Epidemiology and Antifungal Susceptibility of Candida Species Isolated from 10 Tertiary Care Hospitals in Iran
ABSTRACT In recent decades, the incidence of Candida infections has increased in immunocompromised patients. This multicenter study aimed to evaluate in vitro antifungal activities of 8 antifungal agents against the Candida species isolated from 10 university hospitals in Iran. During the period fro...
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| Format: | Article |
| Language: | English |
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American Society for Microbiology
2022-12-01
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| Series: | Microbiology Spectrum |
| Subjects: | |
| Online Access: | https://journals.asm.org/doi/10.1128/spectrum.02453-22 |
| _version_ | 1798003798362292224 |
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| author | Parisa Badiee Teun Boekhout Pardis Haddadi Rasoul Mohammadi Abdolkarim Ghadimi-Moghadam Jafar Soltani Ali Zarei Mahmoudabadi Seyyed Amin Ayatollahi Mousavi Mohammad Javad Najafzadeh Kambiz Diba Ali Reza Salimi-Khorashad Maneli Amin Shahidi Fatemeh Ghasemi Hadis Jafarian |
| author_facet | Parisa Badiee Teun Boekhout Pardis Haddadi Rasoul Mohammadi Abdolkarim Ghadimi-Moghadam Jafar Soltani Ali Zarei Mahmoudabadi Seyyed Amin Ayatollahi Mousavi Mohammad Javad Najafzadeh Kambiz Diba Ali Reza Salimi-Khorashad Maneli Amin Shahidi Fatemeh Ghasemi Hadis Jafarian |
| author_sort | Parisa Badiee |
| collection | DOAJ |
| description | ABSTRACT In recent decades, the incidence of Candida infections has increased in immunocompromised patients. This multicenter study aimed to evaluate in vitro antifungal activities of 8 antifungal agents against the Candida species isolated from 10 university hospitals in Iran. During the period from Dec 2019 to Dec 2021, Candida species were collected from clinical samples of patients. The isolates were identified by PCR restriction fragment length polymorphism and sequencing methods. The antifungal susceptibility tests of each isolate to eight antifungal agents were performed according to the microdilution CLSI M27, M59, and M60 standard methods. A total of 598 Candida strains were isolated from clinical samples. The most commonly isolated Candida species was C. albicans, followed by C. glabrata, C. parapsilosis, Debaryomyces hansenii (Candida famata), C. tropicalis, Pichia kudriavzevii (Candida krusei), C. orthopsilosis, Meyerozyma guilliermondii (Candida guilliermondii), Kluyveromyces marxianus (Candida kefyr), and Clavispora lusitaniae (Candida lusitaniae). MIC90 values in all Candida species were as follows: 0.25 μg/mL for caspofungin and voriconazole; 0.5 μg/mL for amphotericin B and isavuconazole; 2 μg/mL for itraconazole, luliconazole, and posaconazole; and 16 μg/mL for fluconazole. Although 30/285 C. albicans, 15/31 C. hansenii, 3/12 M. guilliermondii, 67/125 C. glabrata, 5/15 P. kudriavzevii, 6/60 C. parapsilosis, and 5/23 C. tropicalis isolates were multiazole resistant with resistance to 2 to 4 azoles, pan-azole resistance was not observed. According to our data, Candida albicans and C. glabrata were the most frequent species isolated from clinical samples in Iran. Caspofungin and voriconazole, with lower MIC90 values, are the most effective than other antifungal agents for the treatment of Candida infections in this region. IMPORTANCE Candida species cause severe invasive infections of the heart, brain, eyes, bones, and other parts of the body. Knowledge of regional distributions of causative Candida agents and their antifungal susceptibility patterns can help to monitor resistance to antifungal agents of various species and support local and national surveillance programs. In the present study, C. albicans and C. glabrata were the most frequently isolated species from clinical samples in Iran. Increasing rates of non-albicans Candida isolates from the Iranian population should be looked at as alarming due to various levels of intrinsic MIC values or resistance to various antifungal drugs. Caspofungin and voriconazole are recommended over fluconazole for the treatment of Candida infections in the study region. However, amphotericin B and isavuconazole are also active against the most common Candida species isolated from patients. Pan azole-resistant Candida species were not observed in the present study. |
| first_indexed | 2024-04-11T12:13:32Z |
| format | Article |
| id | doaj.art-0aae9db9d88847ecafd181770284a29d |
| institution | Directory Open Access Journal |
| issn | 2165-0497 |
| language | English |
| last_indexed | 2024-04-11T12:13:32Z |
| publishDate | 2022-12-01 |
| publisher | American Society for Microbiology |
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| series | Microbiology Spectrum |
