Salene Angelini Colombo

Background: Osteoarticular infection is an emerging complication of sporotrichosis, often leading to a significant increase in morbidity and longer treatment. Methods: We conducted a retrospective cohort study of osteoarticular sporotrichosis (OS) in southeastern Brazil (2014–2024) using clinical, epidemiological, and molecular data. Results: Among 252 patients, 20 (7.9%) had OS, including 10 (4%) with osteomyelitis. The median age of patients with OS was 58 years (IQR 39–64; range 18–83) and 55% were male. Hypertension (45%), diabetes (40%), alcohol use (40%), smoking (40%), and HIV infection (15%) were the most frequent conditions identified. Cutaneous lesions occurred in 95% of cases, and 90% of patients presented with arthralgia and edema. Multifocal OS was observed in 50% of cases, most commonly affecting the knees, fingers, and wrists. The mean time to diagnosis was 14.2 months. Most patients were treated with itraconazole combined with amphotericin B; 13 required surgical intervention, including 2 amputations. The mean treatment duration was 21 months. Multisystem involvement due to sporotrichosis was observed in 45% of cases, including pulmonary involvement. Mortality was 15%. Diabetes (OR = 4.11; 95% CI, 1.50–11.38; p = 0.006) was independently associated with OS. Conclusions: OS is associated with substantial morbidity and prolonged treatment. Diabetes may increase the risk of OS, while delayed diagnosis jeopardizes outcomes, underscoring the need for early management.

The sporotrichosis epidemic has significantly impacted public health across Brazil, including Minas Gerais. This study describes the epidemiological evolution of human sporotrichosis during the first six years of mandatory reporting (2018-2023) in the Minas Gerais state. A total of 2,351 confirmed cases were recorded, mostly diagnosed by clinical-epidemiological criteria (68.7%). Cases predominantly affected women (67.2%), individuals of brown ethnic group (47.7%), and those with a median age of 42.5 years. Spatial analysis revealed a consistent territorial expansion, with all mesoregions reporting cases, by 2023; central and southeastern regions were most affected. Incidence rates varied widely (0.46 to 165.51/100,000 people). Most affected municipalities had higher Municipal Human Development Index scores (62%) and were small-sized (44.56%). Our study highlights critical issues related to local social and spatial factors, underscoring the need to develop more effective surveillance and control strategies at both regional and municipal levels.

Brazil currently faces the highest incidence of zoonotic sporotrichosis, primarily linked to interactions with sick cats. However, this article sheds light on an emerging phenomenon: an increasing number of sporotrichosis cases in dogs. The objective of this report is to examine a case of canine sporotrichosis resulting in zoonotic transmission to human. The affected animal displayed a fixed cutaneous manifestation, and its owner became infected through direct contact with the lesion while handling the pet, subsequently developing the lymphocutaneous form. Both the owner and their pet received accurate diagnosis and treatment. Unfortunately, the dog died. The owner underwent antifungal therapy and attained clinical recovery post-treatment. Documenting occurrences of human sporotrichosis consequent to exposure to infected canines alerts doctors and veterinarians about this new disease’s epidemiological dynamics. This particular case, acquired through contact with an infected dog, highlights the increasing zoonotic role for canines in sporotrichosis transmission to humans.

