E (2016) Microsporum canis and other dermatophytes isolated from humans, dogs and cats in mexico city
Glob Dermatol, 2016 doi: 10.15761/GOD.1000173 Volume 3(2): 275-278
Results
From the 8,684 human patients, zoophilic dermatophytes
were isolated only in 57(0.65%) patients: M. canis 43 (75.5%), T.
mentagrophytes (0.65%) var. mentagrophytes 13 (22.9%)and M.
nanum1 (1.6%) (Graph 1), 40.8% were men and 59.2% females.
e most aected age groups were 0 to 10 (46.89%); and the group
21 to 30 (12.5%) (Graph 2). Clinical features are shown in Graph 3.
At the Veterinary Faculty, 480 samples from dogs and cats
were studied: 377 from dogs and 103 from cats, with 33 (8.73%)
and 36 (34.95%) positive cultures respectively. In dogs M. canis
(72.70%), TrJichophytonterrestre (12.15%), M. gypseum (9.10%)
and T. mentagrophytes (6.10%), were isolated, while in cats the only
dermatophyte was M. canis (Graph 1).
Discussion
According with 4th National Consensus of Supercial Mycoses
in Mexico (2008), 70 to 80% of mycoses in outpatients were caused
by dermatophytes [4]: 2% tineamannus, 4% tineacruris, 4-10%
tineacapitis, 15% tineacorporis, 30% tineaungium and 45% tineapedis
[4]. ese data are considered on the basis of a general population, but
only tineacapitis is almost always present just in children. [5]
In the current study, the majority of the cases in humans correspond
to tineacapitis (46.89%) followed by tineacorporis (27.86%) because
the highest percentage of patients was found from 0-10 years of age
(46.89%).is data is congruent, as tineacapitis was the most frequent
aected was the pediatric group, with an exceptional case in a 97 year-
old female [5].
M. canis was the most frequent dermatophyte. It is present in
4.1% among general statistics and is the causal agent in 60 to 89%
of tineacapitis in Mexican children [3,6]. e contact with domestic
animals represents the main source of infection in up to 83%. [3,6]
Similar results by Monteagudo [7], aer his study conducted in
Santiago de Compostela with 196 cases of tineacapitis, observed M.
canis in 70-95%, and T. mentagrophytes var. mentagrophytes in 14.8%,
and a low frequency of other non-zoophilic species. ese data are
dierent from USA reports, where the main causal agent of tineacapitis
is T. tonsurans (90%), the increase incidence of this agent is related
to migrations of Afro-Americans and Latin American [3,8]. Also in
Madrid, T. tonsurans’ incidence has increased in the last years, and M
canis is now in the second place. In Puerto Rico about two thirds of
tineacapitis are caused by T. tonsurans and the other third by M. canis
[9].
In Jordan aer conducting a 6 years epidemiological study, Shagra
[10] found T. violaceum as the main causal agent in tineacapitis, and in
second place, M. canis. Mseddi and Makni in Tunez, separately reported
83 and 68% tineacapitis caused by T. violaceum, and M. canis in 29.2%
[11,12]. Also Ouidaina, in Morocco, aer nishing a study with 1299
patients from 1993 to 2007, identied 76.4% of tineacapitis due to
T. mentagrophytes, while M. canis 13.4% [13]. In the same country,
Boumhil, studied 162 patients from 2002 to 2008, nding 63.58% of
infections due to T. violaceum and 33.33% to M. canis [14]. Arenas et
al., reported in an epidemiological study conducted in the urban and
rural zones of Dominican Republic, a resurging of M. audouinii and T.
tonsurans respectively, probably due to the migratory movements from
Haiti, while M. canis was found in 19.04% and 11.65% respectively [15].
Tineacorporis, ranked second in frequency of the clinical forms
observed in our study (27.86%). According to the National Consensus
of Supercial Mycoses [4], T. rubrum was the main causal agent,
followed by M. canis, however it must be considered that tineacorporis
caused by M. canis is more typical of pediatric patients, as we are
reporting in this paper. In a retrospective study in Mexico 357 cases
oineacorporis were reported in 21 years, and M. canis was found in
16.7% [16]. Meanwhile, Cafarchia et al. [17], in 2005, performed in
Bari, Italy, a dermatophitic search in dogs and cats, which owner had
or had not tinea and found M. canis in 53.6% of cats and 36.4% in dogs
whose owners had tinea, and in only 14.6% of cats and non in the dogs
which owners did not have tinea, concluding that one must be aware
that the animals are a source of infection.
0
5
10
15
20
25
30
35
40
45
50
Humanos
Perros
Gatos
Zoophilic dermatophyes isolated from humans, dogs and cats.
Graph 1. Zoophilic dermatophytes isolated from humans, dogs and cats.
46.8 %
6.2
12.5 %
9.5 % 9.5 %
6.2 %
9.5 %
0
5
10
15
20
25
30
35
40
45
50
0 - 10
11-20
21 - 30
51 - 60
más de 61
Frequency of dermatophytoses in each age group
Graph 2. Frequency of dermatohytoses according to age group.
