PMID- 33826630 OWN - NLM STAT- MEDLINE DCOM- 20210729 LR - 20240401 IS - 1935-2735 (Electronic) IS - 1935-2727 (Print) IS - 1935-2727 (Linking) VI - 15 IP - 4 DP - 2021 Apr TI - An update on the occurrence of Paracoccidioides species in the Midwest region, Brazil: Molecular epidemiology, clinical aspects and serological profile of patients from Mato Grosso do Sul State. PG - e0009317 LID - 10.1371/journal.pntd.0009317 [doi] LID - e0009317 AB - BACKGROUND: 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. METHODOLOGY AND MAIN FINDINGS: 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. CONCLUSIONS: 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. FAU - Mattos, Karine AU - Mattos K AUID- ORCID: 0000-0003-1177-2092 AD - Programa de Pos-Graduacao em Doencas Infecciosas e Parasitarias, Faculdade de Medicina, Universidade Federal de Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil. FAU - Cocio, Tiago Alexandre AU - Cocio TA AUID- ORCID: 0000-0002-3306-3118 AD - Departamento de Clinica Medica, Faculdade de Medicina de Ribeirao Preto (FMRP/USP), Universidade de Sao Paulo, Sao Paulo, Ribeirao Preto, Brazil. FAU - Chaves, Edilania Gomes Araujo AU - Chaves EGA AUID- ORCID: 0000-0003-0095-2215 AD - Laboratorio de Biologia Molecular, Instituto de Ciencias Biologicas, Universidade Federal de Goias, Goiania, Goias, Brazil. FAU - Borges, Clayton Luiz AU - Borges CL AUID- ORCID: 0000-0002-9914-8771 AD - Laboratorio de Biologia Molecular, Instituto de Ciencias Biologicas, Universidade Federal de Goias, Goiania, Goias, Brazil. FAU - Venturini, James AU - Venturini J AUID- ORCID: 0000-0003-0035-2439 AD - Programa de Pos-Graduacao em Doencas Infecciosas e Parasitarias, Faculdade de Medicina, Universidade Federal de Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil. FAU - de Carvalho, Lidia Raquel AU - de Carvalho LR AUID- ORCID: 0000-0003-0575-2263 AD - Universidade Estadual Paulista (UNESP), Departamento de Bioestatistica do Instituto de Biociencia de Botucatu, Botucatu, Sao Paulo, Brazil. FAU - Mendes, Rinaldo Poncio AU - Mendes RP AD - Programa de Pos-Graduacao em Doencas Infecciosas e Parasitarias, Faculdade de Medicina, Universidade Federal de Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil. AD - Universidade Estadual Paulista 'Julio Mesquita Filho' (UNESP), Faculdade de Medicina de Botucatu, Sao Paulo, Brazil. FAU - Paniago, Anamaria Mello Miranda AU - Paniago AMM AUID- ORCID: 0000-0002-8925-7712 AD - Programa de Pos-Graduacao em Doencas Infecciosas e Parasitarias, Faculdade de Medicina, Universidade Federal de Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil. FAU - Weber, Simone Schneider AU - Weber SS AUID- ORCID: 0000-0002-4181-142X AD - Laboratorio de Biociencia (LaBio), Faculdade de Ciencias Farmaceuticas, Alimentos e Nutricao, Universidade Federal de Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil. AD - Instituto de Ciencias Exatas e Tecnologia (ICET), Universidade Federal do Amazonas, Itacoatiara, Amazonas, Brazil. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20210407 PL - United States TA - PLoS Negl Trop Dis JT - PLoS neglected tropical diseases JID - 101291488 RN - 0 (Antibodies, Fungal) RN - 0 (Antigens, Fungal) SB - IM MH - Adolescent MH - Adult MH - Antibodies, Fungal/immunology MH - Antigens, Fungal/*immunology MH - Brazil/epidemiology MH - Humans MH - Male MH - Middle Aged MH - Molecular Epidemiology MH - Paracoccidioides/classification/*immunology/isolation & purification MH - Paracoccidioidomycosis/diagnosis/*immunology/*microbiology MH - Polymerase Chain Reaction MH - Polymorphism, Restriction Fragment Length MH - Serotyping MH - Young Adult PMC - PMC8055028 COIS- The authors have declared that no competing interests exist. EDAT- 2021/04/08 06:00 MHDA- 2021/07/30 06:00 PMCR- 2021/04/07 CRDT- 2021/04/07 17:28 PHST- 2020/09/06 00:00 [received] PHST- 2021/03/17 00:00 [accepted] PHST- 2021/04/19 00:00 [revised] PHST- 2021/04/08 06:00 [pubmed] PHST- 2021/07/30 06:00 [medline] PHST- 2021/04/07 17:28 [entrez] PHST- 2021/04/07 00:00 [pmc-release] AID - PNTD-D-20-01595 [pii] AID - 10.1371/journal.pntd.0009317 [doi] PST - epublish SO - PLoS Negl Trop Dis. 2021 Apr 7;15(4):e0009317. doi: 10.1371/journal.pntd.0009317. eCollection 2021 Apr.