Cutaneous candidiasis in Tehran-Iran: from epidemiology to multilocus sequence types, virulence factors and antifungal susceptibility of etiologic Candida species

Abstract

Background and Objectives: Cutaneous candidiasis is a multipicture fungal infection caused by members of the genus Candida which is considered as a public health problem all over the world with urgency of effective treatment and control. This study was performed to analyze the clinical epidemiology and molecular aspects of cutaneous candidiasis in Tehran-Iran in relation to antifungal susceptibility and virulence factors of etiologic Candida species.
 Materials and Methods: Candida species were isolated from skin (27.3%) and nail scrapings (72.7%) of suspected patients and identified by ITS sequencing. Phylogeny of the isolates was evaluated using multilocus sequence typing (MLST) and antifungal susceptibility and virulence factors of the isolates were determined in relation to clinical presentation.
 Results: Candida albicans was the most prevalent species (39.8%), followed by C. parapsilosis (32.9%), C. orthopsilosis (10.4%), C. tropicalis (7.9%), C. glabrata and C. guilliermondii, each (4.5%). Molecular typing of 35 C. albicans isolates by MLST revealed 28 novel sequence types with 11 singletons with 80.0% new diploid sequence types (DSTs). Majority of the isolates were susceptible to amphotericin B (91.5%), followed by posaconazole (90.3%), fluconazole (84.3%), itraconazole (74.1%), caspofungin (53.6%), and voriconazole (26.8%). Biofilm formation, yeast-to-hyphae transformation and phospho- lipase activity were reported species-dependent.
 Conclusion: Our results demonstrated clinical epidemiology of various Candida species from cutaneous candidiasis dis- tributed in new molecular types with increasing importance of drug resistant of non-albicans Candida species. Our results showed that drug susceptibility and genetic variability of Candida species may be attributed to their clinical features and source of isolation.

In vivo and in vitro Pathogenesis and Virulence Factors of Candida albicans Strains Isolated from Cutaneous Candidiasis

“…We have experimented oral and systemic models of candidiasis using C. albicans strains isolated from skin lesions and selected four clades derived from typing by MLST method [13] . The murine model that is considered as the "gold standard" in the study of oral and systemic Candida infections can be used to prove genetic determinants of Candida virulence ability [32] .…”

“…The present study was designed to evaluate the virulence activity of the C. albicans strains isolated from skin lesions to induce systemic and oral candidiasis in murine models. Eight C. albicans isolates were selected according to the highest and the lowest in vitro virulence activity in four clades derived from typing by MLST method [13] (Fig. 1).…”

“…The present study was designed to evaluate the ability of molecular-typed C. albicans strains [13] isolated from skin lesions to induce systemic and oral candidiasis in murine models. In our study, the presumptive relation between in vivo and in vitro pathogenesis and differences in molecular types and evolutionary origin of C. albicans isolates were considered.…”

Predicting the impact of climate change on the area of wetlands using remote sensing

“…The maximum watershed area of the wetland has been 1663 hectares, with water depth reaching 1 meter in some areas. Its maximum volume was 43 million cubic meters in 2011 (Sadeghi and Raisi Ardakani, 2018). With an approximate area of 90 square kilometers and a height of 1990 meters, it is part of the Arjan-Parishan biosphere reserve.…”

“…In this regard, the water volume change is inspected for at least three decades. Therefore, the water balance equation is usually used to calculate the difference in the volume of incoming and outgoing water (Sadeghi and Raisi Ardakani, 2018). Remote sensing (RS) is a low-cost tool that uses different algorithms to accurately classify wet and dry regions and calculate the wetland area.…”