title: Eco-epidemiologic study of emerging fungi related to the work of babaçu coconut breakers in the State of Maranhão, Brazil.
abstract: BACKGROUND
  There are more than 300,000 extractors using the babaçu coconut as a source of income in the States of Maranhão, Pará, Tocantins and Piauí, and this activity is associated with fungal infections. The objective of this study was to examine the occurrence of emergent fungi in the conjunctiva, nails and surface and subcutaneous injuries of female coconut breakers in Esperantinópolis, Maranhão. Additionally, soil samples and palm structures were collected.
  
  
  METHODS
  The obtained samples were cultured in Petri dishes containing potato-dextrose-agar and chloramphenicol. The etiological agent was confirmed by a direct mycological exam and growth in culture.
  
  
  RESULTS
  In total, 150 domiciles were visited, and samples were collected from 80 patients. From the ground, the most frequently isolated fungus was Aspergillus niger (53. 8%). the most frequently detected fungus in babaçu coconut was Aspergillus niger (66.7%). Conjunctival fungal growth occurred in 76.3% of the women. The ocular fungal microbiota consisted of filamentous fungi (80.6%), and yeasts were present in 19.4% of cases. Onychomycosis was diagnosed in 44% (11/25) of the women.
  
  
  CONCLUSIONS
  The identification of the genera Neosartorya, Rhizopus and Curvularia in onychomycoses shows that emergent filamentous fungi can be isolated. Aspergillus sp., Penicillium sp. and Scedosporium sp. were the predominant genera found in the babaçu coconut. From ocular conjunctiva, Candida spp. were the most prevalent species isolated, and Fusarium sp. was present only in one woman. The nearly permanent exposure of coconut breakers to the external environment and to the soil is most likely the reason for the existence of a mycotic flora and fungal infections, varying according to the individual's practices and occupation.
authors.affiliation: Departamento de Patologia, Núcleo de Imunologia Básica e Aplicada, Universidade Federal do Maranhão, São LuisMA, Departamento de Patologia, Núcleo de Imunologia Básica e Aplicada, Universidade Federal do Maranhão, São Luis, MA.
authors.forename: Maria do Desterro Soares Brandão
authors.initials: Mdo D
authors.lastname: Nascimento
authors.affiliation: Programa de Pós Graduação em Ginecologia, Universidade de São Paulo, São PauloSP, Programa de Pós Graduação em Ginecologia, Universidade de São Paulo, São Paulo, SP.
authors.forename: Valéria Maria Sousa
authors.initials: VM
authors.lastname: Leitão
authors.affiliation: Curso de Medicina, Universidade Federal do Maranhão, São LuisMA, Curso de Medicina, Universidade Federal do Maranhão, São Luis, MA.
authors.forename: Marcos Antonio Custódio da
authors.initials: MA
authors.lastname: Neto Silva
authors.affiliation: Programa de Pós Graduação em Medicina, Universidade Federal do Espírito Santo, VitóriaES, Programa de Pós Graduação em Medicina, Universidade Federal do Espírito Santo, Vitória, ES.
authors.forename: Leonardo Bezerra
authors.initials: LB
authors.lastname: Maciel
authors.affiliation: Departamento de Patologia, Núcleo de Imunologia Básica e Aplicada, Universidade Federal do Maranhão, São LuisMA, Departamento de Patologia, Núcleo de Imunologia Básica e Aplicada, Universidade Federal do Maranhão, São Luis, MA.
authors.forename: Walbert Edson
authors.initials: WE
authors.lastname: Filho Muniz
authors.affiliation: Departamento de Patologia, Núcleo de Imunologia Básica e Aplicada, Universidade Federal do Maranhão, São LuisMA, Departamento de Patologia, Núcleo de Imunologia Básica e Aplicada, Universidade Federal do Maranhão, São Luis, MA.
authors.forename: Graça Maria de Castro
authors.initials: GM
authors.lastname: Viana
authors.affiliation: Departamento de Patologia, Núcleo de Imunologia Básica e Aplicada, Universidade Federal do Maranhão, São LuisMA, Departamento de Patologia, Núcleo de Imunologia Básica e Aplicada, Universidade Federal do Maranhão, São Luis, MA.
authors.forename: Geusa Felipa de Barros
authors.initials: GF
authors.lastname: Bezerra
mesh_terms: D000382:Agricultural Workers' Diseases / Q000453:epidemiology / Q000382:microbiology*; D001938:Brazil / Q000453:epidemiology; D003059:Cocos / Q000382:microbiology*; D016021:Epidemiologic Studies; D015821:Eye Infections, Fungal / Q000453:epidemiology / Q000382:microbiology*; D005260:Female; D005658:Fungi / Q000145:classification / Q000302:isolation & purification*; D006801:Humans; D009181:Mycoses / Q000453:epidemiology / Q000382:microbiology*; D014009:Onychomycosis / Q000453:epidemiology / Q000382:microbiology*; D012307:Risk Factors