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کاربرد نوع شرط:
- جایگاه : پژوهشی
- مجله: Current Medical Mycology
- نوع مقاله: Journal Article
- کلمات کلیدی: PCR-RFLP,Candida species,Vulvovaginal candidiasis,Antifungal Susceptibility testing,C. lusitaniae
- چکیده:
- چکیده انگلیسی: Background and Purpose: The aim of the current study was to investigate the epidemiology of vulvovaginal candidiasis (VVC) and recurrent VVC (RVVC), as well as the antifungal susceptibility patterns of Candida species isolates.
Materials and Methods: A cross-sectional study was carried out on 260 women suspected of VVC from February 2017 to January 2018. In order to identify Candida species isolated from the genital tracts, the isolates were subjected to polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) using enzymes Msp I and sequencing. Moreover, antifungal susceptibility testing was performed according to the Clinical and Laboratory Standards Institute guidelines (M27-A3).
Results: Out of 250 subjects, 75 (28.8%) patients were affected by VVC, out of whom 15 (20%) cases had RVVC. Among the Candida species, C. albicans was the most common species (42/95; 44.21%), followed by C. lusitaniae (18/95; 18.95%), C. parapsilosis (13/95; 13.69%), C. glabrata (8/95; 8.42%), C. kefyr (6/95; 6.31%), C. famata (5/95; 5.26%), C. africana (2/95; 2.11%), and C. orthopsilosis (1/95; 1.05%), respectively. Multiple Candida species were observed in 28% (21/75) of the patients. Nystatin showed the narrowest range of minimum inhibitory concentration (MIC) (0.25-16 μg/ml) against all Candida strains, whereas fluconazole (0.063-64 μg/ml) demonstrated the widest MIC range. In the current study, C. lusitaniae, as the second most common causative agent of VVC, was susceptible to all antifungal agents. Furthermore, 61.1% of C. lusitaniae isolates were inhibited at a concentration of ≤ 2 μg/ml, while38.9% (n=7)of them exhibited fluconazole MICs above the epidemiologic cutoff values (ECV). Candida species showed the highest overall resistance against fluconazole (61.3%), followed by itraconazole (45.2%) and caspofungin (23.7%). All of C. albicans strains were resistant to itraconazole with a MIC value of ≥ 1 μg/ml; in addition, 87.5% of them were resistant to fluconazole. Moreover, 100% and 87.5% of C. glabrata strains were resistant to caspofungin and fluconazole, respectively.
Conclusion: As the findings revealed, the majority of VVC cases were caused by non-albicans Candida species which were often more resistant to antifungal agents. Candida lusitaniae generally had fluconazole MICs above the ECV. Given the propensity of C. lusitaniae to develop resistance under drug pressure, antifungals should be administered with caution. The emergence of these species justify the epidemiological surveillance surveys to watch out the distribution of yeast species.- انتشار مقاله: 24-03-1398
- نویسندگان: Seyedebrahim Hashemi,Tahereh Shokohi,Mahdi Abastabar,Narges Aslani,Mahbobeh Ghadamzadeh,Iman Haghani
- مشاهده
- جایگاه : پژوهشی
- مجله: Current Medical Mycology
- نوع مقاله: Journal Article
- کلمات کلیدی: Candida parapsilosis,Resistant,Azoles,Iranian isolates
- چکیده:
- چکیده انگلیسی: Background and Purpose: Candida parapsilosis isolates usually have a low minimum inhibitory concentration (MIC) against azoles. Although Candida parapsilosis isolates usually have low MICs against azoles, recent studies candida invasive infections due to azole resistant-C. parapsilosis isolates . Regarding this, the main aim of this study was to determine the susceptibility pattern of Iranian clinical C. parapsilosis against available azole antifungal drugs.
Materials and Methods: This study was conducted on 105 previously-identified isolates of C. parapsilosis sensu stricto. For the purpose of the study, the isolates were subjected to antifungal susceptibility testing against fluconazole (FLZ), itraconazole (ITZ), voriconazole (VRZ), and two new azole drugs, namely luliconazole (LUZU) and lanoconazole (LZN). The broth microdilution reference method adopted in this study was according to the Clinical & Laboratory Standards Institute M27-A3 and M27-S4 documents.
Results: According to the results, 89% (n=94) of C. parapsilosis isolates showed a MIC of ≥ 1 μg/ml, indicating resistance against ITZ. Multi-azole resistance was observed in 3.8% of the isolates. In addition, LUZU and LZN demonstrated the highest efficacy with the MIC50 values of 0.5 and 1 μg/ml, respectively.
Conclusion: The majority of the isolates showed high MIC values against ITZ. This may have been associated with the long-term ITZ prophylaxis/therapy in patients infected with candidiasis. Hence, the adoption of an appropriate antifungal agent is a crucial step for starting the treatment.
Background and Purpose: Although Candida parapsilosis isolates have usually low MICs against azoles but recent study confirmed Candida –related invasive infections due to azoles resistance C. parapsilosis isolates. The main aim of this study was to determine the susceptibility pattern of Iranian clinical C. parapsilosis against available azolesantifungal drugs. .
Material and Methods: One hundred and five previously-identified isolates of C. parapsilosis sensu stricto were subjected to antifungal susceptibility testing against fluconazole, itraconazole, voriconazole and two new azole drugs, loliconazole and lanoconazole using the broth microdilution reference method according to CLSI M27-A3 and M27-S4 document.
