临床和环境毛霉目真菌的分子流行病学、多样性及抗真菌药敏谱：伊朗一项为期五年的多中心研究（2018 - 2023年）
Molecular epidemiology, diversity, and antifungal susceptibility profiles of clinical and environmental mucorales: a five-year multicenter study in Iran (2018-2023).
作者信息
Raeisabadi Abbas, Nosratabadi Mohsen, Abtahian Zahra, Khodavaisy Sadegh, Kiasat Neda, Rezaei-Matehkolaei Ali, Mohammadi Rasoul, Javidnia Javad, Faeli Leila, Haghani Iman, Zarrinfar Hossein, Alhashemi Raheleh, Armaki Mojtaba Taghizadeh, Aghili Seyed Reza, Moazeni Maryam, Abastabar Mahdi, Badali Hamid
机构信息
Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran.
Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
出版信息
BMC Infect Dis. 2025 Jul 1;25(1):849. doi: 10.1186/s12879-025-11189-7.
PURPOSE
The incidence of Mucormycosis has increased during the last decades globally due to more patients being at risk for these life-threatening infections. Early diagnosis and proper selection of appropriate antifungal therapy are vital in enhancing patient outcomes. Mucorales species present a significant challenge due to their resistance to many drugs, so investigations for new therapies and strategies must be undertaken. This study elucidates the distribution and antifungal susceptibility profiles of Mucorales isolates from Iran over five years.
METHODS
Species identification was performed based on morphological features and Internal Transcribed Spacer (ITS) sequences analysis. Antifungal susceptibility testing for commonly used antifungal agents was conducted following CLSI M38-A3 broth microdilution.
RESULTS
One hundred eighty-one (116 clinical and 65 environmental) isolates were analyzed. Rhizopus arrhizus (67.9%, n = 123) and Mucor circinelloides (23.2%, n = 42) were the predominant species. The various clinical samples analyzed included sinus biopsies, nasal secretions, orbital tissues, maxilla tissues, throat, and brain tumors.
CONCLUSION
The lowest geometric mean minimum inhibitory concentration values were observed against the clinical and environmental isolates for amphotericin B, posaconazole, and isavuconazole. Understanding Mucorales' distribution and antifungal susceptibility patterns helps clinicians select antifungal therapies. However, further studies are warranted to correlate these findings with clinical outcomes.
目的
在过去几十年中，全球毛霉病的发病率有所上升，因为有更多患者面临这些危及生命的感染风险。早期诊断和正确选择合适的抗真菌治疗对于改善患者预后至关重要。毛霉目真菌由于对多种药物耐药，带来了重大挑战，因此必须开展新治疗方法和策略的研究。本研究阐明了伊朗五年内毛霉目分离株的分布及抗真菌药敏谱。
方法
基于形态学特征和内转录间隔区（ITS）序列分析进行菌种鉴定。按照CLSI M38 - A3肉汤微量稀释法对常用抗真菌药物进行抗真菌药敏试验。
结果
共分析了181株分离株（116株临床分离株和65株环境分离株）。少根根霉（67.9%，n = 123）和卷枝毛霉（23.2%，n = 42）是主要菌种。分析的各种临床样本包括鼻窦活检组织、鼻分泌物、眼眶组织、上颌组织、咽喉和脑肿瘤。
结论
两性霉素B、泊沙康唑和艾沙康唑对临床和环境分离株的几何平均最低抑菌浓度值最低。了解毛霉目的分布和抗真菌药敏模式有助于临床医生选择抗真菌治疗方法。然而，有必要进一步开展研究，将这些发现与临床结果相关联。
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