An Autochthonous Susceptible Candida auris Clade I Otomycosis Case in Iran
Abstract
:1. Introduction
2. Case Presentation
3. Materials and Methods
4. Results
5. Discussion
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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First Isolate | Second Isolate | Third Isolate | Fourth Isolate | Fifth Isolate | Sixth Isolate | ||
---|---|---|---|---|---|---|---|
[Original reference] year | [15] 2018 | [24] 2021 | [25] 2021 | [26] 2021 | [27] 2022 | Current study | |
Geographical clade | V | V | I | V | V | I | |
Demographic Data | Age (year) | 14 | 40 | 30 months | 33 | Teenager | 78 |
Sex | Female | Female | Male | Female | Female | Male | |
Underlying diseases | Otitis | Bilateral otalgia | Meningitis | Otitis | Epidermal dysplasia (TB63 Genetic variant) | Diabetes mellitus | |
Origin City and Zone | Babol; North of Iran | Babol; North of Iran | Isfahan; Center of Iran | Isfahan; Center of Iran | Shiraz; South of Iran | Bushehr; South-west of Iran | |
Site of Isolation | Ear discharge | Ear discharge | LP (CSF) | Ear discharge | - Ear discharge; - Skin scrapings | Ear discharge | |
Clinical Signs and Symptoms | - Right-sided earache; - Severe itching; - Hearing loss; - White-to-creamy discharge from the ear canal; - Inflammation; - Redness and tympanic membrane perforation in right ear | - Itching of external ear canal; - Creamy discharge of ear canal; - Inflammation (redness and swelling) | - Vomiting; - Loss of consciousness; - Frequent seizures | - Right-sided earache; - Severe itching; - Hearing loss; - White-to-creamy discharge from the ear canal; - Pruritus; - Otalgia; - Tinnitus; - Otorrhea; - Inflammation; - Redness in her right ear | - Severe itching; - Ear discharge | - Itching; - Ear discharge | |
Predisposing Factor | - No trauma or predisposing factor; -No travel history | - Repeated ear manipulation; - Ear eczema; - No travel history | - Previous hospitalization in Pakistan | - No predisposing factor; - No travel history | - Ichthyosis; - No travel history | - Diabetes mellitus type 2; - No travel history | |
Identification Methods | Mycological | - KOH smear; - Culture on SDA (white); - CHROM agar Candida (pink) - MALDI-TOF MS | - KOH smear; - Culture on SDA (white); - CHROM agar Candida (pale pink to dark purple) | - KOH smear; - Culture on SDA (white to creamy; yeast); - MALDI-TOF MS | - KOH and Giemsa smear (hyphae and yeasts); - Culture on SDA MALDI-TOF MS (filamentous fungi; Aspergillus sp.) (white to creamy; yeast); - CHROM agar Candida (pink) | - KOH smear; - Culture on SDA; - CHROM agar Candida; - MALDI-TOF MS | - KOH smear (round and oval cells); - Culture on SDA (white to cream); - CHROM agar Candida (pale pink to dark purple) |
Molecular | WGS | - PCR of ITS gene region WGS | - Multiplex PCR; - PCR of ITS gene region | - PCR of beta tubulin gene region; - PCR of ITS gene region; - STR genotyping WGS | - STR genotyping WGS | - Multiplex PCR of ITS gene region STR genotyping; -WGS | |
Reference Sequencing | ITS rDNA [MK123931.1] | ITS rDNA [MW019910.1] | ITS rDNA MZ853742.1 | - Beta tubulin gene; - ITS rDNA MZ389242.1 | ND | ITS rDNA OQ740733 | |
