Antifungal susceptibility to azoles drugs in Candida species isolated from patients with onychomycosis

Background and Aim: Onychomycosis is an infection caused by yeast, filamentous and non-filamentous fungi, due to diverse conditions. This study aimed to investigate the pattern of azole susceptibility of candidate species isolated from Iranian patients in Tehran. Methods: After sampling from patients, identification of the isolated strains were performed with Candida chrom agar medium and PCR-sequencing test. Drug Susceptibility pattern of the species to fluconazole, itraconazole and ketoconazole were determined by CLSI-M27-A3/S4 standard method. Results: In this study, 34 candidate isolates were identified, of which 26 isolates (76.5%) were Candida albicans and 8 isolates (23.5%) were Candida glabrata. In fluconazole, 4 (11%) of the isolates were dose-dependent sensitive and the others were sensitive. In itraconazole, 21 (61%) dose-dependent isolates and 2 (5%) resistant isolates were identified, and in ketoconazole, all isolates were sensitive. The geometric mean (GM) of the minimum inhibitory concentration for fluconazole, itraconazole and ketoconazole was 0.32, 0.21 and 0.15 μg/mL, respectively. In this study, the most frequently isolated species was C. albicans. According to the GM values, the most effective azoles was ketoconazole. Conclusion: The prevalence and pattern of susceptibility of Candida species to azole may vary in different populations of patients. Therefore, it is recommended that the clinicians pay attention to the results of drug susceptibility tests and then treat patients by considering drug interactions and side effects.