Molecular Identification of Candida Species Isolated from Onychomycosis with In Vitro Antifungal Susceptibility Profi

Background: Onychomycosis is one of the most common fungal infections. The most common etiological agents of onychomycosis in Iran are Candidaspecies, especially fingernails. It is more common in women than men, particularly workers in occupations requiring them to submerge their hands or feet in water for prolonged periods. Objectives: The current study s main aim was to determine the abundance of candidal onychomycosis, identify the Candidaspecies using molecular methods, and evaluate the in vitroantifungal susceptibility profiles. Methods: One hundred forty samples were obtained from patients suspected of onychomycosis, and 51 (36.4%) Candidastrains were identified by PCR-RFLP. The in vitrosusceptibility of four triazole (fluconazole, itraconazole, voriconazole and posaconazole) antifungal drug testing of 51 Candidaspecies was performed using broth microdilution. Results: Direct microscopic examination by KOH 20% of 140 nail samples showed that 51 (36.4%) samples were positive in terms of fungal elements, with Candida parapsilosiscomplex being the most frequently isolated of patients, followed by C. albicanscomplex, C. glabrata, C. krusei, C. tropicalis, C. guilliermondii, C. famata, C. kefyr, and Candidaspecies. All Candidaspecies showed they were susceptible to four triazoles, except that five C. kruseiwere resistant to fluconazole. Only one C. glabrataisolates and one C. parapsilosisisolate were resistant to fluconazole. Conclusions: The growing trend towards the frequency of fingernail onychomycosis in housewives has been noticeable in the last decades in Iran. Therefore, accurate identification of Candidaspecies and perform in vitroantifungal susceptibility testing can aid physicians in choosing an effective potential drug for treating onychomycosis patients.