Similarity with the Standard/ex-type Isolate | 99.5% with EU884189.1 | 100% with MH427523.1 | 100% with MT912579.1 | - 99.5% with MT974681.1 | ND | 100% with OK625328.1 | |
Antifungal Susceptibility Profile (μg/mL) | - Fluconazole: 16; - Itraconazole: 0.063 - Voriconazole: 0.125; - Micafungin: 0.031; - Amphotericin B: 0.5; - Anidulafungin: 0.016; - Posaconazole: 0.016; - Isavuconazole: 0.063 | - Fluconazole: ≥32; - Itraconazole: 0.016 - Voriconazole: 1; - Micafungin: 0.032; - Amphotericin B: 0.25; - Anidulafungin: 0.016; - Posaconazole: 0.016; - Isavuconazole: 0.016; - Ravuconazole: 0.5; - Ketoconazole: 2; - Clotrimazole: 2 - Nystatin: 2 | - Fluconazole: >64; Amphotericin B: 1; - Itraconazole: 0.125; - Voriconazole: 0.25; - Clotrimazole: 0.015; - Nystatin: 8; - Caspofungin: 0.5; - Anidulafungin: 1; - 5-flucytosine: 0.125 | - Fluconazole: >64; - Itraconazole: 0.5; - Voriconazole: 1; - Micafungin: 0.015; - Caspofungin: 0.015; - Amphotericin B: 1; - Anidulafungin: 0.125; - Terbinafine: >16; - 5-flucytosine: 0.5 | - Fluconazole: 1; - Itraconazole: 0.016; - Voriconazole: 0.016; - Micafungin: 0.031; - Amphotericin B: 0.25; - Anidulafungin: 0.63; - Posaconazole: 0.016; - Isavuconazole: 0.016 | - Fluconazole: 8; - Itraconazole: 0.5; - Caspofungin: 1; - Amphotericin B: 1; - Miconazole: 4 | |
Therapeutic Strategies | - Empirical antibacterial therapy: Cefixime (400 mg/d); Topical gentamicin - Antifungal therapy: Topical nystatin (100,000 Units/g); Terbinafine (250 mg/d) | - Empirical antibacterial therapy: Ciprofloxacin; Gentamicin - Inflammation therapy: Betamethasone - Antifungal therapy: Topical clotrimazole; Topical miconazole | - Empirical antibacterial therapy: Meropenem; Vancomycin - antiepileptic drugs: Phenobarbital; Phenytoin; Levetiracetam Inflammation therapy: IFN-γ - Antifungal therapy: Fluconazole (100 mg/kg/d); IV Liposomal amphotericin B (3 mg/kg/day; i.v); Oral flucytosine (250 mg/kg/d) | - Empirical antibacterial therapy: Myxacort; Bactimide - Surgery - Inflammation therapy: Hydrocortisone-acetic acid otic - Antifungal therapy: Topical clotrimazole | ND | - Empirical antibacterial therapy: Topical ciprofloxacin (0.3%) -Inflammation therapy: Betamethasone | |
Outcome | Improved | Improved | No follow-up available | Improved | Improved | Improved |
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Ahmadi, B.; Naeimi, B.; Ahmadipour, M.J.; Morovati, H.; de Groot, T.; Spruijtenburg, B.; Badali, H.; Meis, J.F. An Autochthonous Susceptible Candida auris Clade I Otomycosis Case in Iran. J. Fungi 2023, 9, 1101. https://doi.org/10.3390/jof9111101
Ahmadi B, Naeimi B, Ahmadipour MJ, Morovati H, de Groot T, Spruijtenburg B, Badali H, Meis JF. An Autochthonous Susceptible Candida auris Clade I Otomycosis Case in Iran. Journal of Fungi. 2023; 9(11):1101. https://doi.org/10.3390/jof9111101
Chicago/Turabian StyleAhmadi, Bahram, Behrouz Naeimi, Mohammad Javad Ahmadipour, Hamid Morovati, Theun de Groot, Bram Spruijtenburg, Hamid Badali, and Jacques F. Meis. 2023. "An Autochthonous Susceptible Candida auris Clade I Otomycosis Case in Iran" Journal of Fungi 9, no. 11: 1101. https://doi.org/10.3390/jof9111101