title: Molecular Characterization and In Vitro Antifungal Susceptibility of 316 Clinical Isolates of Dermatophytes in Iran.
abstract: Dermatophytosis is a common mycotic infection of the skin, nail, and hair, associated with major public health concern worldwide. Various species of dermatophytes show significant differences in susceptibility to antifungals. Here, we present the antifungal susceptibility of a large collection of molecularly identified dermatophyte isolates obtained from tropical region of south of Iran. A total of 9485 patients clinically suspected to have cutaneous fungal infections were examined. Dermatophytosis was confirmed in 1502 cases by direct microscopy and culture. Three hundred and sixteen isolates recovered in culture were identified to species level using PCR sequencing of ITS region and RFLP. Tinea corporis was the most prevalent type of clinical manifestation (35.2 %), followed by tinea cruris (17 %), tinea capitis (12.8 %), tinea pedis (11.3 %), tinea manuum (11 %), tinea unguium (6.9 %), and tinea barbae (5.8 %). Trichophyton interdigitale was the most common isolate (49.36 %), followed by Trichophyton rubrum (18.98 %), Epidermophyton floccosum (13.29 %), Microsporum canis (9.17 %), Arthroderma benhamiae (T. anamorph of A. benhamiae; 5.38 %), and Trichophyton tonsurans (3.79 %). Overall, irrespective of the geographical region, terbinafine was the most potent antifungal against all isolates, with an MIC range of 0.002-0.25 μg/mL, followed by itraconazole (0.004-0.5 μg/mL), griseofulvin (0.125-8 μg/mL), and fluconazole (4-128 μg/mL). Analysis of our data revealed a significant increase in the frequency of A.benhamiae, which definitely warrants further investigation to explore source of this infection in south of Iran. Moreover, terbinafine was the most effective antifungal against all isolates, in vitro.
authors.affiliation: Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Km 18 Khazarabad Road, P.O. Box 48175-1665, Sari, Iran.|Department of Medical Mycology and Parasitology School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Saham
authors.initials: S
authors.lastname: Ansari
authors.affiliation: Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Km 18 Khazarabad Road, P.O. Box 48175-1665, Sari, Iran. hedayatimt@gmail.com.|Department of Medical Mycology and Parasitology School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran. hedayatimt@gmail.com.
authors.forename: Mohammad T
authors.initials: MT
authors.lastname: Hedayati
authors.affiliation: Department of Parasitology and Mycology, Basic Sciences in Infectious Diseases Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Kamiar
authors.initials: K
authors.lastname: Zomorodian
authors.affiliation: Department of Parasitology and Mycology, Basic Sciences in Infectious Diseases Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Keyvan
authors.initials: K
authors.lastname: Pakshir
authors.affiliation: Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Km 18 Khazarabad Road, P.O. Box 48175-1665, Sari, Iran.|Department of Medical Mycology and Parasitology School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Hamid
authors.initials: H
authors.lastname: Badali
authors.affiliation: Department of Parasitology and Mycology/Infectious and Tropical Medicine Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
authors.forename: Abdollah
authors.initials: A
authors.lastname: Rafiei
authors.affiliation: Department of Parasitology and Mycology, Basic Sciences in Infectious Diseases Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Ravandeh
authors.affiliation: Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Km 18 Khazarabad Road, P.O. Box 48175-1665, Sari, Iran.|Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Erasmus, The Netherlands.|Department of Medical Microbiology, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors.forename: Seyedmojtaba
authors.initials: S
authors.lastname: Seyedmousavi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000494:pharmacology; D003883:Arthrodermataceae / Q000145:classification* / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D002648:Child; D002675:Child, Preschool; D004271:DNA, Fungal / Q000737:chemistry / Q000235:genetics; D021903:DNA, Ribosomal Spacer / Q000737:chemistry / Q000235:genetics; D003881:Dermatomycoses / Q000453:epidemiology / Q000382:microbiology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007492:Iran / Q000453:epidemiology; D008826:Microbial Sensitivity Tests; D008853:Microscopy; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D015995:Prevalence; D017422:Sequence Analysis, DNA; D055815:Young Adult
chemical_list: D000935:Antifungal Agents; D004271:DNA, Fungal; D021903:DNA, Ribosomal Spacer
keywords: Antifungal susceptibility; Arthroderma benhamiae; Dermatophytosis; Molecular identification; South of Iran