Results: Eighty nine percent (n=94) of C. parapsilosis isolates showed MIC ≥ 1µg/ml which indicated resistance against itraconazole. Multi-azoles resistances were observed in 3.8% of the isolates. Loliconazole and lanoconazole demonstrated the highest efficacy with MIC50 values of 0.5 and 1µg/ml, respectively.
Conclusion: The majority of the isolates showed high MIC values against Itraconazole. It may associated with the long term Itraconazole prophylaxis/therapy in patients Infected with candidasis. Hence, choosing the appropriate antifungal is the crucial step for starting treatment.- انتشار مقاله: 17-04-1398
- نویسندگان: Fozieh Hassanmoghadam,Tahere Shokohi,Mohammad Taghi Hedayati,Narges Aslani,Iman Haghani,Mojtaba Nabili,Ensieh Lotfali,Amirhossein Davari,Maryam Moazeni
- مشاهده
- جایگاه : پژوهشی
- مجله: Current Medical Mycology
- نوع مقاله: Journal Article
- کلمات کلیدی: Pneumocystis jirovecii,colonization,immunocompetent,Immunosuppressed,Mitochondrial large subunit,(mtLSU),Respiratory failures
- چکیده:
- چکیده انگلیسی: Background and Purpose: Pneumocystis jirovecii colonization plays a key role in the progression of pulmonary infection. However, there are limited data regarding the colonization of these fungi in the patients residing in different regions of Iran. Regarding this, the present study was conducted to evaluate the prevalence of P. jirovecii colonization in non-HIV-infected patients with respiratory failure introduced by physicians using nested polymerase chain reaction (PCR).
Materials and Methods: This study was conducted on 136 samples obtained from 136 patients with respiratory disorders referring to different hospitals in the capital and north of Iran during 2013-2015. The samples were collected using bronchoalveolar lavage (BAL; n=121) and sputum induction (n=15). Nested PCR method targeting mtLSU rRNA gene was used for the detection of P. jirovecii DNA in the specimens.
Results: The nested PCR analysis resulted in the detection of P. jirovecii DNA in 32 (23.5%) patients. The mean age of the participants was 49.04±11.94 years (age range: 14-90 years). The results revealed no correlation between Pneumocystis colonization and gender. The studied patients were divided into two groups of immunocompromised and immunocompetent patients. In the regard, 25.4% of the patients with detectable P. jirovecii DNA were immunocompromised and had cancer, organ transplantation, asthma, sarcoidosis, dermatomyositis, chronic obstructive pulmonary disease, bronchiectasis, and pulmonary vasculitis. On the other hand, Pneumocystis DNA was detected in 21.8% of the immunocompetent patients. Frequencies of P. jirovecii DNA detection in the patients with tuberculosis, hydatid cyst, and unknown underlying diseases were obtained as 20.8%, 25%, and 22%, respectively. The prevalence of Pneumocystis colonization varied based on age. In this regard, P. jirovecii colonization was more prevalent in patients aged above 70 years.
Conclusion: As the findings indicated, non-HIV-infected patients, especially the elderly, had a high prevalence of P. jirovecii colonization. Therefore, these patients are probably a potential source of infection for others. Regarding this, it is of paramount importance to adopt monitoring and prophylactic measures to reduce this infection.- انتشار مقاله: 15-01-1398
- نویسندگان: Mahdi Abastabar,Elham Mosayebi,Tahereh Shokohi,Mohammad Taghi Hedayati,Mohammad Reza Jabari Amiri,Zahra Seifi,Iman Haghani,Masoud Aliyali,Sasan Saber,Maryam-Fatemeh Sheikholeslami
- مشاهده
- جایگاه : پژوهشی
- مجله: Current Medical Mycology
- نوع مقاله: Journal Article
- کلمات کلیدی: Diagnosis,Nested PCR,Keratitis
- چکیده:
- چکیده انگلیسی: Background and Purpose: Fungal keratitis is a suppurative, ulcerative, and sight-threatening infection of the cornea that sometimes leads to blindness. The aims of this study were: recuperating facilities for laboratory diagnosis, determining the causative microorganisms, and comparing conventional laboratory diagnostic tools and semi-nested PCR. Materials and Methods: Sampling was conducted in patients with suspected fungal keratitis. Two corneal scrapings specimens, one for direct smear and culture and the other for semi- nested PCR were obtained. Results: Of the 40 expected cases of mycotic keratitis, calcofluor white staining showed positivity in 25%, culture in 17.5%, KOH in 10%, and semi-nested PCR in 27.5%. The sensitivities of semi-nested PCR, KOH, and CFW were 57.1%, 28.5%, and 42% while the specificities were 78.7%, 94%, and 78.7%, respectively. The time taken for PCR assay was 4 to 8 hours, whereas positive fungal cultures took at least 5 to 7 days. Conclusion: Due to the increasing incidence of fungal infections in people with weakened immune systems, uninformed using of topical corticosteroids and improper use of contact lens, fast diagnosis and accurate treatment of keratomycosis seems to be essential. Therefore, according to the current study, molecular methods can detect mycotic keratitis early and correctly leading to appropriate treatment.
- انتشار مقاله: 18-04-1398
- نویسندگان: Iman Haghani,Fatemeh Amirinia,Kiumars Nowroozpoor Dailami,Tahereh Shokohi
- مشاهده