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Tonani, L. Clinical isolates susceptibility profile characterization Neoscytalidium dimidiatum and N. dimidiatum var. hyalinum to photosensitizers and antifungals. 2015. 137 f. Dissertation (Master). Faculdade de Medicina de Ribeirão Preto – Universidade de São Paulo, Ribeirão Preto, 2015. Neoscytalidium sp. is increasingly being associated with superficial and deep infections in immunocompromised and immunocompetent patients. The filamentous fungus Neoscytalidium dimidiatum is a saprophytic and plant pathogenic microorganism that is found in soil and vegetation of tropical and subtropical regions. N. dimidiatum var. hyalinum and N. dimidiatum are involved in superficial skin and nail infections. The melanin producer N. dimidiatum is preferably associated with deep infections suggesting that the clinical isolate without melanin, N. dimidiatum var. hyalinum, may be less virulent than the pigmented variety. Little is described in the literature regarding the varieties N. dimidiatum and N. dimidiatum var. hyalinum about the sensitivity to antifungal drugs and photodynamic antimicrobial chemotherapy (PACT), and the physiological characteristics related to the growth at different temperature and pH. Therefore, the present study aimed to investigate clinical isolates of N. dimidiatum and N. dimidiatum var. hyalinum obtained from skin and nail infections. Here in this study were performed the molecular identification, multilocus phylogeny, the in vitro characterization of development at different temperatures and pHs, and the characterization of in vitro susceptibility to antifungal agents and PACT with phenotiazinium photosensitizers (PSs), as well the PACT effects on the biomolecules of the Neoscytalidium spp. arthroconidia. The multilocus phylogeny was performed by sequencing seven different loci where polymorphism were identified in the Internal Transcribed Spacer (ITS) 1 region of rDNA and in the genes β-tubulin (TUB), elongation factor 1α (EF1) and Histone H3 (HH3). The grouping of the clinical isolates from this study in different genotypes allowed the clustering in 6 sequence types (ST), in which the ST5 was composed exclusively by all N dimidiatum var. hyalinum isolates from this study. The analysis of development at different temperatures and pHs showed a reduced colony size for all N. dimidiatum var. hyalinum isolates. Amphotericin B, voriconazole and terbinafine were the most effective antifungal for both varieties. The minimal inhibitory concentrations (MICs) values found for the azoles derivatives were low for all N. dimidiatum var. hyalinum isolates. N. dimidiatum clinical isolates have shown to be less sensitive to PACT with the PS methylene blue (MB), new methylene blue (NMBN), toluidine blue O (TBO) and new synthetic derivative (S137) when compared to hyaline variety. NMBN and S137 have shown more effectiveness for the inactivation of Neoscytalidium spp. Additionally, all PS in PACT have caused plasma membrane permeability, although only NMBN and S137 showed the production of malondialdehyde (MDA), i.e., caused lipid peroxidation in both N. dimidiatum and hyaline variety.

Caracterização do perfil de susceptibilidade de isolados clínicos de &lt;i&gt;Neoscytalidium dimidiatum&lt;/i&gt; e &lt;i&gt;N. dimidiatum&lt;/i&gt; var. &lt;i&gt;hyalinum&lt;/i&gt; aos antifúngicos e a fotossensibilizadores