فهرست مطالب

Current Medical Mycology
Volume:4 Issue: 1, Mar 2018

  • تاریخ انتشار: 1397/01/10
  • تعداد عناوین: 8
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  • Nasser Keikha, Mahdieh Shafaghat, Seyed Mohammad Mousavi, Mahdiyeh Moudi, Farshid Keshavarzi Pages 1-5
    Background and
    Purpose
    Vulvovaginal candidiasis is one of the most common infections in female genital organs, which is caused by Candida species. Candida albicans is the causative agent of more than 80% of infections, and the role of non-Candida strains in the disease etiology is less prominent. The expansion of Azoles resistance among C. albicans strains is considered an important medical problem. According to previous studies, Vitex agnus-castus (vitex) has some antimicrobial effects. We aimed to evaluate the anti-fungal effects of aqueous and alcoholic extracts of vitex against clinical vaginal isolates of C. albicans in comparison with fluconazole.
    Materials And Methods
    Gas chromatography-mass spectrometry analysis was performed on vitex to identify its possible bioactive components. Forty C. albicans clinical isolates were identified by using germ tube, chlamydospore production, culture on CHROMagar, and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Finally, after the extraction of vitex, drug susceptibility test was carried out according to the clinical laboratory standards institute (CLSI) M27-S4 document guidelines.
    Results
    The major chemical components of vitex leaf as determined by gas chromatography included α-Pinene, isoterpinolene, caryophyllene, and azulene. The minimum inhibitory concentrations (MICs) of aqueous and alcoholic extracts of vitex, as well as fluconazole were within the ranges of 15.62–62.5, 7.81–15.62, and 0.25–8 μg/mL, respectively.
    Conclusion
    Our findings showed that the alcoholic and aqueous extracts of vitex had antifungal activity against clinical isolates of C. albicans. Moreover, the alcoholic extract of vitex and fluconazole were more effective against clinical vaginal isolates of C. albicans compared to the aqueous extract of vitex.
    Keywords: Antifungal activity, Candida albicans, Vitex agnus-castus
  • Louis Jacob, Mara John, Matthias Kalder, Karel Kostev Pages 6-11
    Background and
    Purpose
    To the best of our knowledge, no information is available regarding the treatment of vulvovaginal candidiasis in gynecological practices. The goal of this study was to analyze the prevalence of vulvovaginal candidiasis (VVC) and the drugs prescribed for the treatment of this condition in women followed in gynecological practices in Germany.
    Materials And Methods
    All the women followed in 262 gynecological practices between November 2014 and October 2016 were included in this study. The first outcome was the prevalence of patients diagnosed with VVC during this period.
    The second outcome was the prevalence of women with VVC who received an appropriate vaginal or systemic antimycotic prescription within 30 days after their first VVC diagnosis. Covariables included the use of gynecological/systemic antibiotics, consumption of oral/vaginal contraceptives, cancer, pregnancy, diabetes, and psychiatric diseases including depression, anxiety, and adjustment and somatoform disorders.
    Results
    Between 2014 and 2016, 954,186 women were followed in gynecological practices, and 50,279 (5.3%) women were diagnosed with VVC during the same period. The use of gynecological antibiotics (OR=2.88), systemic antibiotics (OR=1.45), oral contraceptives (OR=1.74), and vaginal contraceptives (OR=1.84) were associated with an increase in the risk of VVC diagnosis. Cancer (OR=1.20) and pregnancy (OR=1.59) were additional risk factors. Approximately 75% of women diagnosed with VVC received an antimycotic prescription. The three most frequently prescribed drugs were clotrimazole (72%), fluconazole (14%), and nystatin (6%).
    Conclusion
    More than 5% of women were diagnosed with VVC and the majority of them received an appropriate prescription.
    Keywords: Germany, Gynecological practices, Prescription, Prevalence, Vulvovaginal candidiasis
  • Parastoo Hassani Abharian, Parvin Dehghan, Peyman Hassani Abharian, Sepideh Tolouei Pages 12-17
    Background and
    Purpose
    Candida dubliniensis is closely related to the most pathogenic and prevalent yeast, namely C. albicans. Candida species can opportunistically overgrow in vulnerable individuals and cause a variety of diseases. The current study aimed to identify and isolate C. dubliniensis species present in the Candida albicans species complex identified in the oral cavity of drug abusers.
    Materials And Methods
    This study was conducted on 53 strains of C. albicans species complex, isolated from the oral mucosa of drug abusers in Isfahan, Iran. DNA extraction was accomplished through boiling procedure. Duplex polymerase chain reaction (PCR) was performed to amplify ITS1-5.8S-ITS2 region using four specific primers. Fungal species were identified based on the difference in the size of the bands created in the Agarose gel.
    Results
    Out of the 53 isolates under study, 30 (56.6%) and 14 (26.4%) samples were identified as C. albicans and C. dubliniensis, respectively. In the remaining 9 samples (17%), both types of Candida species were confirmed.
