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Genotypic and Phenotypic Investigation of Clinical Aspergillus isolates from Iran Indicates Nosocomial Transmission Events of Aspergillus flavus

Summary

Researchers studied fungal infections caused by Aspergillus species in Iranian hospitals from 2020 to 2023. They found that Aspergillus flavus was the most common cause of infection and discovered evidence of several hospital-related outbreaks through genetic analysis. All isolates tested were susceptible to current antifungal medications, but the discovery of hospital transmission suggests the need for better infection control measures like improved air filtration in hospitals.

Background

Aspergillosis is one of the most common human fungal infections with increasing prevalence and high mortality rates in invasive cases. Antifungal resistance is emerging as a significant clinical challenge. Limited epidemiological and genetic data regarding aspergillosis are available from Iran, particularly during the COVID-19 pandemic.

Objective

To identify Aspergillus species from clinical isolates in Iran, determine antifungal susceptibility profiles, and use short tandem repeat genotyping to assess genetic relatedness and detect potential nosocomial transmission events.

Results

Among 127 isolates, A. flavus was most common (73%), followed by A. fumigatus (13%), A. terreus (5%), and A. niger (5%). All isolates showed susceptibility to tested antifungals using epidemiological cutoff values. STR genotyping revealed four A. flavus clusters with spatial and temporal clustering patterns suggesting nosocomial transmission, while A. fumigatus and A. terreus isolates displayed unique genotypes.

Conclusion

A. flavus was the dominant species in aspergillosis cases from Iran with susceptible phenotypes. STR genotyping identified multiple A. flavus clusters indicating nosocomial transmission events, highlighting the need for enhanced air filtration and infection prevention measures in hospitals.
  • Published in:Mycopathologia,
  • Study Type:Prospective Observational Study,
  • Source: PMID: 40885863, DOI: 10.1007/s11046-025-00988-w
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