| Autor: |
Zainab, Bandalizadeh, Tahereh, Shokohi, Hamid, Badali, Mahdi, Abastabar, Farhang, Babamahmoudi, Lotfolah, Davoodi, Masoud, Mardani, Mostafa, Javanian, Hamed, Cheraghmakani, Ali Asghar, Sepidgar, Parisa, Badiee, Sadegh, Khodavaisy, Setareh Agha Kuchak, Afshari, Kazem, Ahmadikia, Seyedmojtaba, Seyedmousavi |
| Rok vydání: |
2019 |
| Předmět: |
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| Zdroj: |
Journal of medical microbiology. 69(1) |
| ISSN: |
1473-5644 |
| Popis: |
INTRODUCTION: Limited data regarding the epidemiology and susceptibility profiles of cryptococcosis are available in the Middle East. AIM: Our study aimed to evaluate the molecular diversity, mating types and antifungal susceptibility pattern of Cryptococcus species (n=14) isolated from 320 suspected patients with cryptococcosis. METHODOLOGY: The URA5 gene was subjected to restriction fragment length polymorphism and sequence analysis. In addition, in vitro antifungal susceptibility testing was performed by Clinical and Laboratory Standards Institute (CLSI) M27-A4 and M59 guidelines. RESULTS: Overall, 14 (4.4 %) patients were confirmed as cryptococcosis. Based on molecular type, 85.7 and 14.3 % of the isolates were C. neoformans VN I and VN II, respectively. Phylogenetic analysis of URA5 gene sequences revealed clustering of VN I and VN II isolates into two distinct clades with a substantial difference within each molecular type. Voriconazole and 5-fluorocytosine, respectively, had the lowest (0.031 μg ml(−1)) and highest (8 µg ml(−1)) MICs. The epidemiological cutoff values (ECVs) for amphotericin B, fluconazole, voriconazole and 5-fluorocytosine encompassed ≥97 % of all 14 C. neoformans VN I species. However, according to the CLSI document M59, ECVs for itraconazole (7; 50 % of the isolates) and for posaconazole (1; 7.1 % of the isolate), were one log2 dilution higher than the wild type range. Combinations of amphotericin B with 5-fluorocytosine, amphotericin B with fluconazole and fluconazole with 5-fluorocytosine exhibited synergistic effects against 37, 31 and 12.5 % of the isolates, respectively. CONCLUSION: Our findings may significantly contribute to the development of management strategies for patients at a higher risk of cryptococcosis, particularly HIV-positive individuals. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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