title: Sporothrix schenckii complex in Iran: Molecular identification and antifungal susceptibility.
abstract: 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.
authors.affiliation: Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Shahram
authors.initials: S
authors.lastname: Mahmoudi
authors.affiliation: Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran fzaini@tums.ac.ir.
authors.forename: Farideh
authors.initials: F
authors.lastname: Zaini
authors.affiliation: Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Parivash
authors.initials: P
authors.lastname: Kordbacheh
authors.affiliation: Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mahin
authors.initials: M
authors.lastname: Safara
authors.affiliation: Department of Medical Genetics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mansour
authors.initials: M
authors.lastname: Heidari
mesh_terms: D000935:Antifungal Agents / Q000494:pharmacology*; D002147:Calmodulin / Q000235:genetics; D016000:Cluster Analysis; D006801:Humans; D007492:Iran; D008826:Microbial Sensitivity Tests; D050296:Microbial Viability / Q000187:drug effects; D016533:Mycological Typing Techniques; D010802:Phylogeny; D017422:Sequence Analysis, DNA; D017385:Sequence Homology; D013175:Sporothrix / Q000145:classification / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification*; D013174:Sporotrichosis / Q000382:microbiology*
chemical_list: D000935:Antifungal Agents; D002147:Calmodulin
keywords: Antifungal agents; Calmodulin; Sporothrix; Sporotrichosis