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Title

Investigation of Fungal Colonization Among Iranian Patients with Idiopathic Pulmonary Fibrosis; Molecular Identifi cation and Antifungal Susceptibility Pattern

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Abstract

 Background: Idiopathic pulmonary fi brosis (IPF) is a chronic and progressive lung disease. In patients with lung tissue damage, Fungal Colonization leads to persistent infection. It is expected for there to be an association between fungal agents and etiology of IPF. Objectives: The aim of this study was to investigate the prevalence and molecular identifi cation of fungal species isolated from IPF patients for the fi rst time in Iran. Also, in vitro anti-fungal susceptibility testing of isolates was demonstrated. Methods: Forty nasopharyngeal (NP) swabs or bronchoalveolar lavage (BAL) samples were obtained from Iranian patients with IPF, who were diagnosed by a sophisticated practitioner from year 2015 to 2016 (Tehran, Iran). Direct examination of samples was carried out using hydroxide potassium (KOH) for detection of fungal elements. The specimens were cultured on Sabauroud Dextrose Agar (SDA) medium. Conventional methods, including polymerase chain reaction (PCR) and sequencing, were carried out for identifi cation of fungal species. Indeed, Antifungal Susceptibility Testing of yeast isolates was conducted according to Clinical Laboratory Standards Institute (CLSI M27-S3 and S4) protocol. The data was analysed using SPSS sofware version 20. Results: Of 40 IPF patients, 22 (55%) were female and 18 (45%) were male. Seven (17. 5%) of IPF patients were positive for fungal species as follows; four (10%) Candida albicans (C. albicans), two (5%) Candida glabrata (C. glabrata), and one (2. 5%) Aspergillus fumigatus (A. fumigatus) were identifi ed using the culture and PCR technique. A signifi cant correlation was found between C. albicans colonization in upper respiratory system tract and presence of underlying disease in IPF patients (P < 0. 05). Antifungal Susceptibility Testing showed that all C. albicans isolates were resistant to itraconazole, whereas three (75%) C. albicans were resistant to amphoterecin B. It was found that three (75%) and one (25%) C. albicans isolate were susceptible dose dependantly and resistant to fl uconazole, respectively. Morever, C. glabrata isolates were resistant to fl uconazole, itraconazole, and amphotricin B. Conclusions: Taken together, fungal species were detected in 17. 5% of IPF patients. Resistance of Candida species to antifungal agents is growing, therefore isolation, identifi cation, and Antifungal Susceptibility Testing of fungal elements in IPF patients are necessary for appropriate treatment. However, determining an association between the fungal agents and devasting form of pulmonary fi brosis requires further investigation in the future.

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    APA: Copy

    ROUDBARY, MARYAM, KEYVANI, HOSSEIN, MOUSAVI, SEYED ALI JAVAD, ESGHAEI, MARYAM, ROUDBARMOHAMMADI, SHAHLA, Hedayati, Neda, Salehabadi, Ghazaleh, FALAHATI, MEHRABAN, & ASHRAFI KHOZANI, MAHTAB. (2019). Investigation of Fungal Colonization Among Iranian Patients with Idiopathic Pulmonary Fibrosis; Molecular Identifi cation and Antifungal Susceptibility Pattern. ARCHIVES OF CLINICAL INFECTIOUS DISEASES, 14(2), 0-0. SID. https://sid.ir/paper/748147/en

    Vancouver: Copy

    ROUDBARY MARYAM, KEYVANI HOSSEIN, MOUSAVI SEYED ALI JAVAD, ESGHAEI MARYAM, ROUDBARMOHAMMADI SHAHLA, Hedayati Neda, Salehabadi Ghazaleh, FALAHATI MEHRABAN, ASHRAFI KHOZANI MAHTAB. Investigation of Fungal Colonization Among Iranian Patients with Idiopathic Pulmonary Fibrosis; Molecular Identifi cation and Antifungal Susceptibility Pattern. ARCHIVES OF CLINICAL INFECTIOUS DISEASES[Internet]. 2019;14(2):0-0. Available from: https://sid.ir/paper/748147/en

    IEEE: Copy

    MARYAM ROUDBARY, HOSSEIN KEYVANI, SEYED ALI JAVAD MOUSAVI, MARYAM ESGHAEI, SHAHLA ROUDBARMOHAMMADI, Neda Hedayati, Ghazaleh Salehabadi, MEHRABAN FALAHATI, and MAHTAB ASHRAFI KHOZANI, “Investigation of Fungal Colonization Among Iranian Patients with Idiopathic Pulmonary Fibrosis; Molecular Identifi cation and Antifungal Susceptibility Pattern,” ARCHIVES OF CLINICAL INFECTIOUS DISEASES, vol. 14, no. 2, pp. 0–0, 2019, [Online]. Available: https://sid.ir/paper/748147/en

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