背景:皮肤癣菌具有侵入人类角蛋白层并引起感染的能力。这项研究的目的是通过聚合酶链反应-限制性片段长度多态性方法和测序准确鉴定皮肤癣菌,并比较新的和已建立的抗真菌药物的体外活性。
方法:这项研究输入了来自五个伊朗大学实验室的患者的临床标本。将样品在sabouraud葡萄糖琼脂培养基上培养。对于分子鉴定,提取的DNA通过通用真菌引物ITS1和ITS4扩增,并用MvaI酶消化。每个分离株对特比萘芬的抗真菌药敏试验,灰黄霉素,卡波芬金,氟康唑,伊曲康唑,卢立康唑,并进行了伊沙武康唑,根据微量稀释CLSIM38-A2和CLSIM61标准方法。
结果:通过分子测定,分离出与皮肤癣菌相似的两百七种真菌,其中198种(95.6%)为皮肤癣菌。最常见的是毛癣菌(76/198),其次是毛癣菌(57/198),红色毛癣菌(34/198),扁桃体毛癣菌(12/198),犬小孢子菌(10/198),毛癣菌(3/198),絮状表皮木素(3/198),紫毛癣菌(2/198),和毛癣菌(1/198)。所有分离株的GMMIC和MIC90值如下:特比萘芬(0.091和1μg/ml),灰黄霉素(1.01和4μg/ml),卡泊芬净(0.06和4μg/ml),氟康唑(16.52和32μg/ml),伊曲康唑(0.861和8μg/ml),异戊唑醇(0.074和2μg/ml),和卢立康唑(0.018和0.25μg/ml)。
结论:毛癣菌,间型毛癣菌,和红色毛癣菌是从患者中分离出的最常见的真菌。卢立康唑,特比萘芬,和伊沙武康唑在体外被发现是对所有皮肤癣菌分离物最有效的抗真菌剂。
BACKGROUND: Dermatophytes have the ability to invade the keratin layer of humans and cause infections. The aims of this
study were the accurate identification of dermatophytes by Polymerase Chain Reaction-Restriction Fragment Length Polymorphism method and sequencing and comparison between the in vitro activities of newer and established antifungal agents against them.
METHODS: Clinical specimens of patients from five Iranian university laboratories were entered in this
study. Samples were cultured on sabouraud dextrose agar medium. For molecular identification, extracted DNAs were amplified by the universal fungal primers ITS1 and ITS4, and digested with MvaI enzymes. The antifungal susceptibility test for each isolate to terbinafine,
griseofulvin, caspofungin, fluconazole, itraconazole, luliconazole, and isavuconazole was performed, according to the microdilution CLSI M38-A2 and CLSI M61 standard methods.
RESULTS: Two hundred and seven fungi species similar to dermatophytes were isolated of which 198 (95.6%) were dermatophytes by molecular assay. The most commonly isolated were Trichophyton mentagrophytes (76/198), followed by Trichophyton interdigitale (57/198), Trichophyton rubrum (34/198), Trichophyton tonsurans (12/198), Microsporum canis (10/198), Trichophyton simii (3/198), Epidermophyton floccosum (3/198), Trichophyton violaceum (2/198), and Trichophyton benhamiae (1/198). The GM MIC and MIC90 values for all the isolates were as follows: terbinafine (0.091 and 1 μg/ml),
griseofulvin (1.01 and 4 μg/ml), caspofungin (0.06 and 4 μg/ml), fluconazole (16.52 and 32 μg/ml), itraconazole (0.861 and 8 μg/ml), isavuconazole (0.074 and 2 μg/ml), and luliconazole (0.018 and 0.25 μg/ml).
CONCLUSIONS: Trichophyton mentagrophytes, Trichophyton interdigitale, and Trichophyton rubrum were the most common fungal species isolated from the patients. luliconazole, terbinafine, and isavuconazole in vitro were revealed to be the most effective antifungal agents against all dermatophyte isolates.