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Molecular identification and antifungal susceptibility profiles of yeasts isolated from onychomycosis
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  • somayeh yazdanpanah,
  • Ahmad Jabrodini,
  • marjan motamedi,
  • Kamiar Zomorodian,
  • Mahboobeh Kharazi,
  • Shafigheh Shabanzadeh,
  • Farnia Ghasemi,
  • Sahar Shariat,
  • Maryam Rezaei Arab
somayeh yazdanpanah
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Ahmad Jabrodini
Shiraz University of Medical Sciences
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marjan motamedi
Shiraz University of Medical Sciences School of Medicine

Corresponding Author:[email protected]

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Kamiar Zomorodian
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Mahboobeh Kharazi
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Shafigheh Shabanzadeh
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Farnia Ghasemi
Shiraz University of Medical Sciences
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Sahar Shariat
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Maryam Rezaei Arab
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Abstract

Candida onychomycosis is a common fungal infection affecting the nails, primarily caused by Candida species. Regarding the increasing trend of Candida onychomycosis and antifungal-resistant phenomenon in recent years, this study aims to evaluate the epidemiological characteristics of Candida onychomycosis, the distribution of emerging species, and the antifungal susceptibility profiles of isolates. Onychomycosis caused by yeast species was confirmed through direct examination and culture of nail scraping among all individuals suspected to have onychomycosis and referred to a medical mycology laboratory between June 2019 and March 2022. Species of yeast isolates were identified using the multiplex PCR and RFLP-PCR methods. The antifungal susceptibility of isolates to common antifungal agents and imidazole drugs was evaluated according to the M-27 A3 CLSI protocol. Among 101 yeast strains isolated from onychomycosis, Candida parapsilosis complex (50.49 %) was the most common species, followed by C. albicans (20.79 %) and C. tropicalis (10.89 %). Rare species of yeasts such as C. guilliermondii and Saccharomyces cerevisiae were also identified by molecular methods. Results obtained from antifungal susceptibility testing showed significant differences in MIC values of isoconazole, fenticonazole, and sertaconazole among different species. Overall, 3% fluconazole-resistant rate was found among Candida species. Moreover, there was a statistically significant difference in MICs of fenticonazole and clotrimazole between the two most prevalent causative species, C. parapsilosis complex and C. albicans. Correct identification of the causative agents of onychomycosis and performing susceptibility testing could be helpful in choosing the most appropriate antifungal therapy.