فهرست مطالب انسیه لطف علی

Considering the increase of dermatophytosis trough the Iran and world as well, especially ringworm of the body and groin due to terbinafine-resistant species and the high speed of disease transmission, in order to choose the appropriate treatment, considering the time required for the treatment of the disease and early detection of resistant cases treatment is required. The present study was conducted to determine the antifungal sensitivity of Trichophyton rubrum, Microsporum canis and Epidermophyton flucosum strains to common antifungal drugs.

Antifungal sensitivity test (broth microdilution) was performed for 20 specimens obtained from patients according to CLSI (Clinical and Laboratory Standard Institute) M38-3rd ED protocol, for terbinafine, itraconazole and voriconazole.

According to the antifungal susceptibility test results, 5 patients were resistant to terbinafine and showed a minimum inhibitory concentration more than 2, 3 patients were tolerant to terbinafine and showed a minimum inhibitory concentration between 0.5 and 1. Based on the results of the antifungal susceptibility test, 7 patients were tolerant to itraconazole and showed the minimum inhibitory concentration between 0.5 and 1. All isolates responded well to voriconazole.

The results of the antifungal sensitivity test highlight the importance of mycological tests on dermatophytic skin lesions to prevent the spread of drug-resistant species.

Oral candidiasis is a common opportunistic disease of oral cavity particularly in neonates because of Candida overgrowth. Colonization of infant’s oral mucosa with Candida species is the primary stage for invasive candidiasis. The aim of the present study was to determine the association of risk factors and oral candidiasis.

specimens were obtained from 70 infants who were suspected of having candidiasis, using the swabs samples were taken from the cheek, mucosa, tongue and palate surfaces. Specimens were assessed by routine mycological and molecular approaches. Results were statistically analyzed using the SPSS v16 software

From 70 infants, 50 species of Candida were isolated. The results showed that the incidence of oral candidiasis in infants was pointedly associated to type of delivery (normal/ cesarean), mode of nourishing (breast milk, milk powder, both of them), use of antibiotic medications, and use of milk flask. There was no significant relationship among pacifier and age.

The findings of this study showed that there is a significant relationship between the incidence of oral candidiasis in newborns with type of delivery, breastfeeding, no use of milk jars and antibiotic use. Therefore, the presence of candida in the vagina of the pregnant mothers can cause the baby to develop candidiasis during birth.

Oral lichen planus is a chronic
muco-cutaneous immunopathological disorder that commonly affects the oral mucosa. Candida albicans is the most common pathogen associated with oral candidiasis. The aim of this study was to determine the effect of 810 nm low power laser wavelength as an adjuvant in the treatment of
nystatin-resistant C.albicans in patients with oral lichen planus.

In this experimental study, 5 nystatin-resistant C.albicans were isolated from the oral cavity of patients with ulcerative lichen planus. Drug susceptibility testing was performed based on CLSI-M27-A3 and showed that these isolates were resistant to nystatin. The fungal suspension with a dilution of 0.5 McFarland was exposed to a diode laser with a wavelength of 810 nm and a density energy of 20.38 j / cm2 with a time of 20 seconds. Then the results of minimum inhibitory concentration (MIC) were recorded for each group. 

810 nm laser caused a significant reduction in nystatin-resistant C.albicans colonies (P<0.001). The MIC did not decrease significantly after the exposure. 

Laser irradiation reduces the number of nystatin-resistant C.albicans colonies. But this effect does not necessarily change the MIC. Dentists should be aware that in cases of resistant Candida strains, a low-power diode laser with a wavelength of 810 nm can play a role in reducing colonies and responding better to standard treatment.

Onychomycosis is a nail infection caused by dermatophyte and non-dermatophyte molds and yeasts. The nail involvement is a feature of psoriasis, although skin manifestations are the most principal findings in psoriasis. Onychomycosis and psoriasis are both common disorders in communities. It is possible that in some patients these two diseases are present at the same time. A review was performed using the keywords including nail psoriasis, onychomycoses, dermatophytes, non-dermatophyte molds and yeasts in valid medical databases, such as PubMed, Google scholar, Scopus and Science direct. Articles that were most relevant to the purpose of the study were selected and studied. We investigated the incidence and pathogenic function of fungal agents in causing fungal infections in psoriasis nails.

 Dermatophytosis is a superficial fungal disease. Prosopis farcta has attracted attention for ethnobotany and medical purposes. The present study aimed to investigate the antifungal properties of Prosopis farcta extracts against Trichophyton mentagrophytes (PTCC 5054) and five archived terbinafine resistant clinical isolates of T. mentagrophyte, based on an ethnobotanical report in Yazd province (Iran).

 In vitro drug susceptibility for methanol extract and amphotericin B was carried out according to the CLSI-M38-A2. A topical solution (1%) was formulated by root extract of P. farcta. The nine male Sprague rats were infected by T. mentagrophytes and assessed for in vivo anti-dermatophytic activity.

 The MIC value of amphotericin B was ≤ 0.5 μg/mL against all strains. The methanol extract showed the lowest MIC and MFC values on fungal activity (both with 0.00625 mg/mL). The complete cure of 21-day period with terbinafine is reduced to 10 days with methanol 80% root extract of P. farcta solution.

 Compared with amphotericin B, P. farcta could be considered a potential antifungal agent in terbinafine-resistant clinical isolates of dermatophytes.

