Aspergillus flavus is one of the most important agents of invasive and non-invasive aspergillosis, especially in tropical and subtropical regions of the world, including Iran. Aspergillus oryzae is closely related to A. flavus, and it is known for its economic importance in traditional fermentation industries. Reports of infection due to A. oryzae are scarce. Several studies reported that differentiating these two species in clinical laboratories is not possible using MALDI-TOF or by targeting fungal barcode genes, such as Internal Transcribed Spacer (ITS) and β-tubulin (benA). The species-level identification of causative agents and the determination of antifungal susceptibility patterns can play significant roles in the outcome of aspergillosis. Here, we aimed to investigate the discriminatory potential of cyp51A PCR-sequencing versus that of the ITS, benA and calmodulin (CaM) genes for the differentiation of A. flavus from A. oryzae. In a prospective study investigating the molecular epidemiology of A. flavus in Iran between 2008 and 2018, out of 200 clinical isolates of A. flavus, 10 isolates showed >99% similarity to both A. flavus and A. oryzae. Overall, the ITS, β-tubulin and CaM genes did not fulfil the criteria for differentiating these 10 isolates. However, the cyp51A gene showed promising results, which warrants further studies using a larger set of isolates from more diverse epidemiological regions of the world.

Cryptococcus neoformans is an encapsulated yeast that can cause cryptococcosis, a life-threatening infection that mainly occurs in immunocompromised patients. The major environmental sources of C. neoformans have been shown to be soil contaminated with avian droppings. In the present study, we evaluated the isolation of C. neoformans from swallow (Hirundo rustica) excreta in two northern cities of Iran. Ninety-seven swallow droppings were evaluated and 498 yeast-like colonies were isolated and identified as Rhodotorula spp. (62.8%), Candida spp. (28.5%)and C. neoformans (8.7%). Cryptococcus neoformans was isolated from 5/97 (5.2%) of collected samples. Min-Max colony forming units (CFU) per one gram for the positive samples were 3-10 C. neoformans colonies. The total mean CFU per one gram for the positive samples was 4.8. The results of this study demonstrate that excreta of swallow may harbor different species of potentially pathogenic yeasts, mainly C. neoformans, and may be capable of disseminating these fungi in the environment.

Aspergillus endocarditis (AE) accounts for a-quarter of all fungal endocarditis, mainly in immunocompromised hosts prior to heart-valve surgery with high mortality, even with treatment. Herein, we report a rare case of AE in a diabetic 60-year-old woman with a history of redo mitral valve prosthesis suspecious of acute endocarditis. She underwent second redo surgical mitral valve replacement in combination with mechanical aortic valve replacement. Blood cultures were negative. The explanted valve and vegetation were subjected to identification. Grown colonies were identified as Aspergillus flavus, based on conventional and molecular methods. Despite the administration of liposomal amphotericin B and improvement in her general condition shortly after initiation of therapy, the patient passed away. As AE is a late consequence of redo prosthetic valve replacement, extended follow-up, early diagnosis, repeating valve-replacement surgeries, and timely selective antifungal treatments are warranted.

Volumetric Assessment of Airborne Indoor and Outdoor Fungi at Poultry and Cattle Houses in the Mazandaran Province, Iran: The aim of this study was to assess the volume of airborne fungi in the indoor and outdoor environment of poultry and cattle houses in the Mazandaran Province in Iran. Indoor and outdoor air of twenty cattle houses and twenty-five poultry houses were sampled using a single-stage impactor, which draws air at 20 L min^-1and impacts sampled material onto Petri plates containing malt extract agar. The plates were incubated at 30 °C for seven days, after which the resulting colonies were counted. The fungi were identified and counted microscopically and macroscopically. A total of 4,662 fungal colonies were isolated from 90 plates collected from indoor and outdoor air of cattle and poultry houses.Cladosporium(55.3 %), yeast (10.0 %), andAspergillus(9.4 %) were the most common findings. The concentration of airborne fungi in cattle and poultry houses ranged from 10 CFU m^-3to 1700 CFU m^-3in indoor and 10 CFU m^-3to 2170 CFU m^-3in outdoor environments.Cladosporiumhad the highest mean indoor (424.5 CFU m^-3) and outdoor (449.7 CFU m^-3) air concentration in the cattle houses. In the poultry houses, the highest mean concentrations were measured forCladosporium(551.0 CFU m^-3) outdoors and yeast (440.7 CFU m^-3) indoors. These levels might present an occupational risk, but threshold levels for these environments have yet to be established worldwide.

Diagnosing chronic pulmonary aspergillosis (CPA) is challenging due to nonspecific symptoms, variable radiological findings, and limited mycological evidences. While galactomannan (GM) testing has been validated in serum and bronchoalveolar lavage fluid (BAL) for invasive pulmonary aspergillosis (IPA), its usefulness in sputum samples for CPA remains unclear. This study aimed to determine an appropriate GM cut-off level in sputum samples and its performance in diagnosis of CPA. The diagnostic performance of sputum GM was evaluated in patients with COPD suspected of having CPA referred to the two reference centers for pulmonary diseases in Iran, and compared against established diagnostic criteria, including Aspergillus culture and IgG antibody tests. The sensitivity, specificity and positive and negative predictive value for sputum GM test were calculated. The optimal cut-off for sputum GM was determined by receiver operating characteristic (ROC). Of 196 COPD patients, 189 were analyzed for sputum GM. Sputum GM demonstrated an area under the receiver operating characteristic curve (AUC) of 0.83 (with 95 % confidence intervals (CI) of 0.748 - 0.913 and a p-value < 0.001). The optimal cut-off value for the sputum GM index was 1.44. The sensitivity and specificity were found to be 83.3 % and 74.2 % respectively. The median (IQR) levels of sputum GM index were significantly higher in CPA patients compared to non-CPA patients. (Pv <0.001). Overall, our findings suggest that sputum GM is a valuable tool in the diagnosis of CPA; however, further prospective validation is warranted to increase its clinical utility.