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J Mycol Med. 2014 Jun;24(2):e43-50. doi: 10.1016/j.mycmed.2014.01.004. Epub 2014 Apr 21.

Species distribution and antifungal susceptibility of Candida spp. isolated from superficial candidiasis in outpatients in Iran.

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Department of Medical Mycology, Pasteur Institute of Iran, 13164 Tehran, Iran. Electronic address:
Department of Medical Mycology, Pasteur Institute of Iran, 13164 Tehran, Iran.
Department of Medical Mycology, Faculty of Medical Sciences, Tarbiat Modares University, 14115-331 Tehran, Iran.
Medicinal Chemistry Laboratory, Pasteur Institute of Iran, 13164 Tehran, Iran.
Laboratory of Arboviruses and Viral Hemorrhagic Fevers, Pasteur Institute of Iran, 13164 Tehran, Iran.



Candidiasis is the most prevalent fungal infection affecting human and animals all over the world. This study represents the epidemiological aspects of superficial candidiasis in outpatients and in vitro antifungal susceptibility of etiologic Candida species.


Clinical samples were taken from 173 patients including skin and nail scrapings (107; 61.8%), vaginal discharge (28; 16.2%), sputum (20; 11.6%), oral swabs (7; 4.0%), bronchoalveolar lavage (6; 3.5%) and 1 specimen (0.6%) of each eye tumor, gastric juice, urine, biopsy and urinary catheter and confirmed as candidiasis by direct microscopy, culture and histopathology. Susceptibility patterns of the isolated Candida species were determined using the disk diffusion and broth microdilution methods.


Among 173 Candida isolates, C. albicans (72.3%) was the most prevalent species followed by C. parapsilosis (11.5%). Other identified species were C. glabrata, C. krusei, C. tropicalis, C. guilliermondii, C. intermedia and C. sake. Majority of the Candida isolates were susceptible to fluconazole (95.4%) followed by 5-flucytosine (89.6%), voriconazole (78.6%) itraconazole (48.0%) and ketoconazole (42.8%). Caspofungin was the most potent antifungal drug against C. albicans (MICs; 0.062-1 μg/mL), ketoconazole for C. parapsilosis and C. tropicalis (MICs; 0.031-0.25 μg/mL) and itraconazole for C. krusei, C. glabrata and C. guilliermondii (MICs; 0.031-1 μg/mL).


This study reinforces the significance of superficial candidiasis as an important fungal infection with multiple clinical presentations. Our results further indicate that susceptibility testing to commonly used antifungals is crucial in order to select the appropriate therapeutic strategies which minimize complications while improving patients' life.


Antifongiques; Antifungal drugs; Broth microdilution; CHROMagar Candida; Candida species; Candidiasis; Candidose; Diffusion des disques; Disk diffusion; Espèces de Candida; Microdilution

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