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Molecular Identification and Antifungal Susceptibility Profiles of Candida Dubliniensis and Candida Africana Isolated From Vulvovaginal Candidiasis: A Single-Centre Experience in Iran Publisher Pubmed



Shokoohi G1, 2 ; Javidnia J3, 4 ; Mirhendi H5 ; Rasekhjahromi A6 ; Rezaeimatehkolaei A7 ; Ansari S8 ; Maryami F1, 2 ; Goodarzi S1, 2 ; Romeo O9
Authors
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Authors Affiliations
  1. 1. Department of Medical Parasitology and Mycology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
  2. 2. Zoonosis Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
  3. 3. Student Research Committee Center, Mazandaran University of Medical Sciences, Sari, Iran
  4. 4. Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
  5. 5. Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  6. 6. Department of Obstetrician and Gynecology, Jahrom University of Medical Sciences, Jahrom, Iran
  7. 7. Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
  8. 8. Department of Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  9. 9. Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Messina, Italy

Source: Mycoses Published:2021


Abstract

Background: Vulvovaginal candidiasis (VVC) is a common and debilitating long-term illness affecting million women worldwide. This disease is caused mainly by Candida albicans and a lesser extent by other species, including the two phylogenetically closely related pathogens Candida africana and Candida dubliniensis. Objectives: In this study, we report detailed molecular epidemiological data about the occurrence of these two pathogenic yeasts in Iranian patients affected by VVC, or its chronic recurrent form (RVVC), and provide, for the first time, data on the antifungal activity of two new drugs, efinaconazole (EFN) and luliconazole (LUL). Methods: A total of 133 vaginal yeast isolates, presumptively identified as C albicans by phenotypic and restriction analysis of rDNA, were further analysed by using a specific molecular method targeting the HWP1 gene. All C africana and C dubliniensis isolates were also tested for their in vitro susceptibility to a panel of modern and classical antifungal drugs. Results and Conclusions: Based on the molecular results, among 133 germ-tube positive isolates, we identify 119 C albicans (89.47%), 11 C africana (8.27%) and 3 C dubliniensis (2.26%) isolates. C africana and C dubliniensis showed low MIC values for most of the antifungal drugs tested, especially for EFN and LUL, which exhibited a remarkable antifungal activity. High MIC values were observed only for nystatin and terbinafine. Although C albicans remains the most common Candida species recovered from Iranian VVC/RVVC patients, our data show that its prevalence may be slightly overestimated due to the presence of difficult-to-identify closely related yeast, especially C africana. © 2021 The Authors. Mycoses published by Wiley-VCH GmbH
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