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Species Diversity, Molecular Characterization, and Antimicrobial Susceptibility of Opportunistic Actinomycetes Isolated from Immunocompromised and Healthy Patients of Markazi Province of Iran

Authors Azadi D, Motallebirad T, Ghaffari K, Shokri D, Rezaei F

Received 11 October 2019

Accepted for publication 13 December 2019

Published 7 January 2020 Volume 2020:13 Pages 1—10


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Joachim Wink

Davood Azadi,1,2 Tahereh Motallebirad,1 Kazem Ghaffari,1 Dariuosh Shokri,3 Fatemeh Rezaei1

1Department of Laboratory Sciences, Khomein University of Medical Sciences, Khomein, Iran; 2Molecular Medicine Research Center, Faculty of Medicine, Arak University of Medical Sciences, Arak, Iran; 3Department of Biology and Microbiology, Shahid Ashrafi Isfahani University, Isfahan, Iran

Correspondence: Davood Azadi
Khomein University of Medical Sciences, Gods Street, Khomein, Iran
Tel +98-8646224143

Background: Actinomycetes widely exist in nature and these species cause infections in immunocompromised and healthy patients, although they are frequently found as members of the normal microbiota of humans and animals. These subsequent infections are often misdiagnosed as malignancy and tuberculosis. Due to this issue, the present study aimed to determine the presence and diversity of actinomycetes species causing infections in Iranian patients.
Materials and Methods: A total of 79 clinical samples collected from five hospitals in Markazi province were analyzed for the existence of actinomycetes using standard protocols for isolation and characterization of the isolates. The conventional tests were used for preliminary identification, the PCR amplification of hsp65 gene, the specific region of the 16S rRNA, and sequence analyses of 16S rRNA were applied for the genus and species identification. MICs of the antimicrobial agent were determined by the broth microdilution method and interpreted according to the NCCLS guidelines.
Results: A total of 17 (21.51%) actinomycetes isolates were recovered from clinical samples. In other analyzed samples, eight (10.12%) gram-positive, 12 (15.18) gram-negative bacteria, and six (7.6) fungi isolates were recovered. The most prevalent actinomycetes species were M. fortuitum (17.64%), N. Mexicana and S. heliomycini (11.76% each), and 10 species, ie, N. farcinica, M. lehmannii, M. flavescens, Arthrobacter crystalopoetis, N. neocaledoniensis, M. phocaicum, M. abscessus, M. arupense, M. setense, and N. cyriacigeorgica made up the single isolates. Results of DST illustrated that all of the isolates were susceptible to Amikacin, Levofloxacin, Ofloxacin, and Ciprofloxacin, whereas all of them were resistant to Rifampicin and Doxycycline.
Conclusion: In conclusion, increasing isolation of actinomycetes found in various clinical cases merits special attention by health authorities in developing countries. In health centers, action should be taken to increase awareness of appropriate diagnostic criteria and management guidelines for actinomycetes diseases. Furthermore, an increase in the number as well as the quality of national and regional reference laboratories may facilitate more accurate diagnosis of actinomycetes diseases.

Keywords: actinomycetes, 16SrRNA, drug susceptibility pattern, immunocompromised

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