Background: Zoonotic sporotrichosis caused by Sporothrix brasiliensis has become the main subcutaneous mycosis in Brazil. Minas Gerais (MG) is located in southeast Brazil and since 2015 has experienced an epidemic of zoonotic sporotrichosis.Objectives: This study aimed to reconstruct the epidemiological scenario of sporotrichosis from S. brasiliensis in recent epizooty in the Metropolitan Region of Belo Horizonte (MRBH), MG.Methods: A total of 95 Sporothrix spp. isolates (Sporothirx brasiliensis n = 74, S. schenckii n = 11 and S. globosa n = 10) were subjected to Amplified Fragment Length Polymorphism (AFLP) genotyping and mating‐type analysis to determine genetic diversity and population structure. Of these, 46 S. brasiliensis isolates were recovered from animals (cats n = 41 and dogs n = 5) from MRBH.Results: Our study describes the high interspecific differentiation power of AFLP‐based genotyping between the main phylogenetic Sporothrix groups. S. brasiliensis presents high genetic variability and pronounced population structure with geographically focused outbreaks in Brazil. The genetic groups include older genotypes from the prolonged epidemic in Southeast (Rio de Janeiro and São Paulo), South (Rio Grande do Sul), Northeast (Pernambuco) and new genotypes from the MRBH. Furthermore, we provide evidence of heterothallism mating strategy in pathogenic Sporothrix species. Genotypes originating in Rio de Janeiro and Pernambuco carry the predominant MAT1‐2 idiomorph as opposed to genotypes from Rio Grande do Sul, which have the MAT1‐1 idiomorph. We observed an overwhelming occurrence of MAT1‐1 among MRBH isolates.Conclusion: Our study provides clear evidence of the predominance of a genetic group profile circulating in animals in Minas Gerais, independent of that disseminated from Rio de Janeiro. Our data can help us understand the genetic population processes that drive the evolution of this fungus in Minas Gerais and contribute to future mitigation actions for this ongoing epidemic.

Streptococcus agalactiae is a major health concern in tilapia farming worldwide. In contrast to the availability of susceptibility profile results, interpretative criteria for disk diffusion assays and the influence of serotypes on resistance profiles are not available. To address this, sixty isolates (thirty of each serotype, Ib and III) were evaluated using the disk diffusion assay against six antibiotics, and the epidemiological cut-off value (ECV) was calculated. All the isolates were classified as non-wild type (NWT) for sulfamethoxazole (SUT) and norfloxacin (NOR). The inhibition zones for oxytetracycline (OXY) and doxycycline (DOX) were largely distinct; all serotype Ib and III isolates were classified as wild-type (WT) and NWT, respectively. The results for serotype III of fish group B Streptococcus (GBS) were comparable to the NWT tetracycline profile of human GBS available in EUCAST, suggesting the presence of resistance mechanisms in these fish isolates. The calculation of the cut-off wild type (CO_WT) values for OXY and DOX was appropriate for both serotypes. Differences between the distribution of florfenicol (FLO) and amoxicillin (AMO) were found, and we attribute this to the faster growth rate of serotype III, which promotes smaller inhibition zones. Therefore, using separate CO_WT for each serotype is necessary. In conclusion, the serotype of fish GBS affects its susceptibility profile, and it is recommended to use serotype-specific CO_WT values as interpretative criteria for disk diffusion assays against FLO and AMO.

Background: Systemic sporotrichosis occurs when organs, other than subcutaneous tissues and lymph nodes, are infected. Interestingly, systemic sporotrichosis in apparently immunocompetent individuals is increasing in Brazil, but data on clinical manifestations and risk factors are scarce. Most of the existing data on such condition relate to people living with HIV. We aimed to study the risk factors associated with systemic sporotrichosis among HIV‐negative and HIV‐positive patients.Methods: We performed a retrospective cross‐sectional study with 80 patients from Brazil, diagnosed between 2014 and 2021. The association between disease classification, clinical presentation and risk factors were analysed by logistic regression.Results: Of the 80 patients, 29 (36.3%) presented with systemic sporotrichosis. All HIV‐positive patients developed the systemic form, with increased mortality (p = .002). Alcohol ingestion (p = .009) and diabetes (p = .010) were associated with systemic disease. Alcohol ingestion seemed to favour pulmonary infection (p = .013) and, diabetes favoured osteoarticular (p = .009) and ocular involvement (p = .033). The occurrence of fever (p = .001) and weight loss (p = .006) were significantly associated with systemic sporotrichosis, while meningeal involvement (p = .001) increased mortality risk. Nine (11.3%) patients died from sporotrichosis. The presence of fungal structures in the mycological examination of the patients' lesions were associated with the systemic form (p = .017) and death (p = .002).Conclusion: Our study points to the factors that drive systemic sporotrichosis other than HIV, such as alcohol ingestion and diabetes. Considering the high number of patients presenting severe sporotrichosis, the recognising these factors may contribute to timely diagnosis and proper treatment.

