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Background   Aspergillus flavus  is intensively studied for its role in infecting crop plants and contaminating produce with aflatoxin, but its role as a human pathogen is less well understood. In parts of the Middle East and India,  A. flavus  surpasses  A. fumigatus  as a cause of invasive aspergillosis and is a significant cause of cutaneous, sinus, nasal and nail infections.    Methods  A collection of 45 clinical and 10 environmental  A. flavus  isolates from Iran were analysed using Variable-Number Tandem-Repeat (VNTR) markers with MICROSAT and goeBURST to determine their genetic diversity and their relatedness to clinical and environmental  A. flavus  isolates from Australia. Phylogeny was assessed using partial β-tubulin and calmodulin gene sequencing, and mating type was determined by PCR. Antifungal susceptibility testing was performed on selected isolates using a reference microbroth dilution method.    Results  There was considerable diversity in the  A. flavus  collection, with no segregation on goeBURST networks according to source or geographic location. Three Iranian isolates, two from sinus infections and one from a paranasal infection grouped with  Aspergillus minisclerotigenes , and all produced B and G aflatoxin. Phylogenic analysis using partial β-tubulin and calmodulin sequencing confirmed two of these as  A. minisclerotigenes,  while the third could not be differentiated from  A. flavus  and related species within  Aspergillus  section  flavi . Based on epidemiological cut-off values, the  A. minisclerotigens  and  A. flavus  isolates tested were susceptible to commonly used antifungal drugs.    Conclusions  This is the first report of human infection due to  A. minisclerotigenes,  and it raises the possiblity that other species within  Aspergillus  section  flavi  may also cause clinical disease .  Clinical isolates of  A. flavus  from Iran are not distinct from Australian isolates, indicating local environmental, climatic or host features, rather than fungal features, govern the high incidence of  A. flavus  infection in this region. The results of this study have important implications for biological control strategies that aim to reduce aflatoxin by the introduction of non-toxigenic strains, as potentially any strain of  A. flavus,  and closely related species like  A. minisclerotigenes , might be capable of human infection.

bmc infectious diseases

Multilocus variable-number tandem-repeat analysis of clinical isolates of Aspergillus flavus from Iran reveals the first cases of Aspergillus minisclerotigenesassociated with human infection