Mahmoudi Shahram, Zaini Farideh, Kordbacheh Parivash, Safara Mahin, Heidari Mansour
Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Med Mycol. 2016 Aug 1;54(6):593-9. doi: 10.1093/mmy/myw006. Epub 2016 Mar 1.
Sporotrichosis is a global subcutaneous fungal infection caused by the Sporothrix schenckii complex. Sporotrichosis is an uncommon infection in Iran, and there have been no phenotypic, molecular typing or antifungal susceptibility studies of Sporothrix species. This study aimed to identify nine Iranian isolates of the S. schenckii complex to the species level using colony morphology, carbohydrate assimilation tests, and PCR-sequencing of the calmodulin gene. The antifungal susceptibilities of these Sporothrix isolates to five antifungal agents (amphotericin B (AMB), voriconazole (VRC), itraconazole (ITC), fluconazole (FLC), and terbinafine (TRB)) were also evaluated according to the M27-A3 and M38-A2 protocols of the Clinical and Laboratory Standards Institute for yeast and mycelial phases, respectively. Five of seven clinical isolates were identified as S. schenckii, and two clinical and two environmental isolates were identified as S. globosa. This is the first report of S. globosa in Iran. There was significant agreement (73%) between the results of the phenotypic and genotypic identification methods. TRB and ITC were the most effective antifungals against the Sporothrix isolates. The minimum inhibitory concentration (MIC) values of TRB for the yeast and mycelial phases of S. schenckii differed significantly. There was also a significant difference in the minimum fungicidal concentration (MFC) values of AMB and TRB for the two phases. Considering the low efficacy of VRC and FLC and the wide MIC ranges of AMB (1-16 μg/ml and 1-8 μg/ml for yeast and mycelial forms, respectively) observed in the present study, in vitro antifungal susceptibility testing should be performed to determine appropriate therapeutic regimens.
孢子丝菌病是一种由申克孢子丝菌复合体引起的全球皮下真菌感染。孢子丝菌病在伊朗是一种不常见的感染，目前尚未有关于孢子丝菌属的表型、分子分型或抗真菌药敏研究。本研究旨在利用菌落形态、碳水化合物同化试验以及钙调蛋白基因的PCR测序，将9株伊朗分离的申克孢子丝菌复合体鉴定到种水平。还根据临床和实验室标准协会的M27 - A3和M38 - A2方案，分别对这些孢子丝菌分离株对5种抗真菌药物（两性霉素B（AMB）、伏立康唑（VRC）、伊曲康唑（ITC）、氟康唑（FLC）和特比萘芬（TRB））在酵母相和菌丝相的抗真菌药敏性进行了评估。7株临床分离株中有5株被鉴定为申克孢子丝菌，2株临床分离株和2株环境分离株被鉴定为球形孢子丝菌。这是伊朗首次报道球形孢子丝菌。表型和基因型鉴定方法的结果之间存在显著一致性（73%）。TRB和ITC是对孢子丝菌分离株最有效的抗真菌药物。申克孢子丝菌酵母相和菌丝相对TRB的最低抑菌浓度（MIC）值有显著差异。AMB和TRB在两个相的最低杀菌浓度（MFC）值也有显著差异。考虑到VRC和FLC的疗效较低以及本研究中观察到的AMB较宽的MIC范围（酵母型和菌丝型分别为1 - 16μg/ml和1 - 8μg/ml），应进行体外抗真菌药敏试验以确定合适的治疗方案。
