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Background: Candidiasis is a widespread fungal disease caused by different candida spp. Traditional methods for these yeasts, are time-consuming and in some cases are not successful. New molecular techniques based on differences in DNA targets are faster and more useful. The aim of this study was identification of the most medically common Candida species by PCR-RFLP analysis and their prevalence in Isfahan, central Iran. Methods: Yeast genomic DNA was extracted from living cultures using FTA-filters and ITS1-ITS2 region was amplified by PCR and was digested by the restriction enzyme MspI. RFLP products were loaded on agarose gel and yeast species were identified acorging to differences in their band patterns. Findings: One hundered and eighty two isolates were evaluated from different body locations comprising nail, vagina, groin, blood, wound etc, from which 86 isolates (47.2%) were identified as C. albicans, 31 (17%) as C. parapsilosis, 19 (10.4%) as C. kefyr, 15 (8.2%) as C. tropicalis, 14 (7.7%) as C. glabrata, 14 isolates (7.7%) as C. krusei, 3 isolates (1.6%) as C. guilliermondii. Totally 47.2% isolates were C. albicans and 52.8% isolates were non-albicans spp. Conclusion: Increasing of non-albicans species and their more resistance to antifungal drugs than C. albicans is an important topic of fungal infections that needed precise epidemiological surveys. This study can be a leader for more applicable studies. [ABSTRACT FROM AUTHOR]

Background: The survival rate of patients with severe burn is positively associated with increasing the incidence of the Clostridioides difficile (C. difficile) infection (CDI). The surviving rate of severe burn patients now has an improved but the incidence of Clostridioides difficile (C. difficile) infection (CDI) has been continues increasing during recent two decades. This study assessed the molecular typing and phenotypic characterization isolates of C. difficile in burn patients with diarrhea, as well as environmental and skin infections with C. difficile spores at a referral burn hospital in Isfahan, Iran. It mainly aimed to evaluate the dominant bacterial structure in the gut microbiome of burned subjects with and without CDI.Methods: In general, 309 samples were collected from 189 burned patients with hospital-acquired diarrhea and 120 swabs were collected from the healthcare workers' dominant hands, different sites of patients' skin, and medical tools. In addition, C. difficile isolates were characterized considering the existence of antibiotic resistance and toxin genes. Clinical cultures with identification of organisms and antibiotic susceptibility were done. C. difficle isolates were then genotyped and compared to clinical outcomes. Finally, the clinical characteristics of the participants were gathered through their records, and the bacterial targets of the gut microbiome were detected using quantitative real-time polymerase chain reaction (PCR).Results: Based on the findings, 51 C. difficile isolates were detected from 189 severe burn patients hospitalized in the hospital. Further, PCR amplification tcdB and tcdA showed 23 isolates (12.2%) as toxigenic. Overall, 18.3% (22/120) of skin and environment samples demonstrated a positive result for C. difficile colonization. A low concentration of metronidazole and vancomycin (MIC90, 0.5, and 1.2 mg/L) inhibited all toxigenic C. difficile strains. Moreover, these isolates represented the highest rates of resistance to moxifloxacin and clindamycin (MIC90, 0.5, and 1.6 mg/L). A significantly reduced abundance of Clostridium spp., Bacteroidetes, and Bifidobacterium and an increase in the quantity of Firmicutes was observed in the gastrointestinal microbiome of burn patients (P < 0.01). Burn patients with CDI showed a significant decrease in Faecalibacterium prausnitzii (F. prausnitzii) while higher Akkermansia muciniphila (A. muciniphila) loads in comparison with healthy controls (P < 0.001 and P < 0.05). Contrarily, burned cases displayed increased levels of opportunistic pathogenic bacteria including the members of Enterococcus spp. and Escherichia coli (P < 0.05).Conclusions: Despite appropriate infection control strategies in the burn intensive care unit, CDI remains prevalent in severe burn patients. Eventually, the overgrowth of A. muciniphila and the decreased abundance of F. prausnitzii in burn cases with CDI could be potential predictive microbiome biomarkers in burned patients. [ABSTRACT FROM AUTHOR]