    Conclusion
    The findings of the present study revealed the presence of a noticeable amount of C. dubliniensis in the oral cavity of drug abusers. Therefore, the probable presence of this fungus should be considered during the examination of oral infection among this group. To date, no research has directly investigated this issue in Iran.
    Keywords: Candida albicans, Candida dubliniensis, Drug, PCR, Smoking
  • Saeid Mahdavi Omran, Zahra Yousefzade, Soraya Khafri, Mojtaba Taghizade Armaki, Keyvan Kiakojuri Pages 18-23
    Background and
    Purpose
    There are controversial findings regarding the efficacy of antifungal drugs in the treatment of a ruptured eardrum following fungal infections. Regarding this, the aim of the present study was to evaluate the therapeutic effect of the co-administration of antifungal and antibacterial agents in the treatment of otomycosis with tympanic membrane perforation.
    Materials And Methods
    This analytical, clinical trial was conducted on 87 patients with otomycosis showing no bacterial elements in the direct observation and culture. The study population was assigned into two groups of intervention (n=45) and control (n=42). The demographic and clinical data, as well as the data related to the direct observation and culture of the ear samples were recorded in a checklist. All statistical analysis was performed in SPSS (version 24).
    Results
    The most prevalent symptoms in both groups were hearing loss and itching, and the most common finding was secretion. Aspergillus and Candida were the most frequent fungi isolated from the samples. After the implementation of combination therapy, the intervention group demonstrated a significant decrease in symptoms and signs, compared to the control group (P=0.005).
    Conclusion
    The findings of the present study indicated that the use combination therapy with ceftizoxime powder and clotrimazole ointment was effective the in treatment of the patients with tympanic membrane rupture showing no bacterial effects in direct examination and culture.
    Keywords: Ceftizoxime, Clotrimazole, Middle ear, Otomycosis, Tympanic membrane rupture
  • Mahboobeh Kharazi, Bahram Ahmadi, Koichi Makimura, Armin Farhang, Sahar Kianipour, Marjan Motamedi, Hossein Mirhendi Pages 24-29
    Background and
    Purpose
    Candida parapsilosis is a common cause of candidemia in children and onco-hematologic patients as well as in patients with septic arthritis, peritonitis, vaginitis, and nail and skin infections. Here, we evaluated intra- and inter-species beta tubulin DNA sequence variation within the C. parapsilosis complex with a view to establishing its utility in the identification and phylogenetic analysis of the species.
    Materials And Methods
    The novel primers successfully amplified the target for all 23 strains included in the study.
    Results and
    Conclusion
    Multiple alignment of 623–629 bp-long nucleotide (nt) sequences reflecting the beta tubulin gene indicated an inter-species divergence ranging from 0 to 68 nt in C. parapsilosis, C. orthopsilosis and C. metapsilosis with a mean similarity of 84.7% among the species. Meanwhile, intra-species differences of 0–20 and 0–6 nt were found within the strains of C. parapsilosis and C. orthopsilosis, respectively. The phylogenetic tree topology was characterized by a clade made up by C. parapsilosis and C. orthopsilosis, while C. metapsilosis formed a related but separate lineage. Our data provide the basis for further discoveries of the relationship between the species belonging to the C. parapsilosis complex and the value of beta tubulin DNA sequence data in the identification and taxonomy of C. parapsilosis and other pathogenic yeasts.
    Keywords: Candida parapsilosis, beta tubulin, sequence analysis
  • Ali Ghajari, Ensieh Lotfali, Maryam Norouzi, Zahra Arab-Mazar Pages 30-33
    Background and
    Purpose
    Cryptococcus. magnus is a non-Cryptococcus neoformans species isolated from certain plants, soil, air, and arctic glaciers.
    Case report: This report describes a case of a 23-year-old Iranian female with pruritus and vaginal irritation. Conventional tests and molecular analysis of the samples of vaginal discharge were performed. The mentioned analyses revealed Cryptococcus magnus as the causative agent of vaginal infection. The minimum inhibitory concentration analysis revealed that this species is susceptible to itraconazole, fluconazole, ketoconazole, and amphotericin B. The patient received 200 mg of oral ketoconazole once daily for 10 days. The patient did not show any clinical signs of vaginal infection after six months.
    Conclusion
    C. magnus was found to have the ability to cause vulvovaginitis. This is the first report of successful detection and treatment of vulvovaginal infection with C. magnus.
    Keywords: Cryptococcus magnus, ribosomal 28S DNA sequence, isolation
  • Simhadri Vsdna Nagesh, Muthuchamy Muniappan, Iyanar Kannan, Subramanyam Viswanathan Page 34
  • Hossein Mirhendi, Yayoi Nishiyama, Ali Rezaei-Matehkolaei, Kazuo Satoh, Koichi Makimura Page 35