Chadeganipour Mostafa, Mohammadi Rasoul
Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Infect Drug Resist. 2020 Jul 14;13:2301-2309. doi: 10.2147/IDR.S259162. eCollection 2020.
Aspergillosis is an important fungal disease affecting millions of individuals worldwide. The genus of consist of various complexes, causing a wide spectrum of diseases from superficial infections in immunocompetent hosts to life-threatening disseminated infections among immunocompromised patients. This study aimed to identify species by phenotypic (total isolates) and molecular tests (35 isolates), obtained from patients in Isfahan (the third-largest city of Iran) between 2010 and 2018, and determine the susceptibility of 35 clinical isolates to itraconazole (ITR), amphotericin-B (AMB), and voriconazole (VOR).
Based on clinical signs, a total of 2385 suspected cases were included in this retrospective study from January 2010 to December 2018. Direct microscopic examination with potassium hydroxide, sabouraud dextrose agar with chloramphenicol, and czapekdox agar media was applied to identify etiologic agents. Thirty-five species collected from January 2016 to December 2018 were identified by PCR-sequencing of ITS1-5.8SrDNA-ITS2 region, and their susceptibility to ITR, AMB, and VOR was determined using E-test.
Based on direct microscopy and positive culture, 132 out of 2385 suspected cases had infection (5.5%). Fifty-four patients were male, and 78 patients were female. Patients in the age groups of 41-50 and 21-30 years had the highest and lowest frequencies, respectively. (n=54), (n=24), (n=15), and (n=12) were the most prevalent species, respectively. Among 35 species, the MIC ranges of AMB, ITR, and VOR for , and were (0.5-4 μg/mL; 0.5-16 μg/mL; 0.25-8 μg/mL), (1 μg/mL, 1 μg/mL, 1 μg/mL), and (4-4 μg/mL, 0.5-1 μg/mL, 0.5-1 μg/mL), respectively.
infections have a wide spectrum of clinical manifestations and often occur in immunocompromised patients. Accurate identification at the species level is essential since the emergence of cryptic species is connected to different patterns of AFST that affect patient treatment outcomes. Azole-resistant spp. is a global concern, and the detection of the route of resistance is pivotal to prevent and control infection.
曲霉病是一种重要的真菌病，影响着全球数百万人。曲霉属由各种复合体组成，可引起从免疫功能正常宿主的浅表感染到免疫功能低下患者的危及生命的播散性感染等广泛的疾病。本研究旨在通过表型（全部分离株）和分子检测（35株分离株）鉴定2010年至2018年期间从伊朗第三大城市伊斯法罕的患者中获得的曲霉属物种，并确定35株临床分离株对伊曲康唑（ITR）、两性霉素B（AMB）和伏立康唑（VOR）的敏感性。
基于临床症状，本回顾性研究纳入了2010年1月至2018年12月期间共2385例疑似病例。应用氢氧化钾直接显微镜检查、含氯霉素的沙氏葡萄糖琼脂和察氏琼脂培养基来鉴定病原体。通过对ITS1-5.8SrDNA-ITS2区域进行PCR测序，鉴定了2016年1月至2018年12月收集的35株曲霉属物种，并使用E试验确定它们对ITR、AMB和VOR的敏感性。
基于直接显微镜检查和阳性培养，2385例疑似病例中有132例发生曲霉感染（5.5%）。54例为男性患者，78例为女性患者。年龄在41-50岁和21-30岁组的患者感染频率分别最高和最低。烟曲霉（n=54）、黄曲霉（n=24）、黑曲霉（n=15）和土曲霉（n=12）分别是最常见的曲霉属物种。在35株曲霉属物种中，烟曲霉、黄曲霉和土曲霉对AMB、ITR和VOR的MIC范围分别为（0.5-4μg/mL；0.5-16μg/mL；0.25-8μg/mL）、（1μg/mL，1μg/mL，1μg/mL）和（4-4μg/mL，0.5-1μg/mL，0.5-1μg/mL）。
曲霉感染有广泛的临床表现，且常发生于免疫功能低下患者。由于隐匿种的出现与影响患者治疗结果的不同曲霉药敏模式相关，因此在种水平上进行准确鉴定至关重要。耐唑类曲霉属物种是一个全球关注的问题，检测耐药途径对于预防和控制感染至关重要。
