Phylogenetic Analysis of <i>Scopulariopsis Brevicaulis</i> Isolated From Diabetic Patients in Kirkuk City, Iraq

Background and Aim: Scopulariopsis brevicaulis (S. brevicaulis) is an opportunistic pathogen causing both localized and systemic infections.Recent studies indicated DNA sequence variation among S. brevicaulis isolates from different clinical sources.In this study we aimed to isolate and diagnose S. brevicaulis from nail and skin samples of diabetic patients and investigate their phylogenetic diversity based on the internal transcribed spacer 1 (ITS) sequencing.Materials and Methods: Fifty nail and skin samples were collected from diabetic patients suffering from skin lesions.Conventional diagnostic methods were utilized to identify the bacterial and fungal isolates.Fungal DNA was extracted and ITS 1 region was amplified by PCR and sequenced using Sanger method.Multiple sequence alignment and phylogenetic analysis were conducted using Clustal W and MEGA software.Finally, antifungal susceptibility test was performed by disc diffusion method.Results: Based on the culture, microscopic evaluation, and biochemical tests, various types of bacteria and fungi were isolated.Among 50 nail and skin samples, 25 fungal isolates (50%) and 5 bacterial isolates (10%) were recovered.Interestingly, one of the fungal isolates was identified as Scopulariopsis brevicaulis.This isolate was associated with a clinical case involving a 52-year-old male.Phylogenetic analysis of the ITS region showed our isolate (Scopulariopsis brevicaulis) closely matched and clustered in the same clade as those reported in the US, differing from those reported in Iraq (Basrah), Iran, and Turkey.Furthermore, our isolate exhibited a multi-drug resistance pattern against antifungal agents. Conclusion:This study highlights the importance of identifying S. brevicaulis in diabetic patients due to its multi-drug resistance.DNA sequencing and phylogenetic analysis revealed genetic divergence from the strains within the same country and other different countries.