P138 A decade of cat-transmitted sporotrichosis (CTS) in a tertiary hospital from Curitiba, southern Brazil (2011-21)
Authors: Cognialli Regielly , Daros Fernanda , Ferreira Diésica , Gabriel Adriana , Lopuch Lili , Cavassin Francelise , Lustosa Bruno , Vicente Vânia , Breda Giovanni , Santos-Weiss Izabella , Queiroz-Telles Flávio 
Published: September 2022

Abstract

Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM

Objectives
This study aims to report the evolution of cat-transmitted sporotrichosis (CTS) and map the distribution of these cases within a tertiary hospital in Curitiba (state capital of Paraná, in southern Brazil).

Methods
We reviewed the medical records of 175 patients seen in a hospital service over a period of 10 years (2011-21). Proven CTS consists of patients that had clinical manifestations after contact with sick cats, microbiological, and/or histopathological evidence of sporotrichosis. CTS was considered probable when patients had clinical signs associated with contact with sick cats that had a microbiological diagnosis of sporotrichosis made by a veterinarian. The confirmed cases in culture were submitted to molecular identification performed by sequencing the locus of calmodulin (CAL), determined by the set of primers 1 (5′-GAR TWC AAG GAG GCC TTC TC-3′) and CL2A (5′-TTTT TTG CAT CAT GAG TTG GAC-3 ′). The study was approved by the local Research Ethics Committee. Data analysis was performed using Statistical software for Windows (Version 8.0, StatSoft InC., Tulsa, OK, USA).

Results
The diagnosis of proven sporotrichosis was established in 57 patients (32.6%) and the probable diagnosis was verified in 118 patients (67.4%). Among all 175 patients, 171 (98.3%) cases were reported as zoonotic transmission and only 4 (1,7%) as sapronotic (classical pathway). Molecular identification was performed in 35 isolates and in 97.0% (n = 34) of them, Sporothrix brasiliensis was the main etiological agent identified (Fig. 1). Most cases of sporotrichosis were diagnosed between 2019 to 2021 (n = 105, 60%). The incidence rate increased from 0.27 cases/100.000 patients in 2011 to 30.4 cases/100.000 patients in 2021 (until July) and was observed geographic expansion of human cases of CTS in Curitiba in the last decade (accumulated cases 2011-12, 2011-16, and 2011-21 July) (Fig. 2). Prevalence rate was 4.97 cases per 100 000 patients. The majority of the patients were from Curitiba (n = 145, 82.9%). Women were the most affected (63.4% women vs 36.6% men) with the average age of 40 years old (1-87 years old). A total of 12% (n = 21) of the patients were under 18 years old. The prevalence of CTS in patients at high risk of occupational exposure to the disease was 9.7% (n = 17), 9 being veterinarians, 5 veterinary students, 3 pet house workers, and 2 gardeners. The main clinical manifestation was lymphocutaneous (n = 114, 65.1%), followed by fixed cutaneous (n = 43, 24.6%), ocular (n = 13, 7.4%), and mixed forms (n = 5, 2.9%).

Conclusion
CTS is a public health issue that is aggravated due to the lack of national control programs, unknown prevalence of the disease, lack of knowledge of the population, and health professionals about the epidemic. Besides that, there are difficulties in handling sick cats, lack of diagnosis of human and veterinary cases, and poor access to free medication. In 2011, the first case of CTS was identified in Curitiba, Paraná, Brazil. In 10 years, there has been a significant increase in the number of new cases. Those evidence indicate the continuous dispersion of the disease out of epidemiological control.