Sporotrichosis is a neglected fungal zoonosis with significant impacts on human and animal health. Accurate diagnosis, treatment, and understanding of the transmission dynamics of Sporothrix species are essential for mitigating the spread of sporotrichosis. This study aimed to identify the Sporothrix species involved in the ongoing outbreaks of animal sporotrichosis in the metropolitan region of Belo Horizonte, Minas Gerais, Brazil, and analyse the phylogenetic relationships between pathogenic species to investigate the outbreak origin. Additionally, to better understand the evolution of the disease, we conducted a retrospective survey of positive feline and canine cases from November 2017 to July 2021 with proven cultures for Sporothrix. A significant increase in animal cases over the last 4 years was observed, with cats being the most affected host. Sporothrix brasiliensis was the predominant agent in 100% of the clinical isolates (n = 180) molecularly identified. Phylogenetic and haplotype analysis points towards the cases isolated from Minas Gerais sharing the haplotype originating from a long‐lasting outbreak of cat‐transmitted sporotrichosis in Rio de Janeiro, however, with a secondary contribution from genotypes circulating in other outbreaks in Brazil. Thus, we present clear evidence of the circulation of different S. brasiliensis genotypes associated with animal sporotrichosis in the metropolitan region of Belo Horizonte. Genetic monitoring can contribute to understanding the causal agent for zoonotic sporotrichosis in epidemiological processes and help to implement disease prevention and control measures.

Pigeons are known for their capacity to harbor and spread several zoonotic agents. Studies have suggested that pigeons are also relevant disseminators of multidrug-resistant strains. In this study, pigeons surrounding a veterinary hospital were sampled and tested for the presence of pathogenic Escherichia coli, Salmonella spp., Staphylococcus spp., and Clostridioides (Clostridium) difficile. E. coli isolates from 19 (40.4%) pigeons tested positive for the E. coli heat-stable enterotoxin 1 (EAST1)-encoding gene. The intimin-encoding gene (eae) of enteropathogenicE. coli (EPEC) was found in one isolate (2.1%). Salmonella spp. were found in nine (19.1%) pigeons, all from the first capture event (P < 000.1). S. Typhimurium and S. Heidelberg were isolated from six and three pigeons, respectively. Enterobacterial repetitive intergenic consensus (ERIC-PCR) of the Salmonella spp. isolates suggested that eight of the nine strains had a high genetic similarity, supporting the hypothesis of an outbreak of salmonellosis in these pigeons. Twenty (42.5%) staphylococcal isolates were recovered from 18 (38.3%) pigeons. Eight different species were detected, with S. xylosus being the most frequent. Two (4.3%) C. difficile strains were isolated. Three isolates, one each of S. Typhimurium, S. aureus, and C. difficile, were classified as multidrug-resistant strains. The present research suggested that pigeons residing in urban areas can act as reservoirs and disseminators of pathogenic bacteria, including nosocomial pathogens, such as diarrheagenicE. coli and multidrug-resistant Staphylococcus spp., C. difficile, and Salmonella spp.

Sporotrichosis is a fungal disease that causes symptoms similar to those of other infectious and non-infectious diseases, making diagnosis difficult and challenging. Here, we report a case of an HIV-negative patient presenting disseminated sporotrichosis with widespread cutaneous lesions mimicking pyoderma gangrenosum, with bone marrow infection, pancytopenia, and hemophagocytic syndrome. However, all the clinical manifestations and a bacterial coinfection delayed the request for a fungal diagnosis. Therefore, sporotrichosis should always be investigated in patients from endemic areas presenting with widespread cutaneous lesions associated with pancytopenia.

Although sporotrichosis requires a broad approach for control, few reports have described the relationship between the index case and secondary contacts. In the present work, we report an outbreak involving a woman, a dog, and two cats from the same household environment, including the clinical and epidemiological aspects and outcomes, and discuss the importance of a One Health approach to face this neglected disease. The joint efforts of professionals such as veterinarians and physicians are essential for early diagnosis and surveillance, which contributes to the rapid identification and control of zoonotic sporotrichosis outbreaks.