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Identification of fungal causative agents of rhinosinusitis from Mashhad, Iran

Mohammad J Najafzadeh1,2, Karim Jalaeian Samani3, Jos Houbraken4

  • 1Department of Parasitology and Mycology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Current Medical Mycology
|May 1, 2018
PubMed
Abstract

Insights

Fungal rhinosinusitis diagnosis is challenging. This study identified Aspergillus flavus as the most common cause in Iran, differing from global trends, using advanced sequencing techniques for accurate identification.

Area of Science:

  • Medical Mycology
  • Otorhinolaryngology
  • Infectious Diseases

Background:

  • Fungal rhinosinusitis affects approximately 20% of the population.
  • Accurate identification of fungal agents is crucial for effective treatment and prognosis.
  • Traditional mycological identification methods are often difficult and time-consuming.

Purpose of the Study:

  • To investigate and identify fungal species causing rhinosinusitis in Iranian patients.
  • To validate internal transcribed spacer (ITS) and calmodulin (CaM) sequencing for species-level identification of Mucorales and Aspergillus.
  • To compare the prevalence of fungal species in different forms of fungal rhinosinusitis.

Main Methods:

  • A cross-sectional prospective study involving 106 patients with suspected fungal rhinosinusitis.
  • Clinical and radiological parameters were used for patient selection.
  • Internal transcribed spacer (ITS) and calmodulin (CaM) sequencing were employed for fungal identification.

Main Results:

  • 63 patients had allergic fungal rhinosinusitis (AFRS), 40 had acute invasive fungal rhinosinusitis (AIFRS), and 3 had mycetoma.
  • Fungal culture yielded positive results in only 7 (AFRS), 29 (AIFRS), and 1 (mycetoma) patients.
  • ITS and CaM sequencing identified Aspergillus flavus as the most common species in non-invasive forms, and Aspergillus flavus and Rhizopus oryzae in invasive forms.

Conclusions:

  • Aspergillus flavus is identified as the predominant fungal agent causing rhinosinusitis in Iran.
  • This finding contrasts with global reports indicating Aspergillus fumigatus as the most frequent causative agent.
  • ITS and CaM sequencing offer reliable methods for accurate fungal identification in rhinosinusitis.
Keywords:
CalmodulinFungal rhinosinusitisITSIdentificationMolecular technique

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