46.89%
27.86%
9.50%
9.50%
6.25%
Tinea capis
Tinea corporis
Onicomicosis
Afección en cara
Tinea pedis
Clinical forms of tinea caused by zoophilic dermatophytes
Graph 3. Clinical human dermatophytic infections caused by zoophylic dermatophytes.
Torres–Guerrero E (2016) Microsporum canis and other dermatophytes isolated from humans, dogs and cats in mexico city
Glob Dermatol, 2016 doi: 10.15761/GOD.1000173 Volume 3(2): 275-278
Concerning tineafaciei (20% of tineacorporis) and onychomycosis,
in this study each one was present in 9.5%. In Italy, Monod performed a
study of facial tinea caused by M. canis, reporting 91.3% of the children
infected by their pets. [18] According to Romano et al., the medium
age in tineafaciei is close to 27 years of age, while in Aste et al., paper, it
is more common between 36 and 45 years of age. [19] Our facial cases
were found in the age group of 20 to 50 years.
We found a lower frequency of M. canis in other dermatophytic
infections, 9.5% in onychomycoses and 6.25% in tineapedis.
Kazemi, in Iran, studied 590 patients from 1996 till 2004, found
zoophiticdermatophytes such as T. mentagrophytes and M. canis,
with a frequency of 65.5% of cases with onychomycosis; Sei in Japan,
identied M. canis in just 5 cases in 36,052 ambulatory patients. In
feet and nails, M. canis is uncommon but Trichophyton sppare more
contagious and responsible of outbreaks in endemic countries, and
zoophilic fungi are just related to small familiar epidemics [20-22].
From the veterinary point of view, Microsporumcanis is the
most common dermatophyte in pets [18]. Worldwide 90-100% of
dermatophytoses in cats are caused by M. canis [23] and usually its
isolation in asymptomatic animals indicates subclinical infection or
carrier [24].
In the laboratory of the faculty of veterinary medicine at the
UNAM, 100% of M. canis was reported in the hair of cats and 72.70%
in dogs, similar to Lorio in Italy, who showed that the stray cats are an
important source of dermatomycosis, because he isolated fungi in 100%
of the hair samples [25]. Boumhil in Moroco reported that 56.7% of the
cases with tineacapitis have been originated from direct contact with
animals [14]. Cafarchia in Italy and Seker in Turkey [26,27], described
that in animals one of the main risks to acquire dematophytoses was
the age. Moriello, found that cats with the immunodeciency Felline
virus, the dermatophytosis are three times more prevalent [28].
In this study M. gypseum was isolated in a 9.10% of dogs’ samples,
which diers from the reported percentage by Álvarez et al., in
Colombia, who isolated M. gypseum in 55.9% in stray dogs and owned
dogs in a study in 2001 [29]; Madrid et al., in Brazil, from 7 dogs, 20
day-old, M gypseum was isolated [30].
e isolation of M. gypseum in animals, occurs less frequently and
its presence is in general attributed to its geophilic character, besides
external and internal factors that can alter the normal microbiota of
normal animal’s skin and this way the infection process is favor, as has
been proven in previous studies by Levy et al.. ose who determined
the presence of dermatophytes in the hair of cats in cautivity, found
M. gypseum in 1.6% of animals and they attributed this nding to the
humid conditions, pH and fecal contamination of the place where they
are housed [31].
As mentioned before T. mentagrophytes, is isolated in dierent
inammatory entities in the head and nails, but in animals this
dermatophyte was isolated just in dogs (6.10%). is dermatophyte
has been reported in rodents and less frequently in dogs and other
mammals. Murmu et al. in a previous study isolated in 16.7% from
dogs’ hair, skin and nails with suggestive lesions of dematophytoses
[32]. In India Gangil et al., isolated T. mentagrophytes in 18.3% from
dogs with skin lesions [33], while in Baghdad, Jasim isolated 30.95%
in dogs, from samples taken from various body sites [34].ese data
contrast with our ndings as we found a lower frequency that the
previously cited authors, but this nding becomes relevant as it can be
a source of infection or re-infection in human and animals, so better
hygienic conditions are recommended to dogs´ owners as well as in
places where animals are too close to each other (aesthetic canines and
veterinary clinics).
T. terrestre was isolated just in dogs (12.15%), similar to M.
gypseum, though its presence can be attributed to its geophilic
character, but dierent form the last one, it is considered as a causal
agent of dematophytoses in animals. T. terrestre doesnot count with
conclusive evidence to conrm its role in dematophytoses in dogs,
attributing their presence to the rather natural behavior of the animal,
as when they smell, their snout is in direct contact with the soil, the
source of dermatophyte infection [35].
Conclusions
M. canis is the most frequent zoophilic dermatophyte isolated
from humans and animals. It is still the main causal dermatophyte for
tineacapitis in children and tineacorporis in young adults. is group is
the most frequently aected, because aerward in puberty long-chain
fat acids are in the scalp and have a protective role.
Also, children are more oen in direct contact with pets. Infections
may be related with poor hygiene especially when animals are too close
to each other (esthetics and veterinary clinics) and can become a focus
of infection. Zoophilic or geophilicdermatophytes could also be the
cause of family epidemics.
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