Iranian National Survey on Tinea Capitis: Antifungal Susceptibility Profile, Epidemiological Characteristics, and Report of Two Strains with a Novel Mutation in SQLE Gene with Homology Modeling.

Autor: Abastabar M; Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.; Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran., Babaei M; Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.; Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran., Mohammadi R; Department of Medical Parasitology and Mycology, School of Medicine, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran., Valadan R; Molecular and Cell Biology Research Center (MCBRC), Mazandaran University of Medical Sciences, Sari, Iran., Javidnia J; Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.; Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran., Zaedi A; Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.; Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran., Aghili SR; Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.; Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran., Haghani I; Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.; Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran., Khojasteh S; Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.; Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran., Reazaei-Matehkolaei A; Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran., Kiasat N; Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran., Hesari KK; Department of Dermatopathology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran., Ghasemi Z; Department of Medical Mycology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran., Azish M; Department of Parasitology and Medical Mycology, School of Medicine, Dezful University of Medical Sciences, Dezful, Iran., Zarrinfar H; Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran., Taghizadeh-Armaki M; Department of Parasitology and Mycology, Infectious Diseases and Tropical Medicine Research Center, Health Research Center, School of Medicine, Babol University of Medical Sciences, Babol, Iran., Keikha N; Medical Laboratory Sciences Department, Infectious Diseases and Tropical Medicine Research Center, Resistant Tuberculosis Institute, Zahedan University of Medical Sciences, Zahedan, Iran., Kharazi M; Department of Medical Parasitology and Mycology, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran., Khodadadi H; Department of Medical Parasitology and Mycology, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran., Hedayati MT; Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran. hedayatimt@gmail.com.; Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran. hedayatimt@gmail.com., Shokohi T; Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran. shokohi.tahereh@gmail.com.; Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran. shokohi.tahereh@gmail.com.
Jazyk: angličtina
Zdroj: Mycopathologia [Mycopathologia] 2023 Oct; Vol. 188 (5), pp. 449-460. Date of Electronic Publication: 2022 Aug 18.
DOI: 10.1007/s11046-022-00657-2
Abstrakt: Background: The data on the epidemiological and antifungal susceptibility profile of tinea capitis (TC) in Iran has not been updated in recent decades. This report presents the Iranian epidemiological and drug susceptibility data regarding the distribution of dermatophytes species isolated by six national mycology centers for a period of one year (2020-2021).
Material and Methods: A total of 2100 clinical samples from individuals suspeted to TC were subjected to mycological analysis of direct microscopy and culture. For definite species identification, the culture isolates were additionally subjected to PCR-RFLP and PCR-sequencing of the ITS ribosomal DNA (ITS-rDNA) region. Antifungal susceptibility profiles for eight common antifungal drugs were determined by CLSI M38-A3 guidelines. The SQLE gene was partially amplified and sequenced in two terbinafine-resistant and two susceptible T. mentagrophytes isolates to elucidate probable substitutions involved in resistance.
Results: TC (n = 94) was diagnosed in 75 children (79.8%) and 19 adults (20.2%) by direct microscopy and culture. Frequency of TC was significantly more among males (66 males = 70.2% vs 28 females = 29.8%). The prevalent age group affected was 5-9 years (39.36%). Thirty-two (34.04%) T. mentagrophytes, 27 (28.7%) T. tonsurans, 14 (14.9%) M. canis, 13 (13.8%) T. violaceum, 5 (5.32%) T. indotineae, 2 (2.1%) T. benhamiae, and 1 (1.1%) T. schoenleinii were identified as the causative agents. MIC values of isolates showed susceptibility to all antifungal agents, except for fluconazole and griseofulvin with GM MIC of 11.91 μg/ml and 2.01 μg/ml, respectively. Terbinafine exhibited more activity against isolates, with GM MIC 0.084 μg/ml followed by ketoconazole (0.100 μg/ml), econazole (0.107 μg/ml), itraconazole (0.133 μg/ml), butenafine (0.142 μg/ml), and miconazole (0.325 μg/ml). Two resistant T. mentagrophytes isolates harbored missense mutations in SQLE gene, corresponding to amino acid substitution F397L. Remarkably, one unique mutation, C1255T, in the SQLE sequence of two terbinafine-susceptible T. mentagrophytes strains leading to a change of leucine at the 419th position to phenylalanine (L419F) was detected.
Conclusions: T. mentagrophytes, T. tonsurans, and M. canis remained the main agents of TC in Iran, however less known species such as T. indotinea and T. benhamiae are emerging as new ones. Terbinafine could still be the appropriate choice for the treatment of diverse forms of TC.
(© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)
Databáze: MEDLINE
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