Comparative in vitro activities of seven antifungal drugs against clinical isolates of Candida parapsilosis complex.

OBJECTIVE: Candida parapsilosis species complex, an important set of non-albicans Candida species, is known to cause candidaemia particularly in neonates and infants. However, the incidence has increased in recent years, owing to higher numbers of at individuals at risk for these infections. Our objective was to evaluate the in vitro susceptibility of clinical isolates of C. parapsilosis complex isolates from Iran to seven antifungal drugs. MATERIAL AND METHODS: One hundred-one clinical isolates of C. parapsilosis species complex cultured from humans were included. Species identification had been previously confirmed by combined phenotypic characteristics, matrix-assisted laser desorption ionization-time of flight mass spectrometry-based assay and reconfirmed by DNA sequence analysis of the ITS rDNA region and D1/D2 gene. Minimum inhibitory concentrations (MICs) for amphotericin B, fluconazole, itraconazole, voriconazole, posaconazole, micafungin and anidulafungin were determined against well-characterized isolates by broth microdilution susceptibility testing according to the CLSI M27-A3 guideline. RESULTS: Species identifications were performed on 101 isolates, of which 88 (87.2%) C. parapsilosis sensu stricto and 13 (12.8%) C. orthopsilosis. Amphotericin B and posaconazole were the most active drugs with 100% of isolates being wild-type (WT). Voriconazole and micafungin, 99% of isolates were WT. The low activity was recorded for fluconazole and itraconazole with 93.1% and 89.1% of isolates being WT, respectively. At the species level, all Candida parapsilosis sensu stricto isolates were WT to amphotericin B and posaconazole and all Candida orthopsilosis isolates were WT to amphotericin B, voriconazole, posaconazole, anidulafungin and micafungin. In contrast, the highest rate of non-WT was observed in C. orthopsilosis to itraconazole (4 of 13, 30.8%). CONCLUSIONS: Although almost all of the tested drugs demonstrated potent activity against C. parapsilosis species complex, it seems that more especially C. orthopsilosis isolates had decreased susceptibility to itraconazole. Further studies are needed to determine how these findings may switch into in vivo efficacy.

Comparison of biofilm-producing ability of clinical isolates of Candida parapsilosis species complex.

OBJECTIVE: Candida parapsilosis is one of the main emerging non-Candida albicans species leading to superficial and systemic fungal infections in humans. Candida has the ability to produce biofilms associated with pathogenesis. The aim of the study was to estimate biofilm-producing ability of clinical isolates of C. parapsilosis sp. complex. METHODS: Clinical samples of C. parapsilosis complex have been analyzed. Crystal violet (CV) staining and tetrazolium reduction assay (MTT) have been used to analyze the clinical isolates ability to produce biofilms. The biofilm's structural characteristics have been assessed by using scanning electron microscopy. RESULTS: All 65 isolates were able to form biofilm. In addition, no significant difference was found between biofilm quantification based on two assays at different time intervals (24h, 48h, 72h, 96h) (P>0.05), with the exception of Candida orthopsilosis, which exhibited higher metabolic activity at 24h time point (P<0.05). Moreover, metabolic activity and production of biofilm biomass demonstrated statistically significant correlation (r=0.685, P<0.01). According to microscopic observations, the investigated clinical strains formed the similar surface topography with the slight differences in morphology; in addition, there was no statistically significant difference between efficiency of two assays to quantify biofilm. CONCLUSION: It was shown that, similar to C. parapsilosissensu stricto, two cryptic identified species (C. orthopsilosis and Candida metapsilosis) obtained from different clinical samples, were biofilm producers, while C. parapsilosissensu stricto exhibited the highest biofilm production.

First survey of cutaneous leishmaniasis in Borujerd county, western Islamic Republic of Iran.

Lorestan province in the Islamic Republic of Iran has not previously been known as a focus for cutaneous leishmaniasis (CL). Clinical and epidemiological studies were carried out on patients diagnosed with active CL at the central laboratory in Borujerd city during 1998-2010. A total of 137 patients with corroborated CL were studied (mean estimated annual incidence 4.36 per 100 000 inhabitants). The male:female ratio was > 11:1. Patients ranged in age from 8-63 years but > 70% were aged 21-40 years and only 1 was < or = 10 years. The rate of CL was highest in rural residents (56.9%) and among those working as labourers (38.0%) and drivers (32.8%). The rate of active lesions on the upper limbs (69.3%) was significantly higher than other locations, and more cases were dry sores (57.7%) than wet sores (42.3%). The majority of patients (61.3%) had a single active lesion (mean 1.8 ulcers per patient). This is the first report of CL in the area.

First survey of cutaneous leishmaniasis in Borujerd county, western Islamic Republic of Iran

Lorestan province in the Islamic Republic of Iran has not previously been known as a focus for cutaneous leishmaniasis [CL]. Clinical and epidemiological studies were carried out on patients diagnosed with active CL at the central laboratory in Borujerd city during 1998-2010. A total of 137 patients with corroborated CL were studied [mean estimated annual incidence 4.36 per 100 000 inhabitants]. The male:female ratio was > 11:1. Patients ranged in age from 8-63 years but > 70% were aged 21-40 years and only 1 was </= 10 years. The rate of CL was highest in rural residents [56.9%] and among those working as labourers [38.0%] and drivers [32.8%]. The rate of active lesions on the upper limbs [69.3%] was significantly higher than other locations, and more cases were dry sores [57.7%] than wet sores [42.3%]. The majority of patients [61.3%] had a single active lesion [mean 1.8 ulcers per patient]. This is the first report of CL in the area