| spelling | doaj.art-0aae9db9d88847ecafd181770284a29d2022-12-22T04:24:25ZengAmerican Society for MicrobiologyMicrobiology Spectrum2165-04972022-12-0110610.1128/spectrum.02453-22Epidemiology and Antifungal Susceptibility of Candida Species Isolated from 10 Tertiary Care Hospitals in IranParisa Badiee0Teun Boekhout1Pardis Haddadi2Rasoul Mohammadi3Abdolkarim Ghadimi-Moghadam4Jafar Soltani5Ali Zarei Mahmoudabadi6Seyyed Amin Ayatollahi Mousavi7Mohammad Javad Najafzadeh8Kambiz Diba9Ali Reza Salimi-Khorashad10Maneli Amin Shahidi11Fatemeh Ghasemi12Hadis Jafarian13Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, IranWesterdijk Fungal Biodiversity Institute, Utrecht, The NetherlandsDepartment of Periodontology, Faculty of Dentistry, Lorestan University of Medical Sciences, Khorramabad, IranDepartment of Medical Parasitology and Mycology, School of Medicine, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, IranDepartment of Pediatrics Infectious Disease, Emmam Sajjad Hospital, Yasuj University of Medical Sciences, Yasuj, IranDepartment of Pediatrics, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, IranInfectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IranDepartment of Medical Parasitology and Mycology, Faculty of Medicine, Kerman University of Medical Sciences, Kerman, IranDepartment of Medical Parasitology and Mycology, Mashhad University of Medical Sciences, Mashhad, IranCellular and Molecular Research Center, Urmia University of Medical Sciences, Urmia, IranDepartment of Parasitology and Mycology, School of Medicine, Infectious Diseases and Tropical Medicine Research Center, Zahedan University of Medical Sciences, Zahedan, IranClinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, IranClinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, IranClinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, IranABSTRACT In recent decades, the incidence of Candida infections has increased in immunocompromised patients. This multicenter study aimed to evaluate in vitro antifungal activities of 8 antifungal agents against the Candida species isolated from 10 university hospitals in Iran. During the period from Dec 2019 to Dec 2021, Candida species were collected from clinical samples of patients. The isolates were identified by PCR restriction fragment length polymorphism and sequencing methods. The antifungal susceptibility tests of each isolate to eight antifungal agents were performed according to the microdilution CLSI M27, M59, and M60 standard methods. A total of 598 Candida strains were isolated from clinical samples. The most commonly isolated Candida species was C. albicans, followed by C. glabrata, C. parapsilosis, Debaryomyces hansenii (Candida famata), C. tropicalis, Pichia kudriavzevii (Candida krusei), C. orthopsilosis, Meyerozyma guilliermondii (Candida guilliermondii), Kluyveromyces marxianus (Candida kefyr), and Clavispora lusitaniae (Candida lusitaniae). MIC90 values in all Candida species were as follows: 0.25 μg/mL for caspofungin and voriconazole; 0.5 μg/mL for amphotericin B and isavuconazole; 2 μg/mL for itraconazole, luliconazole, and posaconazole; and 16 μg/mL for fluconazole. Although 30/285 C. albicans, 15/31 C. hansenii, 3/12 M. guilliermondii, 67/125 C. glabrata, 5/15 P. kudriavzevii, 6/60 C. parapsilosis, and 5/23 C. tropicalis isolates were multiazole resistant with resistance to 2 to 4 azoles, pan-azole resistance was not observed. According to our data, Candida albicans and C. glabrata were the most frequent species isolated from clinical samples in Iran. Caspofungin and voriconazole, with lower MIC90 values, are the most effective than other antifungal agents for the treatment of Candida infections in this region. IMPORTANCE Candida species cause severe invasive infections of the heart, brain, eyes, bones, and other parts of the body. Knowledge of regional distributions of causative Candida agents and their antifungal susceptibility patterns can help to monitor resistance to antifungal agents of various species and support local and national surveillance programs. In the present study, C. albicans and C. glabrata were the most frequently isolated species from clinical samples in Iran. Increasing rates of non-albicans Candida isolates from the Iranian population should be looked at as alarming due to various levels of intrinsic MIC values or resistance to various antifungal drugs. Caspofungin and voriconazole are recommended over fluconazole for the treatment of Candida infections in the study region. However, amphotericin B and isavuconazole are also active against the most common Candida species isolated from patients. Pan azole-resistant Candida species were not observed in the present study.https://journals.asm.org/doi/10.1128/spectrum.02453-22Candida speciescaspofunginvoriconazoleamphotericin Bisavuconazoleitraconazole |
| spellingShingle | Parisa Badiee Teun Boekhout Pardis Haddadi Rasoul Mohammadi Abdolkarim Ghadimi-Moghadam Jafar Soltani Ali Zarei Mahmoudabadi Seyyed Amin Ayatollahi Mousavi Mohammad Javad Najafzadeh Kambiz Diba Ali Reza Salimi-Khorashad Maneli Amin Shahidi Fatemeh Ghasemi Hadis Jafarian Epidemiology and Antifungal Susceptibility of Candida Species Isolated from 10 Tertiary Care Hospitals in Iran Microbiology Spectrum Candida species caspofungin voriconazole amphotericin B isavuconazole itraconazole |
| title | Epidemiology and Antifungal Susceptibility of Candida Species Isolated from 10 Tertiary Care Hospitals in Iran |
| title_full | Epidemiology and Antifungal Susceptibility of Candida Species Isolated from 10 Tertiary Care Hospitals in Iran |
| title_fullStr | Epidemiology and Antifungal Susceptibility of Candida Species Isolated from 10 Tertiary Care Hospitals in Iran |
| title_full_unstemmed | Epidemiology and Antifungal Susceptibility of Candida Species Isolated from 10 Tertiary Care Hospitals in Iran |
| title_short | Epidemiology and Antifungal Susceptibility of Candida Species Isolated from 10 Tertiary Care Hospitals in Iran |
| title_sort | epidemiology and antifungal susceptibility of candida species isolated from 10 tertiary care hospitals in iran |
| topic | Candida species caspofungin voriconazole amphotericin B isavuconazole itraconazole |
| url | https://journals.asm.org/doi/10.1128/spectrum.02453-22 |
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