Dermatophytosis are micro-organisms which can lead to skin diseases. In rare occasions they can have atypical skin manifestations, which could result in delay in diagnosis.  

 A 20-year-old Iranian boy was referred to our center with a 5-month history of circular, symmetrical, itchy crusted skin lesions on his groin. Direct microscopy, culture test and PCR-sequencing of ITS regions of the rDNA gene were conducted and showed T. indotinea as the causative agent. Based on antifungal susceptibility test oral pulse therapy with itraconazole 100 mg twice daily for 1 week combined with topical clotrimazole cream for 1 month was initiated, which cleared the lesions.

This case report is of significance since T. indotinea produces atypical skin lesions, as well as, multidrug resistance to antifungal agents.

Onychomycosis is an infection caused by yeast, filamentous and non-filamentous fungi, due to diverse conditions. This study aimed to investigate the pattern of azole susceptibility of candidate species isolated from Iranian patients in Tehran.

After sampling from patients, identification of the isolated strains were performed with Candida chrom agar medium and PCR-sequencing test. Drug Susceptibility pattern of the species to fluconazole, itraconazole and ketoconazole were determined by CLSI-M27-A3/S4 standard method.

In this study, 34 candidate isolates were identified, of which 26 isolates (76.5%) were Candida albicans and 8 isolates (23.5%) were Candida glabrata. In fluconazole, 4 (11%) of the isolates were dose-dependent sensitive and the others were sensitive. In itraconazole, 21 (61%) dose-dependent isolates and 2 (5%) resistant isolates were identified, and in ketoconazole, all isolates were sensitive. The geometric mean (GM) of the minimum inhibitory concentration for fluconazole, itraconazole and ketoconazole was 0.32, 0.21 and 0.15 μg/mL, respectively. In this study, the most frequently isolated species was C. albicans. According to the GM values, the most effective azoles was ketoconazole.

The prevalence and pattern of susceptibility of Candida species to azole may vary in different populations of patients. Therefore, it is recommended that the clinicians pay attention to the results of drug susceptibility tests and then treat patients by considering drug interactions and side effects.

Candida species have been associated with the emergence of resistant strains against antifungal agents, recently. Antifungal agents are usually accompanied with side effects. Plant products have been used traditionally as alternative medicine to cure candidiasis. So it seems vital to find the new antimicrobial agents with fewer side effects. In this survey, we aimed to evaluate the antifungal effects of aqueous extracts of Mentha longifolia against oral pathogenic candida species.

This study was conducted on Candida albicans ( ATCC 10261), and ten Candida albicans isolated from leukemia (AML and ALL) patients with thrush.  
The antifungal activity and minimum inhibitory concentration (MIC) of Mentha longifolia extract were evaluated and then MIC results compared with
Chlorhexidine and nystatin.

Mentha longifolia extract showed antifungal properties. MIC results of extract were in the range of 31.25 to 125 µg/ml. while MIC of Chlorhexidine were in the range of 125 to 250 µg/ml. Moreover, a significance difference was not observed between MIC of standard species and clinical isolates of Candida albicans (P>0.05). According to the results, aqueous extract of Mentha longifolia was more successful in inhibition of growth of Candida isolates, compared to
Chlorhexidine (P<0.001).

The inhibitory effects of Mentha longifolia extract have shown that it has potential to be considered as a promising candidate for the development of antifungal agent for treatment of thrush.

The aim of the present study is rapid and precise identification of yeast species isolated from nail of patients with clinical features of onychomycosis using PCR-RFLP technique.

50 patients with involvement of 29 fingernails and 21 toenails were enrolled in the study. Different yeast species were identified by conventional mycological. The PCR-RFLP was tested on yeast isolated and the PCR-RFLP products were separated by electrophoresis in 2% agarose gel, with DNA stain.

The main causative agents were yeasts in 12 cases (24%). Candida albicans was the most commonly isolated yeast species followed by Candida parapsilosis (6%), and Candida glabrata (4 %).

PCR-RFLP method using ITS1-ITS4 primers and MspI restriction enzymes is a rapid, accurate and cost-effective method for specific diagnosis of the most prevalent candida spp. Its ability to detect low amounts of fungal DNA in patient samples in 6-8 hours could be useful for clinical laboratories for optimal management of these infections.

Superficial dermatophytoses are among the most common infectious disease. The most commonly used antifungal categories reazoles, polyenes and echinocandins. Due to the limited number of available antifungal drugs, toxicity and the emergence of resistant (intrinsic or acquired) strains, antifungal strategy needs to be developed. Recently the researchers try to find alternative antifungal agents. This review emphasizes the action and resistance mechanisms to antifungal drugs, the search for new agents, drug- resistant genes, and the application of combination therapy and immunomodulators (using cytokines and gamma interferon which can provide novel insights to fighting fungal infections). A comprehensive review study was performed using the keywords including Candida, antifungal drugs and drug resistance in valid medical databases, mainly PubMed. Articles that were most relevant to the purposes of the study were selected and studied. Problems with antifungal resistance and the emergence of resistant strains of fungal has produced an enormous demand for new antifungal agents. The clinical complexity of patients with resistant mycoses prevents an easy approach to the detection, prevention, and management of antifungal drug resistance. Continuing investigation will illustrate the role of susceptibility testing for resistant mycoses and on clinical strategies used to fighting antifungal drug resistance in pathogenic fungi.